OBJECTIVES: To compare the use of
lipid-lowering drugs in community-dwelling older
adults with and without dementia.
DESIGN:
Comparison of lipid-lowering drug use by
demented cases and nondemented controls based on
secondary analysis of data from a longitudinal
epidemiologic study.
SETTING:
Longitudinal study of a largely rural, low-
socioeconomic-status, community-based cohort of
older persons residing in the mid-Monongahela
Valley of South-west Pennsylvania (the
Monongahela Valley Independent Elders Survey).
PARTICIPANTS: Eight hundred forty-five
individuals of mean +/- standard deviation (SD)
age of 80.5 +/- 4.6, participating in the fifth
biennial wave of data collection.
MEASUREMENTS: Demographics; medical history;
medication regimen (including examination of
prescription bottle labels); self-report of most
recent visit to primary care physician (PCP);
and standardized clinical assessment to
determine presence of dementia, including
Clinical Dementia Rating (CDR).
RESULTS:
One hundred seventy participants (20.1% of total
subject cohort) had dementia, with a CDR of 0.5
or greater. Mean ages of demented and
nondemented individuals were 83.5 +/- 5.1 and
79.8 +/- 4.2, respectively. Similar proportions,
87.7% and 89.5%, of these groups reported PCP
visits in the previous year. Of the total
sample, 9.4% (3.5% of the demented and 10.8% of
the nondemented) were taking lipid-lowering
drugs. After adjustment for age, sex, education,
visit with PCP within the past year, and
potential confounding clinical and lifestyle
variables (self-reported heart disease, stroke
or transient ischemic attacks, hypertension,
smoking, and alcohol consumption), dementia was
associated with a lower likelihood of taking a
lipid-lowering drug (odds ratio = 0.39, 95%
confidence interval = 0.16-0.95). In post hoc
subgroup analyses, similar results were found
when restricting lipid-lowering drugs to statins
alone but were not statistically significant.
Drug use was not associated with severity of
dementia (CDR = 0.5 vs CDR >or= 1).
CONCLUSIONS: Demented individuals were less
likely than their nondemented counterparts to be
taking lipid-lowering drugs. This finding could
reflect different prescribing patterns by
physicians for demented and nondemented patients
or a possible protective effect of these drugs
against dementia.