J Clin Med Res

Journal of Clinical Medicine Research, ISSN 1918-3003 print, 1918-3011 online, Open Access

Article copyright, the authors; Journal compilation copyright, J Clin Med Res and Elmer Press Inc

Journal website http://www.jocmr.org

Original Article

Volume 9, Number 7, July 2017, pages 638-649

Association of Cognitive Impairment in Patients on 3-Hydroxy-3-Methyl-Glutaryl-CoA Reductase Inhibitors

**Table 1.** Baseline Characteristics
Variable	All (n = 3,500)	Group 1: statin treatment group (n = 720)	Group 2: non-statin treatment group (n = 2,780)	P value (1 vs. 2)
*Wilcoxon two-sample test. ^†Fisher’s exact test.
Age (years), mean (SD)	46.9 (17.6)	65.8 (14.3)	46.9 (16.5)	< 0.001*
Gender
Male (n, %)	1,590 (45.4)	405 (56.2)	1,185 (42.6)	< 0.001^†
Female (n, %)	1,910 (54.6)	315 (43.8)	1,595 (57.4)	< 0.001^†
Race				< 0.001^†
Caucasian (n, %)	2,179 (62.3)	511 (71.0)	1,668 (60.0)
African American (n, %)	473 (13.5)	74 (10.3)	399 (14.4)
Hispanic (n, %)	326 (9.3)	50 (6.9)	276 (9.9)
Other (n, %)	522 (14.9)	85 (11.8)	437 (15.7)
Social factors
Alcohol (n, %)	1,654 (47.3)	318 (44.2)	1,336 (48.1)	0.066^†
Cigarettes (n, %)	1,308 (37.4)	363 (50.5)	945 (34.0)	< 0.001^†
Drugs (n, %)	149 (4.3)	24 (3.3)	125 (4.5)	0.169^†

Table 1. Baseline Characteristics

Variable

All (n = 3,500)

Group 1: statin treatment group (n = 720)

Group 2: non-statin treatment group (n = 2,780)

P value (1 vs. 2)

*Wilcoxon two-sample test. ^†Fisher’s exact test.

Age (years), mean (SD)

46.9 (17.6)

65.8 (14.3)

46.9 (16.5)

< 0.001*

Gender

Male (n, %)

1,590 (45.4)

405 (56.2)

1,185 (42.6)

< 0.001^†

Female (n, %)

1,910 (54.6)

315 (43.8)

1,595 (57.4)

< 0.001^†

Race

< 0.001^†

Caucasian (n, %)

2,179 (62.3)

511 (71.0)

1,668 (60.0)

African American (n, %)

473 (13.5)

74 (10.3)

399 (14.4)

Hispanic (n, %)

326 (9.3)

50 (6.9)

276 (9.9)

Other (n, %)

522 (14.9)

85 (11.8)

437 (15.7)

Social factors

Alcohol (n, %)

1,654 (47.3)

318 (44.2)

1,336 (48.1)

0.066^†

Cigarettes (n, %)

1,308 (37.4)

363 (50.5)

945 (34.0)

< 0.001^†

Drugs (n, %)

149 (4.3)

24 (3.3)

125 (4.5)

