Beatrice A. Golomb, an associate professor of medicine at the University of California, San Diego, suggests that one at-risk group may be people with defects in their mitochondria, the structures within cells that make energy. Statins prevent the body from making an antioxidant that neutralizes the damaging free radicals created by mitochondrial activity. If brain cells—which consume lots of energy—already have mitochondrial problems, then statin therapy could tip the scale and cause noticeable symptoms, such as trouble learning.
Golomb’s theory is supported by a 2006 study published by geneticist Georgirene Vladutiu of the University at Buffalo. Vladutiu reported that statin users who experience muscle pain and weakness as a side effect are more likely than other users to have preexisting genetic defects related to cellular energy production. And as with brain cells, muscle cells are high energy users.
Interestingly, some studies suggest that statins might improve memory in certain people by lowering the risk of dementia. This benefit could occur because cholesterol is involved in the production of the protein clusters that are the hallmark of neurodegenerative diseases such as Alzheimer’s and Parkinson’s. But even if statins are neurologically protective for some, they may be problematic for others, given that the opposing effects probably arise through different biochemical pathways.
Because statins differ in their formulations and can affect so many processes, and because users have different genetic predispositions, simply switching drugs might help people who are experiencing warning signs such as forgetting names. A 2009 Pharmacotherapy study published by Golomb and Marcella A. Evans, a graduate student at the University of California, Irvine, analyzed the characteristics of 171 statin users who reported cognitive side effects. Their findings suggest that people who take the more potent statins—Crestor and Lipitor—are at an increased risk compared with people who take weaker statins.
Graveline, for one, is certain that Lipitor was to blame for his 1999 amnesia incident. Although he immediately stopped taking the drug, his doctor—who was skeptical—convinced him a year later to give it another shot. Sure enough, after another eight weeks of treatment, he suffered a second episode. Graveline has been statin-free ever since, instead following a healthy diet to keep his cholesterol low, and he says he has never felt better. But he also knows that for many, the benefits that statins provide will overshadow their risks. “I’m not asking for statins to be taken off the market,” he says. “I’m just asking for physicians to be aware of their side effects.”
This article was originally published with the title It's Not Dementia, It's Your Heart Medication.