This is an elegant epidemiologic analysis that addresses the ongoing concern that statins could potentially contribute to memory loss. Our view is that the conclusions of this provocative study are reassuring, consistent with those of other recent high-quality studies. The results show nothing special about statins, but rather that all lipid-lowering drugs are potentially associated with acute small amounts of memory loss in a small segment of adults. We agree with the authors’ view that the association is best explained by a “detection bias.” Patients who take statins or other lipid-lowering drugs may have more medical contact than others, giving more opportunities to report memory complaints, which can create a signal between lipid-lowering medications and memory even without a causal connection.

Therefore, when clinicians see patients with memory complaints on statin therapy, it is prudent to cast a wide net in line with the advice of the 2013 ACC/AHA guidelines: “evaluate the patient for nonstatin causes, such as exposure to other drugs, as well as for systemic and neuropsychiatric causes, in addition to the possibility of adverse effects associated with statin drug therapy.”

This retrospective study looked at new statin users in comparison with non-users and with users of non-statin lipid-lowering medications. These data from 1987 to 2013 were based on a database gathered by clinicians in the United Kingdom. It appears that patients on lipid-lowering drugs see their doctors more often and may thus report mild memory issues more often. Our group previously published a meta-analysis in theMayo Clinic Proceedings that statins tend to have a modest protective view against long-term memory problems.