Statins and the elderly: recent evidence and current indications

Cardiovascular disease (CVD) is esti- mated to remain as the main cause of death in devel- oped nations over the next 30 years, with increased prevalence in the older population. This is because the observed decline in the incidence of CVD owing to im- provements in prevention has now been counterbal- anced by the increased shift toward an older and thus more fragile population. Statin treatment reduces car- diovascular morbidity and mortality in middle-aged adults. However, few studies have included older in- dividuals, particularly those aged 80 years or over. The adverse effects associated with high doses of statins and their interactions with other drugs may give rise to more problems in the elderly population. Evidence remains limited regarding the overall benefit of start- ing statin therapy in adults aged 80 and over; so that clinical judgment remains necessary in making the decision to use them. In this review, we present avail- able evidence from randomized clinical trials, as well as relative community and post-approval data directly applicable to the management of CVD in the elderly, in both primary and secondary prevention. Also dis- cussed is the latest evidence regarding the putative pro- tective effects of statins on senile dementia and the re- lationship betwen statin treatment and cancer.