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Statin and cognition

Stephanie Cham, Hayley J Koslik, Beatrice A Golomb
Psychiatric adverse drug reactions (ADRs) have been reported with statin use, but the literature regarding statin-associated mood/behavioral changes remains limited. We sought to elicit information germane to natural history and characteristics of central nervous system/behavioral changes in apparent connection with statin and/or cholesterol-lowering drug use, and delineate mechanisms that may bear on an association. Participants (and/or proxies) self-referred with behavioral and/or mood changes in apparent association with statins completed a survey eliciting cholesterol-lowering drug history, character and impact of behavioral/mood effect, time-course of onset and recovery in relation to drug use/modification, co-occurrence of recognized statin-associated ADRs, and factors relevant to ADR causality determination...
December 2016: Drug Saf Case Rep
Patrice Tremblay, Susan Gold
INTRODUCTION: Post-operative delirium (POD) is a serious surgical complication that can cause significant morbidity and mortality. It is associated with prolonged hospital stay, delayed admission to rehabilitation programs, persistent cognitive deficits, marked health-care costs, and more. The pathophysiology is multi-factorial and not completely understood, which complicates the optimal management. Non-pharmacological measures have been the mainstay of treatment, but there has been an ongoing interest in the medical literature on the prevention of post-operative delirium using medications...
September 2016: Canadian Geriatrics Journal: CGJ
Soheila Adeli, Maryam Zahmatkesh, Gholamreza Tavoosidana, Morteza Karimian, Gholamreza Hassanzadeh
Brain oxidative status is a crucial factor in the development of sporadic Alzheimer's disease (AD). Klotho, an anti-aging protein, diminishes oxidative stress by the induction of manganese superoxide dismutase (MnSOD). Thus, the substances that increase klotho expression could be considered as a potential treatment for Alzheimer's disease when the oxidative imbalance is present. Statins are suggested to up-regulate klotho expression. We examined the effect of simvastatin (5mg/kg, daily for 3weeks) on hippocampal klotho and MnSOD expression in the cognitive declined animal model induced by intracerebroventricular (ICV)-streptozotocin (STZ) administration...
January 4, 2017: Progress in Neuro-psychopharmacology & Biological Psychiatry
Magnus Jörntén-Karlsson, Stéphane Pintat, Michael Molloy-Bland, Staffan Berg, Matti Ahlqvist
Poor adherence to statins increases cardiovascular disease risk. We systematically identified 32 controlled studies that assessed patient-centered interventions designed to improve statin adherence. The limited number of studies and variation in study characteristics precluded strict quality criteria or meta-analysis. Cognitive education or behavioural counselling delivered face-to-face multiple times consistently improved statin adherence compared with control groups (7/8 and 3/3 studies, respectively). None of four studies using medication reminders and/or adherence feedback alone reported significantly improved statin adherence...
October 2016: Drugs
Kristen M Beavers, Iris Leng, Stephen R Rapp, Michael E Miller, Denise K Houston, Anthony P Marsh, Don G Hire, Laura D Baker, George A Bray, George L Blackburn, Andrea L Hergenroeder, John M Jakicic, Karen C Johnson, Mary T Korytkowski, Brent Van Dorsten, Stephen B Kritchevsky
OBJECTIVES: To test whether average long-term glucose exposure is associated with cognitive and physical function in middle-aged and younger-old adults with type 2 diabetes mellitus. DESIGN: Prospective cohort study. SETTING: Data obtained as part of the Action for Health in Diabetes (Look AHEAD) trial (NCT00017953) and Look AHEAD Movement and Memory ancillary study (NCT01410097). PARTICIPANTS: Overweight and obese individuals with type 2 diabetes mellitus aged 45 to 76 at baseline (N = 879)...
