Impact of Statin and Aspirin Use on Dementia Diagnosis Stratified by Cardiovascular Risk

BACKGROUND: Atherosclerotic cardiovascular disease (ASCVD) and Alzheimer's disease (AD) dementia share common risk factors. However, the role of ASCVD prevention therapies in AD dementia prevention is not fully understood. We examined the effect of LLT and antiplatelets with dementia and AD dementia diagnoses across ASCVD risk profiles. METHODS: We used data from primary prevention registry derived from a large healthcare network. Multivariable Cox proportional models were generated to study dementia and AD dementia diagnoses, stratified by ASCVD risk profiles. Impact of aspirin and LLT use on dementia and AD dementia diagnoses was assessed in adjusted models. RESULTS: Among n= 347,128, 2.4% developed dementia and 2.0% developed AD dementia over a median follow-up of 7.94 years. In adjusted models, dementia (HR, 2.59; 95% CI [2.29-2.92]) and AD dementia (HR, 2.85; 95% CI [2.49-3.25]) was higher in high risk patients. Low and high-dose aspirin among high ASCVD risk had lower dementia (HR, 0.88; 95% CI, [0.77-1.00] and HR, 0.83; 95% [CI 0.77-0.90]) and AD dementia (HR, 0.83; 95% CI [0.77-0.91] and HR, 0.85; 95% CI [0.73-0.97]). Similarly, moderate- to high-dose LLT use among high ASCVD risk groups was associated with lower dementia (HR, 0.85; 95% CI [0.79-0.93]) and AD dementia (HR, 0.85; 95% CI [0.78-0.93]). CONCLUSIONS: Higher baseline ASCVD risk was associated with increased risk of dementia and AD dementia diagnoses. Aspirin and moderate- to high-dose LLT use among patients with high ASCVD risk was associated with lower dementia and AD dementia risk.