Inquiry: The Journal of Health Care Organization, Provision, and Financing (May 2021)
Adherence to Statins Use and Risk of Dementia among Patients with Diabetes and Comorbid Hyperlipidemia
Abstract
The results from previous observational studies and clinical trials about the neuroprotective benefits of statins use for the prevention of dementia are contradictory. It is unclear whether the neuroprotective benefits are experienced in a specific group with a higher risk of dementia, such as patients with concurrent diabetes and hyperlipidemia. We aimed to examine the association between adherence to statins and the risk of dementia among patients with diabetes and comorbid hyperlipidemia. This was a retrospective study with a new user design. We used data from the Taiwan National Health Insurance Research Database to identify patients with diabetes and comorbid hyperlipidemia. The occurrence of dementia was the study outcome. The adherence to statins was the exposure, which was measured by the proportion of days covered (PDC) of statins. The good adherence included patients with ≥80% PDC of statins. Cox proportional hazards regression models were used to evaluate the association between adherence to statins and dementia. Among 18,125 included individuals with diabetes and comorbid hyperlipidemia, 33.5% had good adherence to statins. Compared to poor adherence to statins, good adherence to statins was not significantly associated with a reduced risk of dementia (hazard ratio = 0.94; 95%confidence interval = 0.70–1.24) among patients with diabetes and comorbid hyperlipidemia. Good adherence to statins was not found to be associated with the risk of dementia among patients with diabetes and comorbid hyperlipidemia in Taiwan. Future studies with a more diverse study population are needed to evaluate the neuroprotective effects of statins use on dementia prevention.