Sometimes you just have to wonder. About two years ago, I told you about a case of dementia that was caused by statin drugs.
The medical literature has already reported on this several times. But it seems that for some doctors, the only thing that matters for your health and well-being is to have low cholesterol. You can be falling apart, but as long as your cholesterol is low they’re happy.
Well, the story gets worse. You won’t believe it.
I’ll call the patient Dan. Dan was a robust, fully capable 74-year-old man before he was started on a statin drug. And then things started to change. About three months later, he was starting to forget things. Then, a few months after that, it got worse. He was getting more confused and was starting to repeat himself. His doctor, the same one who gave him the statin medication, diagnosed Alzheimer’s. And so he prescribed Dan another drug for that. It was about this time that the patient’s wife consulted me about treatments for Alzheimer’s. The dementia was getting worse and the patient was having some side effects from the Alzheimer’s medication. She wanted to know what alternative treatments were out there for Alzheimer’s.
The first thing I did was something that should have been done originally. But unfortunately in the world of the five minute visit it was never done. I spent an hour with Dan and his wife going over the details of what had happened. In this case, it didn’t take too long to learn that his cognitive function didn’t start to fail until shortly after he started taking the statin drug.
So what’s the issue with statins anyway? The issue is they work really well. They’re supposed to reduce the LDL cholesterol levels – and they do that extremely effectively. The only problem with this is that LDL is critically important for brain function. So when it’s lowered with a statin, there are going to be problems with brain function for many people. Dan was possibly one of them. The evidence for this has been out for a long time.
Two trials published more than 10 years ago showed a link between statins and cognitive problems. The first one reported on 209 men and women with high cholesterol levels. The researchers gave half of them statin drugs and the other half got a placebo. They wanted to see how statin drugs affect learning.
During the next six months, the researchers put them through a series of exercises to improve their attention and reaction time. The men and women on the statin drug were significantly less able to learn than those whose cholesterol levels were left alone. The other study looked at 60 patients on statin drugs who were complaining of memory problems. More than half said their symptoms improved after they stopped taking the drugs. And that’s exactly what happened when I took Dan off the drug.
Within two weeks, his mental function started to return. At that point, we took him off the Alzheimer’s medication. Four months later, he was back to normal. Case solved, right? Right, except for one small problem – his doctor. His doctor was so obsessed over Dan’s high cholesterol that he convinced him to restart the medication. Now here’s where I get completely lost on the logic.
For one, in a patient such as Dan who has never had any cardiovascular problem, the studies show that there is less than a 2% chance that he will ever benefit from having his cholesterol lowered anyway. And, more importantly, you would have to be completely blind to not connect the dots between Dan’s previous use of a statin and the fairly rapid onset of dementia symptoms. But, as with many things in modern medicine, logic is not the only determining factor. Statistics, ignorance, and medical-legal considerations often trump logic. And so Dan started taking a statin drug again.
You can guess what happened. Sure enough, within a matter of months, Dan started to lose his cognitive function once again. Once again, the doctor was unconvinced that it had anything to do with the drug. And so, once again, Dan’s wife called me. And, of course, I explained to her that the negative impact of the drug on Dan’s quality of life far outweighed the minimal benefit it had to offer. There was little to no risk for him to live out the rest of his life with a higher-than-average cholesterol level. And, happily, Dan stopped the drug. I tell you of this case because it points out several problems with giving older patients statin drugs.
One, the older we are, the more sensitive our brains become to medications. According to one review article on the topic, the authors state that because of age and disease-related changes in brain chemistry and drug handling, “Elderly people are more likely than younger patients to develop cognitive impairment as a result of taking medications.”
They go on to say that their research shows that up to 12% of patients with suspected dementia have it as a direct result of drugs. Besides statins, the list includes drugs for depression, anxiety, insomnia, narcotics, anti-seizure drugs, antacid drugs, antihistamines, anti-nausea drugs, muscle relaxants, NSAIDs, and other cardiac drugs, including digoxin and beta-blockers. Of course, the more of these drugs you’re on, the greater the likelihood of a problem.
Two, the cognitive decline caused by the drugs is often not immediately apparent. It may take as long as six to nine months to become noticeable. Also, the symptoms may not be severe. Both of these factors make it harder for the doctor and the family to identify the real problem.
Three, the majority of the patients with cognitive decline from medications are old. So when they start to lose their mental function, the usual response is that it’s just due to old age. God only knows how many people are suffering from cognitive decline simply from the medications they’re taking.
So if you or a loved one is starting to show signs of cognitive decline, think first about the medications. Were they started on any new medications (including over-the-counter drugs)? Or was the dose raised within one year of the beginning of the symptoms? If so, talk with your doctor about how to go about stopping the medications for a few months just to see what happens. And, remember, despite what Big Pharma advertising programs you do believe, having low cholesterol is not the secret to good health. That only comes with regular exercise, good nutrition, and healthy lifestyle habits.
Yours for better health,
Frank Shallenberger, MD