June 2024
How does statin use affect all-cause mortality in nursing home patients with and without dementia?

Statin use was associated with lower mortality risk in nursing home patients with and without dementia.

Statin use in older adults has shown variable outcomes. In this retrospective cohort study, researchers used insurance claims data to analyse the association between statin use and all-cause mortality in German nursing home residents with and without dementia. Statins in the analysis included atorvastatin, fluvastatin, lovastatin, pravastatin, rosuvastatin and simvastatin. Statin users were identified as those with consecutive statin prescriptions for six months or more. The primary outcome was all-cause mortality.

Among 282,693 participants, 96,162 propensity score-matched individuals (69% women; mean age, 83 years) were included in the analysis. There were 54,269 deaths recorded over an average of two years. Statin users with dementia had a 20% decreased risk for all-cause mortality compared with statin nonusers with dementia in adjusted models. Similarly, among individuals without dementia, statin users had a 27% lower risk for all-cause mortality than statin nonusers. All-cause mortality was also lower with statin use versus nonuse in patients with atherosclerotic cardiovascular disease, vascular dementia, Alzheimer’s disease or hyperlipidaemia. Similar findings were seen by sex and among patients in various age groups and levels of care dependency. Low statin intensity was associated with a higher risk for all-cause mortality compared with moderate statin intensity.

Comment: These results support the use of statins for older adults in nursing homes, including those with dementia. How race and lifestyle behaviours such as physical activity and smoking status impact these results requires further study.

Jennifer Rose V. Molano, MD, Associate Professor, Department of Neurology and Rehabilitation Medicine, The University of Cincinnati, Ohio, USA.

O’Sullivan JL, et al. Statin use and all-cause mortality in nursing home residents with and without dementia: a retrospective cohort study using claims data. Neurology 2024; 102: e209189.

This summary is taken from the following Journal Watch title: Neurology.