0.169^†

**Table 2.** Associated Comorbid Conditions
Variable	Group 1: statin treatment group (n = 720)	Group 2: non-statin treatment group (n = 2,780)	P* value (1 vs. 2)
*Fisher’s exact test.
Hyperlipidemia (n, %)	621 (86.3)	677 (24.4)	< 0.001
Hypertension (n, %)	501 (69.6)	683 (24.6)	< 0.001
Diabetes mellitus (n, %)	259 (36.0)	237 (8.5)	< 0.001
Osteoarthritis (n, %)	227 (31.5)	396 (14.2)	< 0.001
Coronary artery disease (n, %)	188 (26.1)	56 (2.0)	< 0.001
Hypothyroidism (n, %)	155 (21.5)	266 (9.6)	< 0.001
Depression (n, %)	139 (19.3)	421 (15.1)	< 0.001
Anxiety disorder (n, %)	118 (16.4)	426 (15.3)	0.482
Other rheumatological disease (n, %)	115 (16.0)	240 (8.6)	< 0.001
Cancer (n, %)	104 (14.4)	183 (6.6)	< 0.001
Asthma (n, %)	96 (13.3)	343 (12.3)	0.474
Other endocrine disorder (n, %)	88 (12.2)	173 (6.2)	< 0.001
Cerebrovascular accident (n, %)	73 (10.1)	34 (1.2)	< 0.001
Chronic kidney disease (n, %)	67 (9.3)	75 (2.7)	< 0.001
Liver disease (n, %)	66 (9.2)	137 (4.9)	< 0.001
Congestive heart failure (n, %)	61 (8.5)	36 (1.3)	< 0.001
Dementia-cognitive impairment (n, %)	57 (7.9)	86 (3.1)	< 0.001
Chronic obstructive airway disease (n, %)	55 (7.6)	48 (1.7)	< 0.001
Carotid stenosis (n, %)	30 (4.2)	6 (0.2)	< 0.001
Family history of dementia (n, %)	19 (2.6)	40 (1.4)	0.026
Bipolar disorder (n, %)	18 (2.5)	72 (2.6)	0.892
Immunodeficiency disease (n, %)	2 (0.3)	3 (0.1)	0.274
Post-transplant immunosuppression (n, %)	2 (0.3)	57 (2.1)	0.001
Schizophrenia (n, %)	1 (0.1)	11 (0.4)	0.479
Human immunodeficiency virus infection (n, %)	1 (0.1)	7 (0.3)	1.000

Table 2. Associated Comorbid Conditions

Variable

Group 1: statin treatment group (n = 720)

Group 2: non-statin treatment group (n = 2,780)

P* value (1 vs. 2)

*Fisher’s exact test.

Hyperlipidemia (n, %)

621 (86.3)

677 (24.4)

< 0.001

Hypertension (n, %)

501 (69.6)

683 (24.6)

< 0.001

Diabetes mellitus (n, %)

259 (36.0)

237 (8.5)

< 0.001

Osteoarthritis (n, %)

227 (31.5)

396 (14.2)

< 0.001

Coronary artery disease (n, %)

188 (26.1)

56 (2.0)

< 0.001

Hypothyroidism (n, %)

155 (21.5)

266 (9.6)

< 0.001

Depression (n, %)

139 (19.3)

421 (15.1)

< 0.001

Anxiety disorder (n, %)

118 (16.4)

426 (15.3)

0.482

Other rheumatological disease (n, %)

115 (16.0)

240 (8.6)

< 0.001

Cancer (n, %)

104 (14.4)

183 (6.6)

< 0.001

Asthma (n, %)

96 (13.3)

343 (12.3)

0.474

Other endocrine disorder (n, %)

88 (12.2)

173 (6.2)

< 0.001

Cerebrovascular accident (n, %)

73 (10.1)

34 (1.2)

< 0.001

Chronic kidney disease (n, %)

67 (9.3)

75 (2.7)

< 0.001

Liver disease (n, %)

66 (9.2)

137 (4.9)

< 0.001

Congestive heart failure (n, %)

61 (8.5)

36 (1.3)

< 0.001

Dementia-cognitive impairment (n, %)

57 (7.9)

86 (3.1)

< 0.001

Chronic obstructive airway disease (n, %)

55 (7.6)

48 (1.7)

< 0.001

Carotid stenosis (n, %)

30 (4.2)

6 (0.2)

< 0.001

Family history of dementia (n, %)

19 (2.6)

40 (1.4)

0.026

Bipolar disorder (n, %)

18 (2.5)

72 (2.6)

0.892

Immunodeficiency disease (n, %)

2 (0.3)

3 (0.1)

0.274

Post-transplant immunosuppression (n, %)

2 (0.3)

57 (2.1)

0.001

Schizophrenia (n, %)

1 (0.1)

11 (0.4)

0.479

Human immunodeficiency virus infection (n, %)

1 (0.1)

7 (0.3)

