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Transl Neurodegener. 2018 Feb 27;7:5. doi: 10.1186/s40035-018-0110-3. eCollection 2018.

The role of statins in both cognitive impairment and protection against dementia: a tale of two mechanisms.

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Regis University School of Pharmacy, 3333 Regis Boulevard H-28, Denver, CO 80221 USA.


Nearly 30% of adults 40 years and older in the United States are on a statin. Their widespread use heightens the importance of careful consideration of their varied effects on the body. Although randomized controlled trials have not confirmed cognitive impairing effects with statins, continuing evidence suggests statins have the ability to cause reversible cognitive impairment in some patients. Paradoxically, statins have also been shown to decrease the risk of dementia, Alzheimer's disease, and improve cognitive impairment in some cases. However, randomized controlled trials have similarly failed to find the beneficial effect. Supporting evidence for both claims is compelling whereas known limitations of the clinical trials may explain the lack of findings. This narrative review aims to explain why there is still controversy and how both effects can, and may, be possible. The mechanisms that have been hypothesized for each effect are seemingly independent from one another and may explain the contradicting results. Being mindful of the complex effects of statins, health care providers need to be able to identify patients who are at risk for or already experiencing cognitive impairment from statin use while also identifying those who could potentially decrease their risk of dementia with statins.


Alzheimer’s disease; Cholesterol; Cognition; Dementia; Memory; Neuroprotection; Statin; Vascular dementia

Conflict of interest statement

Not Applicable.All authors consent to publication of all individual data included within the manuscript.The authors declare they have no competing interests.

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