Cognition, Statins, and Cholesterol in Elderly Ischemic Stroke Patients: A Neurologist’s Perspective
1
Department of Psycho-Neurosciences and Rehabilitation, Faculty of Medicine and Pharmacy, University of Oradea, nr 1 Universitatii Street, 410087 Oradea, Romania
2
Neurology Ward, Clinical Municipal Hospital “dr. G. Curteanu”, nr 12 Corneliu Coposu Street, 410469 Oradea, Romania
3
Neurological Rehabilitation Ward, Clinical Municipal Hospital “dr. G. Curteanu”, nr 12 Corneliu Coposu Street, 410469 Oradea, Romania
*
Author to whom correspondence should be addressed.
Academic Editors: Vincenzo Russo, Vida Demarin and Riccardo Proietti
Medicina 2021, 57(6), 616; https://doi.org/10.3390/medicina57060616
Received: 12 May 2021 / Revised: 28 May 2021 / Accepted: 9 June 2021 / Published: 13 June 2021
(This article belongs to the Special Issue Treatment of Stroke, Dementia and Atrial Fibrillation)
Background and Objectives: The efficacy of hydroxy methyl glutaryl-coenzyme A reductase inhibitors (statins) in reducing the incidence of cardiovascular events pushed the target LDL-cholesterol (LDL-C) levels lower and lower in successive guidelines despite signals regarding potential cognitive side effects. We evaluated the relationship between cognitive impairment and LDL-C levels in elderly ischemic stroke patients. Materials and Methods: 29 ischemic stroke patients aged 65 and above with LDL-C levels ≤70 mg/dL, classified according to the TOAST criteria, underwent detailed neuropsychological testing comprising the MMSE test, Montreal Cognitive Assessment (MoCA) and Addenbrooke’s Cognitive Evaluation (ACE-III) test. Their performances were compared to those of 29 age-matched ischemic stroke patients with LDL-Cl levels >71 mg/dL. Results: The MMSE test failed to detect significant cognitive differences between the two groups. The MoCA and ACE-III tests detected impairments in visuo-spatial/executive function, attention, and recall/memory in patients with low LDL-C. A stepwise linear regression model of the ACE-III total scores revealed that LDL-cholesterol levels could contribute to 13.8% of the detected cognitive dysfunction, second in importance only to age, which contributed to 38.8% of the detected impairment. Conclusions: Physicians should be cautious when prescribing statins to elderly people. Hydrophilic ones may be preferred in cognitively impaired patients.
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Keywords:
cholesterol; LDL; cognitive impairment; ischemic stroke
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MDPI and ACS Style
Jurcau, A.; Simion, A. Cognition, Statins, and Cholesterol in Elderly Ischemic Stroke Patients: A Neurologist’s Perspective. Medicina 2021, 57, 616. https://doi.org/10.3390/medicina57060616
AMA Style
Jurcau A, Simion A. Cognition, Statins, and Cholesterol in Elderly Ischemic Stroke Patients: A Neurologist’s Perspective. Medicina. 2021; 57(6):616. https://doi.org/10.3390/medicina57060616
Chicago/Turabian StyleJurcau, Anamaria, and Aurel Simion. 2021. "Cognition, Statins, and Cholesterol in Elderly Ischemic Stroke Patients: A Neurologist’s Perspective" Medicina 57, no. 6: 616. https://doi.org/10.3390/medicina57060616
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