"Sharon Hope" <shope@anet.net> wrote in part:

I'm talking about all the studies, taken as a whole. CRISP, HPS,
PROSPER were the randomized trials that looked at statins and
cognitive decline, finding no difference between statin and
placebo. With caveats, throw in Muldoon, who found no effect of
simvastatin on cognitive tasks except for (using post hoc
analyses) a few specific tests. In a retest, some of those
specific tests still showed tiny decrements from statins compared
to placebo and some did not.

I don't think so. It depends on the mechanisms and on possible
compensatory benefits.

--
Jim Chinnis   Warrenton, Virginia, USA

For that one study they discussed, perhaps.  I am not aware of how well they screened for the kinds of statin-induced dementia my husband suffers, are you?  Also, in his case it took 4 years - was the study that long?

3 studies by Dr. Gaist.  You would expect that for a diabetic, who is already at tremendous risk for peripheral neuropathy, it would be much higher, but I don't have data on that.  Just common sense.

Dr. Gaist's studies:

"For patients treated with statins for 2 or more years the odds ratio of definite idiopathic polyneuropathy was 26.4 (7.8 to 45.4). CONCLUSIONS: Long-term exposure to statins may substantially increase the risk of polyneuropathy." (See 1, below)

From the full-text of the study: "Patients with a diagnosis of polyneuropathy in their medical
records established before January 1, 1994 (n
54)

and potential cases, in whom the nerve conduction test did

not support the diagnosis or had not been performed, were

excluded (n
75). Patients were also excluded if any of the

following diseases and conditions were stated as diagnoses

in the medical records, or appropriate tests indicated their

presence (n
287): diabetes, renal insufficiency, overuse of

alcohol, hypothyroidism, cancer, monoclonal gammopathy

of undetermined significance, AIDS, Lyme disease, connective

tissue disease, heavy metal intoxication, cobalamine

or folic acid deficiency, familial polyneuropathy, or chronic

inflammatory idiopathic polyneuropathy."

Keep in mind that POLYneuropathy is worse than peripheral neuropathy.  Also, keep in mind that his threshold for counting the case as polyneuropathy was very high:
"The neurophysiologic criteria were
abnormal conduction (velocity or compound action potential)

in two or more peripheral nerves, with at least one

being a leg nerve. In cases where the nerve conduction

study could not be retrieved, the conclusion of the study

had to be reported in the medical record as being compatible

with peripheral neuropathy. A diagnosis of peripheral

neuropathy was only accepted if both the clinical data and

the nerve conduction study were compatible with the diagnosis.

Verified cases of peripheral neuropathy that had

been adequately worked up, i.e., tested for all previously

listed exclusion diagnoses and conditions, and where no

apparent cause for the neuropathy had been established

were classified as definite idiopathic cases."

Interestingly: "The relative risk of polyneuropathy

increased by duration of statin use and by cumulative

dose, a relationship that was not reflected in the average

daily dose."

Also interesting:

"Discussion. We found that users of statins were at

a 4- to 14-fold increased risk of developing idiopathic

polyneuropathy compared with the background population,

and that this adverse effect may primarily

occur after long-term treatment with statins...

Our results are in line with several studies that

indicate an association between statin use and polyneuropathy..."

1:  Gaist D, Jeppesen U, Andersen M, Garcia Rodriguez LA, Hallas J, Sindrup SH.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt«stract
&list_uids011277Statins and risk of polyneuropathy: a case-control study.
Neurology. 2002 May 14;58(9):1333-7.
PMID: 12011277 [PubMed - indexed for MEDLINE]

2:  Gaist D, Garcia Rodriguez LA, Huerta C, Hallas J, Sindrup SH.
Are users of lipid-lowering drugs at increased risk of peripheral neuropathy?http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt«stract
&list_uids317483
Eur J Clin Pharmacol. 2001 Mar;56(12):931-3.
PMID: 11317483 [PubMed - indexed for MEDLINE]

3:  Jeppesen U, Gaist D, Smith T, Sindrup SH. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt«stract
&list_uids027656
Statins and peripheral neuropathy.
Eur J Clin Pharmacol. 1999 Jan;54(11):835-8.
PMID: 10027656 [PubMed - indexed for MEDLINE]

"Sharon Hope" <shope@anet.net> wrote in part:

...

I think the data speak against your interpretation above. The
studies performed simply do not find that dementia rates rise when
statins are given.
...

Does it increase the odds for "ANYONE?" Is the alleged
polyneuropathy increase with statins accomplished by a mechanism
that would multiply the already rather high odds of diabetics? Any
evidence?
--
Jim Chinnis   Warrenton, Virginia, USA

Like a cure for cancer, EVERYONE is hopeful of a treatment or prevention
(actually both) for Alzheimer's, a horrific condition that is devastating
for not only the patient but all who know the patient.

Statins cause a dementia condition that is so close to Alzheimer's it is
typically misdiagnosed as such.  The difference is that, years after the
statin drug is halted, the memory slowly improves.  Very slowly.

Statin dementia is, exactly as I described Azlheimer's, a horrific condition
that is devastating for not only the patient but all who know the patient.

The SIGNIFICANT difference between statin dementia and Alzheimer's is that
STATIN DEMENTIA IS PREVENTABLE - there is no need for a patient to develop
statin dementia.  If doctors warned about it, not just the patient, but the
family, and if the family and the doctors watched for it, and if there were
baseline NP testing prior to prescribing statins and regular NP testing
thereafter, just as there is for CK, there would be no need AT ALL for a
statin patient to develop STATIN COGNITIVE DAMAGE, CONFUSION, MEMORY LOSS,
TRANSIENT GLOBAL AMNESIA, APHASIA, or the other disabling cognitive impacts.