September 27, 2016: Journal of the American Geriatrics Society
Diane M A Swallow, Michael A Lawton, Katherine A Grosset, Naveed Malek, Johannes Klein, Fahd Baig, Claudio Ruffmann, Nin P Bajaj, Roger A Barker, Yoav Ben-Shlomo, David J Burn, Thomas Foltynie, Huw R Morris, Nigel Williams, Nicholas W Wood, Michele T M Hu, Donald G Grosset
BACKGROUND: Cardiovascular disease (CVD) influences phenotypic variation in Parkinson's disease (PD), and is usually an indication for statin therapy. It is less clear whether cardiovascular risk factors influence PD phenotype, and if statins are prescribed appropriately. OBJECTIVES: To quantify vascular risk and statin use in recent-onset PD, and examine the relationship between vascular risk, PD severity and phenotype. METHODS: Cardiovascular risk was quantified using the QRISK2 calculator (high ≥20%, medium ≥10 and <20%, low risk <10%)...
November 2016: Journal of Neurology, Neurosurgery, and Psychiatry
Caio M Massari, Adalberto A Castro, Tharine Dal-Cim, Débora Lanznaster, Carla I Tasca
Parkinson's disease (PD) involves the loss of striatal dopaminergic neurons, although other neurotransmitters and brain areas are also involved in its pathophysiology. In rodent models to PD it has been shown statins improve cognitive and motor deficits and attenuate inflammatory responses evoked by PD-related toxins. Statins are the drugs most prescribed to hypercholesterolemia, but neuroprotective effects have also been attributed to statins treatment in humans and in animal models. This study aimed to establish an in vitro model of 6-hydroxydopamine (6-OHDA)-induced toxicity, used as an initial screening test to identify effective drugs against neural degeneration related to PD...
December 2016: Toxicology in Vitro: An International Journal Published in Association with BIBRA
Peter Sever, Ajay Gupta, David Thompson, Andrew Whitehouse, Tim Collier, Bjorn Dahlof, Neil Poulter
OBJECTIVE: To test the hypothesis that adverse effects of statins are only reported in excess in observational studies and not in blinded randomized trials. DESIGN AND METHOD: We collated all reported AEs in hypertensive patients in the Lipid-Lowering arm of the Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT-LLA) during the randomised, double-blind phase (when atorvastatin was compared with placebo) and the subsequent non-randomised un-blinded LLA-extension phase (when patients were offered open-label statin)...
September 2016: Journal of Hypertension
Fang-Chi Hsu, Mingxia Yuan, Donald W Bowden, Jianzhao Xu, S Carrie Smith, Lynne E Wagenknecht, Carl D Langefeld, Jasmin Divers, Thomas C Register, J Jeffrey Carr, Jeff D Williamson, Kaycee M Sink, Joseph A Maldjian, Barry I Freedman
AIMS: To assess associations between body mass index (BMI), waist circumference (WC), and computed tomography-determined volumes of pericardial, visceral, and subcutaneous adipose tissue with magnetic resonance imaging-(MRI) based cerebral structure and cognitive performance in individuals with type 2 diabetes (T2D). METHODS: This study was performed in 348 African Americans (AAs) and 256 European Americans (EAs) with T2D. Associations between adiposity measures with cerebral volumes of white matter (WMV), gray matter (GMV), white matter lesions, hippocampal GMV, and hippocampal WMV, cognitive performance and depression were examined using marginal models incorporating generalized estimating equations...
November 2016: Journal of Diabetes and its Complications
Bernadette McGuinness, Chris R Cardwell, Peter Passmore
BACKGROUND: There are approximately 24 million people worldwide with dementia; this is likely to increase to 81 million by 2040. Dementia is a progressive condition, and usually leads to death eight to ten years after first symptoms. End-of-life care should emphasise treatments that optimise quality of life and physicians should minimise unnecessary or non-beneficial interventions. Statins are 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors; they have become the cornerstone of pharmacotherapy for the management of hypercholesterolaemia but their ability to provide benefit is unclear in the last weeks or months of life...
