BACKGROUND There is clinical uncertainty regarding the benefits and harms of prescribing statins in healthy subjects ≥70 years of age. OBJECTIVES The aim of this study was to examine the association among statins, dementia-free and disability-free survival, and cardiovascular disease (CVD) among healthy older adults using data from the ASPREE (Aspirin in Reducing Events in the Elderly) trial. METHODS ASPREE was a randomized trial of 19,114 community-dwelling persons in Australia and the United States ≥65 years of age and free of documented CVD, dementia, and disability. Data were collected for those ≥70 years of age, and participants who took statins at baseline were compared with those who did not using Cox proportional hazards regression with inverse probability weighting. The primary outcome, referred to as "disability-free survival," was a composite of all-cause mortality, dementia, or persistent physical disability. Other outcomes included the individual components of the composite outcome, major adverse cardiovascular events, fatal CVD, myocardial infarction, and stroke. RESULTS Of the 18,096 included participants (median age 74.2 years, 56.0% women), 5,629 took statins at baseline. Over a median follow-up period of 4.7 years, baseline statin use was not associated with disability-free survival or with the risk for all-cause mortality or dementia. However, it was associated with lower risks for physical disability and all cardiovascular outcomes. CONCLUSIONS Among healthy community-dwelling adults ≥70 years of age, statin use may be beneficial for preventing physical disability and CVD but not beneficial for prolonging disability-free survival or avoiding death or dementia. Future clinical trials are needed to confirm these findings.

中文翻译：

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健康老年人中他汀类药物使用与无残疾生存和心血管疾病的关联

背景 在 70 岁以上的健康受试者中处方他汀类药物的益处和危害存在临床不确定性。目的 本研究的目的是使用 ASPREE（阿司匹林减少老年人事件）试验的数据，检查健康老年人中他汀类药物、无痴呆和无残疾生存率与心血管疾病 (CVD) 之间的关联。方法 ASPREE 是一项随机试验，纳入了澳大利亚和美国 19,114 名年龄≥65 岁且无 CVD、痴呆和残疾记录的社区居民。收集 70 岁以上患者的数据，并将基线时服用他汀类药物的参与者与未使用 Cox 比例风险回归和逆概率加权的参与者进行比较。主要结果，称为“无残疾生存”，是全因死亡率、痴呆或持续身体残疾的综合。其他结局包括复合结局的各个组成部分、主要不良心血管事件、致命性心血管疾病、心肌梗塞和中风。结果 在纳入的 18,096 名参与者（中位年龄 74.2 岁，56.0% 女性）中，5,629 人在基线时服用他汀类药物。在 4.7 年的中位随访期间，基线他汀类药物使用与无残疾生存或全因死亡或痴呆风险无关。然而，它与身体残疾和所有心血管结果的风险较低有关。结论 在 70 岁以上的健康社区居民中，他汀类药物的使用可能有益于预防身体残疾和 CVD，但无益于延长无残疾生存期或避免死亡或痴呆。