Drugs & Aging

, Volume 35, Issue 8, pp 679–686 | Cite as

How Common is Statin Use in the Oldest Old?

  • Wade ThompsonEmail author
  • Anton Pottegård
  • Jesper Bo Nielsen
  • Peter Haastrup
  • Dorte Ejg Jarbøl
Current Opinion


There is a lack of evidence surrounding the efficacy of statins in the oldest old (≥ 80 years of age). As such, there is controversy surrounding use of statins in this population. We sought to evaluate the prevalence of statin use in the oldest old worldwide to understand the scope of this issue. We searched PubMed and grey literature over the last 5 years. Studies had to report the prevalence of statin use in adults ≥ 80 years of age. The first author performed screening and extracted data. Our search produced 1870 hits; 14 articles were considered eligible. We found three studies of nursing home residents, eight studies of community-dwelling patients and three studies in the combined population (i.e., both community-dwelling patients and nursing home residents). The prevalence of statin use ranged from 17 to 39% in nursing home residents, 12 to 59% for community-dwelling patients and 18 to 45% in combined populations. Beyond age 80 years, the prevalence of statin use appeared to decrease with advancing age. Statin use was more common as secondary prevention compared with primary prevention. The prevalence of statin use in the oldest old has increased over recent decades. The increase in prevalence appears to be more pronounced in the oldest old compared with younger old, as reported by two studies. Statins are widely used in the oldest old despite the lack of evidence in this population. Given how common statin use is in the oldest old, clinical evidence surrounding their efficacy in this group is urgently needed to guide appropriate use and shared decision-making.


Author Contributions

WT conceived the article, performed the search, interpreted data, drafted and revised the manuscript. AP, JBN, PH, and DEJ interpreted data, drafted the article, and provided critical revisions. All authors gave final approval for publication and are accountable for all aspects of the work.

Compliance with Ethical Standards


No external funds were used in the preparation of this manuscript.

Conflict of interest

Wade Thompson, Anton Pottegård, Jesper Bo Nielsen, Peter Haastrup, and Dorte Ejg Jarbøl declare no potential conflicts of interest that might be relevant to the contents of this manuscript.

Supplementary material

40266_2018_567_MOESM1_ESM.pdf (313 kb)
Supplementary material 1 (PDF 312 kb)


