ArticleThe Lancet regional health. Europe2026
Association between timing of statin treatment after diabetes diagnosis and risk of dementia: a nationwide observational study.
Article in The Lancet regional health. Europe, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: The burden of dementia is projected to rise with aging populations, particularly in those with diabetes; however, there are no effective treatments, and attention has turned to prevention through treatment of modifiable risk factors such as low-density lipoprotein cholesterol. We tested the hypothesis that early initiation of statin treatment following type 2 diabetes diagnosis is associated with lower risk of all-cause dementia than delayed or no initiation. Methods: Using nationwide registers, we identified 132,585 statin-naïve individuals in Denmark developing type 2 diabetes from 2006 through 2019. Follow-up was until dementia, death, emigration, or December 31, 2021. Using a clone-censor weighting design emulating a target trial we compared: i) no statin within 5 years after diagnosis (reference), ii) late statin (start at 1-5 years), and iii) early statin (start at ≤ 1 year). The primary outcome was 10-year risk of all-cause dementia based on Aalen-Johansen survival curves with death treated as competing risk. Findings: During median 7.1 years of follow-up (interquartile range: 3.8-9.9 years), 3592/132,585 = 2.7% developed dementia. Estimated 10-year absolute risks of dementia from the weighted Aalen-Johansen analysis were 3.9% in those with no statin initiation, 3.3% in those with early statin initiation, and 3.5% in those with late statin initiation. Following diabetes diagnosis and compared to no statin initiation, early statin treatment was associated with 15% lower relative risk of dementia at 10 years (95% confidence interval: 9%-21%) while the corresponding relative risk for late statin treatment was 10% lower (3%-15%). Corresponding absolute risk differences were 0.59% (0.34%-0.86%) and 0.38% (0.12%-0.61%) lower, respectively. Interpretation: In statin-naïve individuals developing type 2 diabetes, statin therapy was associated with lower relative and absolute risks of dementia, most pronounced in those with early statin initiation. There is a need for trial evidence to confirm the findings. Funding: The Danish Cardiovascular Academy and the Danish Heart Foundation.
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