1.000

**Table 3.** Associated Comorbid Conditions in the 51 - 80 Years Age Subgroup
Variable	Group 1: statin treatment group (n = 511)	Group 2: non-statin treatment group (n = 1,004)	P* value (1 vs. 2)
*Fisher’s exact test. NS: not significant.
Age (years), mean (SD)	56.6 (8.3)	61.2 (8.1)	NS
Hyperlipidemia (n, %)	460 (90.0)	431 (42.9)	< 0.001
Hypertension (n, %)	363 (71.0)	426 (42.4)	< 0.001
Diabetes mellitus (n, %)	194 (37.9)	141 (14.0)	< 0.001
Osteoarthritis (n, %)	163 (31.9)	252 (25.1)	< 0.001
Coronary artery disease (n, %)	130 (25.4)	38 (3.8)	< 0.001
Hypothyroidism (n, %)	101 (19.8)	147 (14.6)	NS
Depression (n, %)	102 (19.9)	172 (17.2)	NS
Anxiety disorder (n, %)	78 (15.3)	158 (15.7)	NS
Other rheumatological disease (n, %)	77 (15.1)	150 (14.9)	NS
Cancer (n, %)	71 (13.9)	120 (12.0)	NS
Asthma (n, %)	73 (14.3)	127 (12.6)	NS
Other endocrine disorder (n, %)	60 (11.7)	88 (8.8)	NS
Cerebrovascular accident (n, %)	42 (8.2)	20 (2.0)	< 0.001
Chronic kidney disease (n, %)	67 (9.3)	49 (4.9)	< 0.001
Liver disease (n, %)	49 (9.6)	67 (6.7)	NS
Congestive heart failure (n, %)	37 (7.2)	18 (1.8)	< 0.001
Dementia-cognitive impairment (n, %)	35 (6.8)	33 (3.3)	< 0.001
Chronic obstructive airway disease (n, %)	35 (6.8)	34 (3.4)	< 0.001
Carotid stenosis (n, %)	19 (3.7)	5 (0.5)	< 0.001
Family history of dementia (n, %)	15 (2.9)	23 (2.3)	NS
Bipolar disorder (n, %)	12 (2.3)	18 (1.8)	NS
Immunodeficiency disease (n, %)	2 (0.4)	2 (0.2)	NS
Post-transplant immunosuppression (n, %)	2 (0.4)	57 (5.7)	< 0.001
Schizophrenia (n, %)	0 (0.0)	6 (0.6)	NS
Human immunodeficiency virus infection (n, %)	0 (0.0)	2 (0.2)	NS

Table 3. Associated Comorbid Conditions in the 51 - 80 Years Age Subgroup

Variable

Group 1: statin treatment group (n = 511)

Group 2: non-statin treatment group (n = 1,004)

P* value (1 vs. 2)

*Fisher’s exact test. NS: not significant.

Age (years), mean (SD)

56.6 (8.3)

61.2 (8.1)

Hyperlipidemia (n, %)

460 (90.0)

431 (42.9)

< 0.001

Hypertension (n, %)

363 (71.0)

426 (42.4)

< 0.001

Diabetes mellitus (n, %)

194 (37.9)

141 (14.0)

< 0.001

Osteoarthritis (n, %)

163 (31.9)

252 (25.1)

< 0.001

Coronary artery disease (n, %)

130 (25.4)

38 (3.8)

< 0.001

Hypothyroidism (n, %)

101 (19.8)

147 (14.6)

Depression (n, %)

102 (19.9)

172 (17.2)

Anxiety disorder (n, %)

78 (15.3)

158 (15.7)

Other rheumatological disease (n, %)

77 (15.1)

150 (14.9)

Cancer (n, %)

71 (13.9)

120 (12.0)

Asthma (n, %)

73 (14.3)

127 (12.6)

Other endocrine disorder (n, %)

60 (11.7)

88 (8.8)

Cerebrovascular accident (n, %)

42 (8.2)

20 (2.0)

< 0.001

Chronic kidney disease (n, %)

67 (9.3)

