Lipoprotein levels and statin treatment related to dementia and cognitive decline in individuals with type 2 diabetes : an observational analysis from the ADVANCE study
af Geijerstam, Peder ; Chalmers, John ; Pikkemaat, Miriam LU
; Peters, Ruth
; Marre, Michel
; Mancia, Giuseppe
LU
; Woodward, Mark
and Harris, Katie
(2025)
In Cardiovascular Diabetology
24(1).
- Abstract
Introduction: Studies on the association between lipid levels and lipid-lowering treatment and the risk of dementia and/or cognitive decline (CD) have shown conflicting results and are few in individuals with type 2 diabetes (T2D). The aim was to evaluate the relationship of baseline LDL cholesterol levels and statin treatment with the development of dementia/CD in patients with T2D from the Action in Diabetes and Vascular Disease: Preterax and Diamicron Modified Release Controlled Evaluation trial. Methods: Dementia was diagnosed using the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV), and CD was defined as at least a 3-point decrement in the Mini Mental State Examination score. Exposures were baseline LDL... (More)
Introduction: Studies on the association between lipid levels and lipid-lowering treatment and the risk of dementia and/or cognitive decline (CD) have shown conflicting results and are few in individuals with type 2 diabetes (T2D). The aim was to evaluate the relationship of baseline LDL cholesterol levels and statin treatment with the development of dementia/CD in patients with T2D from the Action in Diabetes and Vascular Disease: Preterax and Diamicron Modified Release Controlled Evaluation trial. Methods: Dementia was diagnosed using the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV), and CD was defined as at least a 3-point decrement in the Mini Mental State Examination score. Exposures were baseline LDL cholesterol levels, statin treatment at baseline, and statin treatment initiation during the first 18 months of follow-up. Multinomial logistic regression was used to estimate the odds ratio (OR) and 95% CI for the composite of dementia/CD. Results: Of 11,140 participants, 1827 (16.4%) developed dementia/CD over the 5-year follow up. The OR (95% CI) of dementia/CD were 1.06 (1.00–1.14) per standard deviation higher in baseline LDL cholesterol and 0.90 (0.79–1.03) for participants with vs without statin treatment. Conclusion: We observed an association between LDL levels, but not statin treatment, and incident dementia/CD. Although causality cannot be determined by our study, the results are in line with multiple randomised controlled trials. However, to understand the long-term effects of lipid levels and statin treatment on dementia/CD, studies of longer follow-up are still needed.
(Less)
- author
- af Geijerstam, Peder
; Chalmers, John
; Pikkemaat, Miriam
LU
; Peters, Ruth
; Marre, Michel
; Mancia, Giuseppe
LU
; Woodward, Mark
and Harris, Katie
- organization
- publishing date
- 2025-12
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Cholesterol, Cognitive decline, Dementia, Diabetes, Diabetes complications, Lipids, Lipoproteins, Type 2 diabetes
- in
- Cardiovascular Diabetology
- volume
- 24
- issue
- 1
- article number
- 340
- publisher
- BioMed Central (BMC)
- external identifiers
-
- pmid:40826451
- scopus:105013490295
- ISSN
- 1475-2840
- DOI
- 10.1186/s12933-025-02894-3
- language
- English
- LU publication?
- yes
- id
- be8e5e8b-fced-48a7-8ea6-4cf089f30d71
- date added to LUP
- 2025-10-03 13:05:09
- date last changed
- 2025-10-04 03:00:02
@article{be8e5e8b-fced-48a7-8ea6-4cf089f30d71,
abstract = {{<p>Introduction: Studies on the association between lipid levels and lipid-lowering treatment and the risk of dementia and/or cognitive decline (CD) have shown conflicting results and are few in individuals with type 2 diabetes (T2D). The aim was to evaluate the relationship of baseline LDL cholesterol levels and statin treatment with the development of dementia/CD in patients with T2D from the Action in Diabetes and Vascular Disease: Preterax and Diamicron Modified Release Controlled Evaluation trial. Methods: Dementia was diagnosed using the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV), and CD was defined as at least a 3-point decrement in the Mini Mental State Examination score. Exposures were baseline LDL cholesterol levels, statin treatment at baseline, and statin treatment initiation during the first 18 months of follow-up. Multinomial logistic regression was used to estimate the odds ratio (OR) and 95% CI for the composite of dementia/CD. Results: Of 11,140 participants, 1827 (16.4%) developed dementia/CD over the 5-year follow up. The OR (95% CI) of dementia/CD were 1.06 (1.00–1.14) per standard deviation higher in baseline LDL cholesterol and 0.90 (0.79–1.03) for participants with vs without statin treatment. Conclusion: We observed an association between LDL levels, but not statin treatment, and incident dementia/CD. Although causality cannot be determined by our study, the results are in line with multiple randomised controlled trials. However, to understand the long-term effects of lipid levels and statin treatment on dementia/CD, studies of longer follow-up are still needed.</p>}},
author = {{af Geijerstam, Peder and Chalmers, John and Pikkemaat, Miriam and Peters, Ruth and Marre, Michel and Mancia, Giuseppe and Woodward, Mark and Harris, Katie}},
issn = {{1475-2840}},
keywords = {{Cholesterol; Cognitive decline; Dementia; Diabetes; Diabetes complications; Lipids; Lipoproteins; Type 2 diabetes}},
language = {{eng}},
number = {{1}},
publisher = {{BioMed Central (BMC)}},
series = {{Cardiovascular Diabetology}},
title = {{Lipoprotein levels and statin treatment related to dementia and cognitive decline in individuals with type 2 diabetes : an observational analysis from the ADVANCE study}},
url = {{http://dx.doi.org/10.1186/s12933-025-02894-3}},
doi = {{10.1186/s12933-025-02894-3}},
volume = {{24}},
year = {{2025}},
}