September 9, 2016: Cochrane Database of Systematic Reviews
Sally-Ann Cooper, Temitope Ademola, Muriel Caslake, Elizabeth Douglas, Jonathan Evans, Nicola Greenlaw, Caroline Haig, Angela Hassiotis, Andrew Jahoda, Alex McConnachie, Jill Morrison, Howard Ring, John Starr, Ciara Stiles, Chammy Sirisena, Frank Sullivan
BACKGROUND: Dementia is very common in Down syndrome (trisomy 21) adults. Statins may slow brain amyloid β (Aβ, coded on chromosome 21) deposition and, therefore, delay Alzheimer disease onset. One prospective cohort study with Down syndrome adults found participants on statins had reduced risk of incident dementia, but there are no randomised controlled trials (RCTs) on this issue. Evidence is sparse on the best instruments to detect longitudinal cognitive decline in older Down syndrome adults...
2016: Trials
Shibani S Mukerji, Joseph J Locascio, Vikas Misra, David R Lorenz, Alex Holman, Anupriya Dutta, Sudhir Penugonda, Steven M Wolinsky, Dana Gabuzda
BACKGROUND: Dyslipidemia and apolipoprotein E4 (APOE ϵ4) allele are risk factors for age-related cognitive decline, but how these risks are modified by human immunodeficiency virus (HIV) infection is unclear. METHODS: In a longitudinal nested study from the Multicenter AIDS Cohort Study, 273 HIV type 1-infected (HIV(+)) men aged 50-65 years with baseline HIV RNA <400 copies/mL and on continuous antiretroviral therapy (ART) in ≥95% of follow-up visits were matched by sociodemographic variables to 516 HIV-uninfected (HIV(-)) controls...
October 15, 2016: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Rafael Bitzur
The issue of statin-associated cognitive impairment has been a hot topic among both patients and health care providers, especially since the U.S. Food and Drug Administration (FDA) issued a statement regarding rare postmarketing reports of ill-defined cognitive impairment associated with statin use. This statement was based on case reports, and no objective measures of cognitive function were used. Nevertheless, many patients at high risk of cardiovascular disease have expressed concerns about possible cognitive decline and may have opted to forgo statin therapy...
August 2016: Diabetes Care
Roelof A J Smit, Stella Trompet, Behnam Sabayan, Saskia le Cessie, Jeroen van der Grond, Mark A van Buchem, Anton J M de Craen, J Wouter Jukema
BACKGROUND: Recently, it was shown that intraindividual variation in low-density lipoprotein cholesterol (LDL-C) predicts both cerebrovascular and cardiovascular events. We aimed to examine whether this extends to cognitive function and examined possible pathways using a magnetic resonance imaging substudy. METHODS: We investigated the association between LDL-C variability and 4 cognitive domains at month 30 in 4428 participants of PROSPER (PROspective Study of Pravastatin in the Elderly at Risk)...
July 19, 2016: Circulation
Akira Tamaoka
Several lines of evidences support a possible involvement of serum cholesterol in the development of dementia/Alzheimer's disease (AD), with hypercholesterolemia as one of the risk factors that can be targeted by therapeutic interventions. It has also been suggested that statins, prescribed as lipid-lowering drugs to patients at risk for cardiovascular conditions, may be useful in both the prevention and treatment of AD. Currently, conflicting evidences from epidemiological studies indicate a controversial association between dyslipidemia and dementia/AD risk...
