Statins linked to more hospitalizations in dementia
Among nursing home residents with dementia, statin use was associated with slightly higher hospitalization risk for heart or stroke-related events.
*Retrospective cohort study; Level 2b (OCEBM).

Citation

Lech S, Kohl R, O’Sullivan JL, Thevathasan T, Schuster J, Kuhlmey A, Gellert P, Yasar S. Statin Use Is Not Associated With Reduced Cardio- and Cerebrovascular Hospitalizations in Older Adults With Dementia. Stroke. 2026;57:404–414. doi:10.1161/STROKEAHA.125.051157

Background

Statins reduce heart and stroke events in many adults, but benefits in people with dementia are uncertain, especially in nursing homes. This study compared statin users and nonusers with similar health profiles.

Patients

German nursing home residents (n=96,162): 58,900 with dementia; 37,262 without dementia.

Intervention

Statin use during the year before follow-up (including dose groups and newly started use).

Control

No statin use.

Outcome

Hospitalization for heart or stroke-related events (primary). Hemorrhagic stroke hospitalization (secondary).

Follow-up Period

Mean 2.3 years (dementia) and 2.0 years (no dementia); data from 2015–2019.

Results

Population (matched comparison) Significant finding Hazard ratio (95% confidence interval)
Dementia: statin vs no statin (primary) Higher hospitalization risk 1.06 (1.01–1.12)
Dementia: moderate-dose statin vs no statin (primary) Higher hospitalization risk 1.15 (1.07–1.23)
Dementia: high-dose statin vs no statin (primary) Higher hospitalization risk 1.55 (1.15–2.10)
Dementia without known atherosclerotic cardiovascular disease (primary) Higher hospitalization risk 1.30 (1.12–1.52)
Dementia, newly started statin vs no statin (primary) Higher hospitalization risk 2.71 (2.33–3.15)
No dementia: high-dose statin vs no statin (primary) Higher hospitalization risk 1.51 (1.04–2.19)
No dementia: newly started statin vs no statin (primary) Higher hospitalization risk 1.99 (1.56–2.52)
No dementia: statin vs no statin (hemorrhagic stroke hospitalization) Lower hospitalization risk 0.68 (0.47–0.97)
Statin users and nonusers were matched; analyses accounted for deaths during follow-up.

Limitations

Observational claims data; dementia severity unknown; residual confounding and reverse causation likely (especially new starts); hospitalizations may reflect care practices, not biology.

Funding

Stiftung Charité/Berlin Institute of Health grant; no disclosed conflicts.

Clinical Application

For nursing home patients with dementia, do not expect fewer vascular hospitalizations from statins; reconsider new starts and discuss goals of care and overall risks.