That this PREVENTABLE DEMENTIA continues to affect people, and doctors in
denial continue to consider it in the diagnosis is UNCONSCIONABLE.

Further, giving a person at high risk of Alzheimer's dementia a known
neurotoxic substance that has demonstrated over and over again that it
causes STATIN DEMENTIA in a percentage of patients, is UNCONSCIONABLE.

For a brief moment in time there was a willing suspension of disbelief that
statins, although they cause DEMENTIA, might somehow work in reverse for
Alzheimer's prevention (sort of like giving stimulants to hyperactive/ADD
children and they work in the opposite effect).  That time has passed.

By all means, we need a treatment toward a cure for Alzheimer's and a
prevention for Alzheimer's.

By all means we also need a treatment toward a cure for Statin dementia and
memory loss and cognitive damage and amnesia and aphasia, and a screening
ability to prevent others from suffering this PREVENTABLE DEMENTIA.

The time has passed for giving a neurotoxic drug to Alzheimer's patients and
those at risk.

Similarly, someone needs to call for a halt of giving a known neurotoxic
statin drug to diabetics, who by the condition of diabetes alone are already
at risk of developing peripheral neuropathy.  Why is it that they are now
prescribing a drug that, after 2 years of treatment, makes ANYONE TWENTY SIX
TIMES MORE LIKELY to experience polyneuropathy?  Note the POLY, not just
peripheral neuropathy, POLYNEUROPATHY.

What twisted medical ethics are currently in force?

The article makes it clear that there are conflicting studies: some
show
no protection against dementia, others do. Obviously, much more
research
is needed.

Who wouldn't hope that there *might* be some benefit from statins
against
this most debilitating disease, alzheimers? <<

COMMENT:

While we're visiting this subject, let us note that Alzheimer's is
responsible for maybe half of dementia only. A large fraction of the
other half is caused by mini-strokes and vascular disease. And of
course, there's a 20 to 30% overlap of people who have both problems.

Of these, Alzheirmer's is the process I would LEAST expect statins to
interfere with. They might, but they might not.  However, statins have
already show impressive anti-stroke capability, even in people with
normal cholesterol levels. So if statins do not work in slowing or
preventing progression of Alzheimer's, this in no way means we've ruled
out their role in preventing "dementia."

SBH

Another misleading subject line.....

The article makes it clear that there are conflicting studies: some show
no protection against dementia, others do. Obviously, much more research
is needed.

Who wouldn't hope that there *might* be some benefit from statins against
this most debilitating disease, alzheimers?

L.

Many of us who have been exposed first-hand to the devastating cognitive
adverse effects of statins have been tremendously skeptical of the "Can
statins prevent Alz?????" headlines, which appeared at a time that
conveniently offset articles in the popular media that exposed the memory
loss caused by statins.

We doubters also questioned how the studies would differentiate between Alz
and statin-induced memory loss.

As it turns out, this latest study shows that statins do NOT prevent
Alzheimer's:

     Statins Don't Protect Against Dementia: Study
     http://today.reuters.co.uk/news/newsArticle.aspx?type=healthNews&storyID=2005-02
-10T211401Z_01_B371082_RTRIDST_0_HEALTH-STATINS-DEMENTIA-DC.XML
     Reuters.uk, UK - 5 hours ago
     NEW YORK (Reuters Health) - The use of cholesterol-lowering drugs
belonging to the statin family, such as Lipitor or Pravacol, does not seem
to have any effect ...

     Statins Don't Protect Against Dementia: Study
     http://www.reuters.com/newsArticle.jhtml?type=healthNews&storyID=7598600
     Reuters - 5 hours ago
     NEW YORK (Reuters Health) - The use of cholesterol-lowering drugs
belonging to the statin family, such as Lipitor or Pravacol, does not seem
to have any effect ...

     Statins Don't Protect Against Dementia: Study
     http://abcnews.go.com/Health/wireStory?id=488976
     ABC News - 5 hours ago
     Feb 10, 2005 - NEW YORK (Reuters Health) - The use of
cholesterol-lowering drugs belonging to the statin family, such as Lipitor
or Pravacol, does not seem ...

Statins Don't Protect Against Dementia: Study
Thu Feb 10, 2005 9:15 PM GMT

NEW YORK (Reuters Health) - The use of cholesterol-lowering drugs belonging
to the statin family, such as Lipitor or Pravacol, does not seem to have any
effect on the risk of dementia or Alzheimer's disease, according to findings
from a new study.

This supports the results of another study, but run counter other study
findings that have linked statin use with a reduced risk of dementia.

The current study involved elderly residents living in Cache County, Utah,
who were evaluated for statin use and dementia between 1995 and 1997 and
then again between 1998 and 2000.

Dr. John C. S. Breitner, from the VA Puget Sound Health Care System in
Seattle, and colleagues report their findings in the Archives of General
Psychiatry.

Of the 4,895 subjects evaluated at the initial assessment, 355 had dementia,
including 200 with Alzheimer's disease. In this analysis, statin use was
associated with a 56-percent reduction in risk of dementia.

During 3-year follow-up, 185 of 3308 at-risk survivors were diagnosed with
dementia, including 104 with Alzheimer's disease. In this analysis, statin
use at the start of the study or at follow-up had no effect on the risk of
dementia or Alzheimer's disease.

One explanation for the different findings could be that after dementia sets
in, patients may simply be less likely to use statins, along with other
drugs.

Studies with sufficient statistical power are needed to assess the effect of
statin use on dementia risk, the authors note. "Until such research is able
to demonstrate more promising results, however, we suggest that costly
randomized trials of statins are premature."

SOURCE: Archives of General Psychiatry, February 2005.