Abstract
There is increasing evidence linking cholesterol metabolism with the neurofibrillary
pathology of Alzheimer's disease (AD). Cholesterol and its transport have been shown
to be involved in the regulation of amyloid production and tau hyperphosphorylation
in the brain, while also contributing to intracranial vascular disease and cerebral
ischemia. Statins inhibit HMG-CoA reductase, the enzyme that catalyzes the rate-limiting
step in cholesterol biosynthesis thus inserting itself into the pathogenesis of AD.
Numerous studies have examined the role of statins in the prevention of dementia and
treatment of established AD. This paper describes the role of cholesterol in the pathogenesis
of AD and explores how statins may influence this balance. A review of the epidemiological
and clinical trials with statins in dementia and AD is also presented. While evidence
from retrospective case control studies suggests a beneficial role of statins in the
prevention of AD, a similar benefit has not been established in prospective cohort
studies or clinical trials. The ability of statins in protecting against AD is not
yet elucidated. In the near future recently completed but not yet reported randomized
clinical trials will hopefully clarify the role of statins in the treatment of AD.
Keywords
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Article info
Publication history
Published online: March 25, 2009
Footnotes
☆Disclosures: Dr. Howard Feldman has received grant research support from Pfizer, Eisai, Janssen, Lilly, Astra Zeneca, Sanofi Synthelabo and Glaxo Smith Kline. He has served as consultant for Pfizer, Novartis, Janssen, Servier, Sanofi Synthelabo, Glaxo Smith Kline, Myriad, Targacept, Lundbeck, Forest and Avonyx. Dr. Nagaendran Kandiah has no conflicts of interest to disclose.
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© 2009 Published by Elsevier Inc.