July 2016: Brain and Nerve, Shinkei Kenkyū No Shinpo
Barry I Freedman, Crystal A Gadegbeku, R Nick Bryan, Nicholette D Palmer, Pamela J Hicks, Lijun Ma, Michael V Rocco, S Carrie Smith, Jianzhao Xu, Christopher T Whitlow, Benjamin C Wagner, Carl D Langefeld, Amret T Hawfield, Jeffrey T Bates, Alan J Lerner, Dominic S Raj, Mohammad S Sadaghiani, Robert D Toto, Jackson T Wright, Donald W Bowden, Jeff D Williamson, Kaycee M Sink, Joseph A Maldjian, Nicholas M Pajewski, Jasmin Divers
To assess apolipoprotein L1 gene (APOL1) renal-risk-variant effects on the brain, magnetic resonance imaging (MRI)-based cerebral volumes and cognitive function were assessed in 517 African American-Diabetes Heart Study (AA-DHS) Memory IN Diabetes (MIND) and 2568 hypertensive African American Systolic Blood Pressure Intervention Trial (SPRINT) participants without diabetes. Within these cohorts, 483 and 197 had cerebral MRI, respectively. AA-DHS participants were characterized as follows: 60.9% female, mean age of 58...
August 2016: Kidney International
G B John Mancini, Steven Baker, Jean Bergeron, David Fitchett, Jiri Frohlich, Jacques Genest, Milan Gupta, Robert A Hegele, Dominic Ng, Glen J Pearson, Janet Pope, A Yashar Tashakkor
The Canadian Consensus Working Group has updated its evaluation of the literature pertaining to statin intolerance and adverse effects. This overview introduces a pragmatic definition of statin intolerance (goal-inhibiting statin intolerance) that emphasizes the effects of symptoms on achieving nationally vetted goals in patients fulfilling indications for lipid-lowering therapy and cardiovascular risk reduction. The Canadian Consensus Working Group provides a structured framework for avoiding, evaluating and managing goal-inhibiting statin intolerance...
July 2016: Canadian Journal of Cardiology
Robert F James, Daniel R Kramer, Zaid S Aljuboori, Gunjan Parikh, Shawn W Adams, Jessica C Eaton, Hussam Abou Al-Shaar, Neeraj Badjatia, William J Mack, J Marc Simard
New neuroprotective treatments aimed at preventing or minimizing "delayed brain injury" are attractive areas of investigation and hold the potential to have substantial beneficial effects on aneurysmal subarachnoid hemorrhage (aSAH) survivors. The underlying mechanisms for this "delayed brain injury" are multi-factorial and not fully understood. The most ideal treatment strategies would have the potential for a pleotropic effect positively modulating multiple implicated pathophysiological mechanisms at once...
August 2016: Current Treatment Options in Neurology
Kyung-Ho Yu, Keun-Sik Hong, Mi-Sun Oh, Juneyoung Lee, Ji Sung Lee, Sun U Kwon
GOAL: Cognitive impairment and dementia are common disabilities after stroke and are associated with increased risks of mortality and recurrent stroke. The prevention of dementia and preserving cognitive function are also important in stroke patients, but its strategy is not established yet. This PICASSO-COG (PreventIon of CArdiovascular events in iSchemic Stroke patients with high risk of cerebral hemOrrhage for reducing COGnitive decline) substudy aims to assess the effects of cilostazol and/or probucol on cognitive function...
August 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Lidia Glodzik, Henry Rusinek, Angela Kamer, Elizabeth Pirraglia, Wai Tsui, Lisa Mosconi, Yi Li, Pauline McHugh, John Murray, Schantel Williams, Ricardo S Osorio, Catherine Randall, Tracy Butler, Anup Deshpande, Shankar Vallabhajolusa, Mony de Leon
INTRODUCTION: Hypertension, hypercholesterolemia, and obesity increase the risk of dementia. Although their detection is commonly followed by an introduction of treatment, little is known about how medications frequently used to treat vascular risk affect amyloid deposition. METHODS: A cross-sectional study of 156 subjects who underwent positron emission tomography with PiB. Using linear regression, we tested whether blood pressure, cholesterol, overweight/obese status, angiotensin receptor blockers (ARBs), beta-blockers, diuretics, angiotensin converting enzyme inhibitors, and statins predicted amyloid deposition...
2016: Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring
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