Early statin use linked to 15% lower dementia risk

Starting statin treatment soon after a type 2 diabetes diagnosis was associated with a reduced risk of developing dementia, according to research presented at ESC Congress 2026 and published in The Lancet Regional Health - Europe.

As populations age, the number of people living with dementia is expected to increase substantially. Because there are currently no effective treatments capable of preventing or reversing most forms of dementia, researchers are increasingly focused on identifying factors that could reduce the likelihood of developing the condition.

According to the Lancet Commission, nearly half of dementia cases could theoretically be prevented by addressing 14 modifiable risk factors. One of those factors involves managing cholesterol beginning in midlife.

"Detecting and treating high levels of low-density lipoprotein cholesterol (LDL-C) from midlife is one such highlighted risk factor," explained presenter, Doctor Tummas Ternhamar from Copenhagen University Hospital, Denmark.

This issue may be especially relevant for people with type 2 diabetes. High LDL-C is common among these patients, while diabetes itself is recognized as a risk factor for cognitive decline and dementia.

"We hypothesized that early initiation of LDL-C-lowering statins following type 2 diabetes diagnosis could be associated with a lower risk of dementia," said Doctor Ternhamar. "And we tested this in a large nationwide study using analysis methods to emulate a randomized trial and reduce some of the bias associated with observational studies," he noted.

Tracking More Than 132,000 People

Using Danish national registers, researchers identified 132,585 people who had not previously taken statins and who developed type 2 diabetes between 2006 and 2019. Participants were followed through the end of 2021, and medical records were examined for diagnoses of all-cause dementia.

The researchers used a clone-censor-weight design to compare dementia rates according to when statin therapy began. One group did not start statins within five years of receiving a diabetes diagnosis. A second group began statins early, within one year of diagnosis, while a third began treatment later, between one and five years after diagnosis.

During a median follow-up period of 7.1 years, 2.7% of participants developed dementia.

Earlier Statin Use Linked to Lower Risk

Compared with people who did not begin statin therapy, those who started statins within the first year after being diagnosed with type 2 diabetes had a 15% lower relative risk of dementia over 10 years.

Starting treatment later was also associated with a benefit, although the association was smaller. People who began statins between one and five years after diagnosis had a 10% lower relative risk of dementia over 10 years. Similar results were observed in women and men.

Doctor Ternhamar concluded: "In individuals developing type 2 diabetes, statins were associated with a lower risk of dementia, most pronounced in those with early initiation. Statins seem to be underused in patients with type 2 diabetes, despite their protective effects against cardiovascular disease. Our findings suggest another potentially important reason to ensure that patients with type 2 diabetes and high LDL-C receive timely statin treatment."

Findings Cannot Prove Statins Prevent Dementia

The results suggest that beginning statin therapy sooner after a type 2 diabetes diagnosis may have potential benefits beyond the drugs' established role in protecting cardiovascular health. However, because the research was observational, it cannot establish that taking statins directly prevents dementia.

Commenting on the findings, Professor Isabel Goncalves, Member of the ESC Communication Committee, said: "People with type 2 diabetes already have a higher risk of dementia and are advised to lower cholesterol to reduce their risk of heart attack and stroke. This study suggests that starting statins soon after a type 2 diabetes diagnosis may also be linked to a modest reduction in dementia risk, with greater benefit than delaying treatment. Because statins are widely available and inexpensive, the findings are potentially important. However, this was an observational study, so it cannot prove that statins prevent dementia. The results should therefore support further research and help inform discussions between patients and clinicians."

This work was supported by grants from the Danish Cardiovascular Academy, which is funded by the Novo Nordisk Foundation and The Danish Heart Foundation, Herlev and Gentofte Hospital, Snedkermester Sophus Jacobsen og hustru Astrid Jacobsens Fond, Beckett fonden, Overlæge Johan Boserup og Lise Boserups legat and Direktør Jakob Madsens og Hustru Olga Madsens fond.