“Inhibitors on Cognition in Patients With Alzheimer’s Dementia”
“We hypothesized that individuals with preexisting dementia would be more vulnerable to statin-related cognitive effects.”
“68 subjects met inclusion and exclusion criteria and were approached for participation. Twenty-four subjects consented to participate in the study, and 18 completed”
This is a tiny short-term study
Not even worth the time it took to read it. This is so statistically insignificant it boggles the mind that they even got it published.
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That’s basically true, but just too much smoke around this issue for there not to be some fire.
Too many alternatives.
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Some Metamucil with citrus bergamot.
Excellent lipid control and you’ll remember where you put the car key.
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AnUser
#1389
Unblinded, no control group, non-randomized…
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rivasp12
#1390
Doesn’t matter.
Why risk cognitive impairment, which is obviously showing up as a risk, even in imperfect studies, when there are many other options available?
Fighting over the quality of studies isn’t worth dementia risk. There’s some fire when there’s this much smoke.
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AnUser
#1391
I don’t even know what the risk is or how large the effect is. It might just be hysteria about a population which has a higher likelihood of having cognitive decline. Also which can be better or worse during certain periods, and going of statins is just ‘timing’ this natural deviations in cognition for elders. There is also nocebo effects.
If you do a blinded trial where one group keeps taking their statin and the other a placebo and compare cognition, then I will be very convinced about any possible effect. Where the patienst also are randomized into each group. And an effect size is reported.
“Oh they have a warning about cognition”
“Now I am off this statin and testing my memory”
“Oh I performed better!” 
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How unscientific is that!?
By that criteria, we might as well just stop taking all supplements including rapamycin.
I highly recommend that you don’t take a statin.
AnUser
#1393
So anything goes then and we can believe anything we want.
Not adjusting decisions based on quality of evidence is a grave mistake, not something a commander would do in a war and neither should we do with our health.
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rivasp12
#1394
I can achieve the same results with Metamucil and citrus bergamot. Not a whiff of evidence that it’s going to impair my mental status, now or in the future.
I’m not so much of a scientific purist that I’m going to insist on a great study when I can just switch.
Sometimes it’s just common sense.
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AnUser
#1395
Of course, except that most people won’t achieve the same results with two supplements. If you can keep apoB low and one intervention has less possible risk than the other, sure. However, statins have benefits in stabilizing plaques etc, so lifestyle and supplements cannot completely replace it.
It found that a daily dose of about 10 grams of psyllium husk lowered harmful LDL cholesterol 13 mg/dL when taken for at least three weeks.
That won’t cut it. I tried the same with oat beta glucans, but it has such a small effect it isn’t worth it. And berberine which I took is a dirty drug with unknown side effects.
Citrus bergamot seems like it requires a lot of research, and I would want to know how it lowers ldl cholesterol if it does.
That might be because very few use it, there is a very little data and trials. Absence of evidence is not evidence of absence. I believe you when it comes to psylium husk though.
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rivasp12
#1396
Actually lots of studies on citrus bergamot and very impressive.
No myopathy, joint pains, liver damage or cognitive impairment.
Everyone has their own risk tolerance.
It depends on the magnitude of the side effects.
In treating high blood pressure, hctz gave low potassium in some patients, so I just monitor the levels and supplement when necessary.
On the other hand, lisinopril was associated with lung cancer. Studies weren’t perfect but from then on I switched to the ARB’s.
I’m not risking dementia or cancer waiting for the perfect study. First do no harm.
Medicine is an art as well as a science.
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AnUser
#1398
Risking dementia or cancer from all statins is ludicrous. But we differ in what evidence we deem is of acceptable quality. Anti-statins in this way is just populism and ideology, and not rooted in evidence. Accepting low quality studies means you aren’t basing decisions on evidence. The real world effect will be as expected.
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I think this study was funded by the pharmaceutical industry. For a different perspective read - Eat Rich, Live Long. Blockages are most likely the result of stressors (diet, stress, enviromental) that cause damage to the arteries. The body is programmed to fix those and it does so with a combination of Calcium, LDL and others. The biggest cause of damage is Insulin Resistance. If you are concerned about your heart health you need to get a heart CAC test. I do not have the study but I did read some research that Rapamycin shows promise in easing blockage and artery stiffness. Vitamin K2 is the thing that will keep calcium out of the arteries. Google or Youtube - Vitamin K2 and heart etc.
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My own symptom was two things that I knew I knew, but I had problems retrieving the memory. I have just tried to retrieve them again (having stopped RYR a while ago) and had no problem. Its not a spectactularly reliable anecdote, but its good enough for me.
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I believe that Metamucil has too much lead. You may want to switch to one of the three brands of psyllium husk with low lead levels.
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Salt substitutes shown to reduce CVD risks.
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tongMD
#1403
The potential for negative cognitive effect appears to be tied to HMGCRi in the brain, perhaps confounded by positive cerebrovascular effects - so we seem to observe a net near zero (but probably present) negative cognitive effect.
I’m not sure hydrophilic statins like rosuvastatin would be an issue since it basically doesn’t cross the BBB. Very much hepatoselective.
Ultimately, one can capture a bulk of the effect of rosuvastatin with low-dose intermittent once weekly - active for ~4 days with ED50 at ~2 mg. But ultimately I’d like to see someone at least close to borderline indicated before Rx statins personally.
Always about the benefit/risk assessment of course.
For secondary prevention, or in those at high CV risk, I do see the advantage of crestor . I like the low dose option as well.
For primary prevention, the absolute risk reduction of total mortality is so low with statins that the benefit/risk no longer works. I’ve seen both mild and severe cognitive issues . This study is also concerning:
Mendelian Randomization Study of PCSK9 and HMG-CoA Reductase Inhibition and Cognitive Function | Journal of the American College of Cardiology (jacc.org)
For the low risk rapa user, I think fiber and citrus bergamot are good choices if concerned over lipids.
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AnUser
#1405
Dr. Brad Stanfield is actually quite based.
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