49 (4.9)

< 0.001

Liver disease (n, %)

49 (9.6)

67 (6.7)

Congestive heart failure (n, %)

37 (7.2)

18 (1.8)

< 0.001

Dementia-cognitive impairment (n, %)

35 (6.8)

33 (3.3)

< 0.001

Chronic obstructive airway disease (n, %)

35 (6.8)

34 (3.4)

< 0.001

Carotid stenosis (n, %)

19 (3.7)

5 (0.5)

< 0.001

Family history of dementia (n, %)

15 (2.9)

23 (2.3)

Bipolar disorder (n, %)

12 (2.3)

18 (1.8)

Immunodeficiency disease (n, %)

2 (0.4)

2 (0.2)

Post-transplant immunosuppression (n, %)

2 (0.4)

57 (5.7)

< 0.001

Schizophrenia (n, %)

0 (0.0)

6 (0.6)

Human immunodeficiency virus infection (n, %)

0 (0.0)

2 (0.2)

**Table 4.** Comparative Vitals and Lipid Analysis
Variable	Group 1: statin treatment group (n = 720)	Group 2: non-statin treatment group (n = 2,780)	P* value (1 vs. 2)
BMI: body mass index; SBP: systolic blood pressure; DBP: diastolic blood pressure; TC: total cholesterol; TG: triglyceride; HDL-C: high-density lipoprotein cholesterol; LDL-C: low-density lipoprotein cholesterol. *Wilcoxon two-sample test.
Vitals
BMI (kg/m²), mean (SD)	29.7 (6.5)	29.5 (10.9)	0.556
SBP (mm Hg), mean (SD)	127.4 (14.9)	123 (13.7)	< 0.001
DBP (mm Hg, mean (SD)	75.9 (9.6)	76.5 (9.1)	0.141
Lab tests
TC (mg/dL), mean (SD)	176.5 (47.4)	185.1 (35.9)	< 0.001
TG (mg/dL), mean (SD)	136.1 (102.3)	113.4 (70.8)	< 0.001
HDL-C (mg/dL), mean (SD)	51.2 (15.8)	54.5 (17.9)	< 0.001
LDL-C (mg/dL), mean (SD)	98.0 (40.8)	108.2 (30.8)	< 0.001

Table 4. Comparative Vitals and Lipid Analysis

Variable

Group 1: statin treatment group (n = 720)

Group 2: non-statin treatment group (n = 2,780)

P* value (1 vs. 2)

BMI: body mass index; SBP: systolic blood pressure; DBP: diastolic blood pressure; TC: total cholesterol; TG: triglyceride; HDL-C: high-density lipoprotein cholesterol; LDL-C: low-density lipoprotein cholesterol. *Wilcoxon two-sample test.

Vitals

BMI (kg/m²), mean (SD)

29.7 (6.5)

29.5 (10.9)

0.556

SBP (mm Hg), mean (SD)

127.4 (14.9)

123 (13.7)

< 0.001

DBP (mm Hg, mean (SD)

75.9 (9.6)

76.5 (9.1)

0.141

Lab tests

TC (mg/dL), mean (SD)

176.5 (47.4)

185.1 (35.9)

< 0.001

TG (mg/dL), mean (SD)

136.1 (102.3)

113.4 (70.8)

< 0.001

HDL-C (mg/dL), mean (SD)

51.2 (15.8)

54.5 (17.9)

< 0.001

LDL-C (mg/dL), mean (SD)

98.0 (40.8)

108.2 (30.8)

< 0.001

**Table 5.** Statin Therapy and Dementia or Cognitive Impairment
Variable	Dementia or cognitive impairment (n = 143)	No dementia or cognitive impairment (n = 3,357)	P
Statin therapy (n, %)	57 (39.9)	662 (18.9)	< 0.001

Table 5. Statin Therapy and Dementia or Cognitive Impairment

Variable

Dementia or cognitive impairment (n = 143)

No dementia or cognitive impairment (n = 3,357)

Statin therapy (n, %)

57 (39.9)

662 (18.9)

< 0.001