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Data-mining for Medications That Affect the Incidence of Dementia
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Ben Wolozin of the Boston University School of Medicine presented some results from analyzing a 4.5 million-subject database of medical records to identify medications that are associated with reduction or increase in the incidence of dementia. His team's most recent study confirmed previous reports which suggested that statin (cholesterol-lowering) drugs may be protective. What's more, the new analysis found interesting differences among statin drugs. Simvastatin, for example, appears to significantly reduce the incidence of dementia only among individuals who do not have hypertension. These findings were presented at the recent International Conference on Alzheimer's Disease in Madrid, Spain (see abstract below). We also discussed issues relating to mining large health-record databases for insight into factors that influence the development of Alzheimer disease.
Ben Wolozin led this Webinar on 25 August 2006. Readers are invited to submit additional comments by using our Comments form at the bottom of the page.
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Background
Statins use is associated with a reduction in the incidence of dementia
Benjamin Wolozin1*, Stan Wang2, Austin Wang4, Todd Lee3 and Lewis Kazis2,4
1Boston University School of Medicine, 2Bedford Veterans Affairs Medical Center, 3Hines Veterans Affairs Medical Center and 4Boston University School of Public Health
Abstract We have analyzed the decision support system of the US Veterans Affairs database, which continues diagnostic, medication and demographic information on 4.5 million subjects, to examine whether statins are associated with a reduced incidence of dementia. We observed that simvastatin and lovastatin are associated with a reduced incidence of dementia in subjects 65 years or older after adjustment for hypertension, cardiovascular disease, diabetes and obesity. The odds ratio for incident dementia for simvastatin is 0.723 (CI 0.657 – 0.795, p<0.0001), for atorvastatin is 0.638 (CI 0.549 – 742, p<0.0001). Analysis of cumulative incidence curves and hazard ratios confirmed that simvastatin and atorvastatin are associated with a lower incidence of dementia. The effect of simvastatin was sensitive to the presence of hypertension. The hazard ratio for incident dementia in subjects without hypertension was 0.443 (CI 0.346 – 0.568, p<0.0001) and with hypertension was 0.889 (CI 0.802 – 0.985, p<0.05). Statins are also associated with a reduced incidence of two other degenerative diseases, Parkinson disease and emphysema, but not with two proliferative diseases, prostatic neoplasm and prostatic hypertrophy. The large size of this dataset provides strong support for the hypothesis that statins might be beneficial in delaying the onset of dementia.
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Webinar: A Webinar is a seminar conducted remotely over the Web. Attendees view the slides through their Web browser and hear the presentations over their own telephones. 