  1. 1.
    Naci H, Brugts JJ, Fleurence R, Tsoi B, Toor H, Ades A. Comparative benefits of statins in the primary and secondary prevention of major coronary events and all-cause mortality: a network meta-analysis of placebo-controlled and active-comparator trials. Eur J Prev Cardiol. 2013;20(4):641–57. Scholar
  2. 2.
    Afilalo J, Duque G, Steele R, Jukema JW, de Craen AJM, Eisenberg MJ. Statins for secondary prevention in elderly patients. J Am Coll Cardiol. 2008;51(1):37–45. Scholar
  3. 3.
    Savarese G, Gotto AM, Paolillo S, et al. Benefits of statins in elderly subjects without established cardiovascular disease: a meta-analysis. J Am Coll Cardiol. 2013;62(22):2090–9. Scholar
  4. 4.
    Chou R, Dana T, Blazina I, Daeges M, Jeanne TL. Statins for prevention of cardiovascular disease in adults: evidence report and systematic review for the US preventive services task force. JAMA. 2016;316(19):2008–24. Scholar
  5. 5.
    Strandberg TE, Kolehmainen L, Vuorio A. Evaluation and treatment of older patients with hypercholesterolemia. JAMA. 2014;312(11):1136. Scholar
  6. 6.
    Petersen LK, Christensen K, Kragstrup J. Lipid-lowering treatment to the end? A review of observational studies and RCTs on cholesterol and mortality in 80+-year olds. Age Ageing. 2010;39(6):674–80. Scholar
  7. 7.
    Shepherd J, Blauw GJ, Murphy MB, et al. Pravastatin in elderly individuals at risk of vascular disease (PROSPER): a randomised controlled trial. Lancet. 2002;360(9346):1623–30. Scholar
  8. 8.
    Han BH, Sutin D, Williamson JD, et al. Effect of statin treatment vs usual care on primary cardiovascular prevention among older adults: the ALLHAT-LLT randomized clinical trial. JAMA Intern Med. 2017;177(7):955–65. Scholar
  9. 9.
    Huesch MD. Association of baseline statin use among older adults without clinical cardiovascular disease in the SPRINT trial. JAMA Intern Med. 2018. Scholar
  10. 10.
    Kjekshus J, Apetrei E, Barrios V, et al. Rosuvastatin in older patients with systolic heart failure. N Engl J Med. 2007;357(22):2248–61. Scholar
  11. 11.
    Krumholz HM. Statins evidence: when answers also raise questions. BMJ. 2016;354:i4963. Scholar
  12. 12.
    Noaman S, Ibrahim JE, Grenfell R. Prescribing statins for cardiovascular disease prevention in the old: an absence of evidence and an absence of guidelines. Heart Lung Circ. 2014;23(7):619–24. Scholar
  13. 13.
    Campitelli MA, Maxwell CJ, Giannakeas V, et al. The variation of statin use among nursing home residents and physicians: a cross-sectional analysis. J Am Geriatr Soc. 2017;65(9):2044–51. Scholar
  14. 14.
    Gnjidic D, Wilson N, March L, Cumming RG, Cameron ID, Hilmer SN. Statin utilisation patterns in older Australians living in residential care: 1-year prevalence study. Intern Med J. 2015;45(1):106–9. Scholar
  15. 15.
    Chokshi NP, Messerli FH, Sutin D, Supariwala AA, Shah NR. Appropriateness of statins in patients aged ≥ 80 years and comparison to other age groups. Am J Cardiol. 2012;110(10):1477–81. Scholar
  16. 16.
    Johansen M. Statin use in very elderly individuals, 1999–2012. JAMA Intern Med. 2015;7(October):25–6. Scholar
  17. 17.
    Taipale H, Koponen M, Tanskanen A, Tolppanen A-M, Tiihonen J, Hartikainen S. Drug use in persons with and without Alzheimer’s disease aged 90 years or more. Age Ageing. 2016;45(6):900–4. Scholar
  18. 18.
    Upmeier E, Korhonen MJ, Helin-Salmivaara A, Huupponen R. Statin use among older Finns stratified according to cardiovascular risk. Eur J Clin Pharmacol. 2013;69(2):261–7. Scholar
  19. 19.
    Turner JP, Shakib S, Singhal N, et al. Statin use and pain in older people with cancer: a cross-sectional study. J Am Geriatr Soc. 2014;62(10):1900–5. Scholar
  20. 20.
    Gulliford M, Ravindrarajah R, Hamada S, Jackson S, Charlton J. Inception and deprescribing of statins in people aged over 80 years: cohort study. Age Ageing. 2017;46(6):1001–5. Scholar
  21. 21.
    Jacobs JM, Cohen A, Ein-Mor E, Stessman J. Cholesterol, statins, and longevity from age 70 to 90 years. J Am Med Dir Assoc. 2013;14(12):883–8. Scholar
  22. 22.
    Proulx J, Hunt J. Drug use among seniors on public drug programs in Canada, 2012. Healthc Q. 2015;18(1):11–3.CrossRefPubMedGoogle Scholar
  23. 23.
    Wallach-Kildemoes H, Stovring H, Holme Hansen E, Howse K, Pétursson H. Statin prescribing according to gender, age and indication: what about the benefit-risk balance? J Eval Clin Pract. 2016;22(2):235–46. Scholar
  24. 24.
    Tija J, Cutrona S, Peterson D, Reed G, Andrade S, Mitchell S. Statin discontinuation among nursing home residents with advanced dementia. J Am Geriatr Soc. 2014;62(11):2095–101. Scholar
  25. 25.
    Chee WJ, Abdullahi H, Chan Y, Rattle A, Snedden S, Junckerstorff R. Retrospective evaluation of statin prescription in the elderly. Intern Med J. 2018. Scholar
  26. 26.
    Noaman S, Al-Mukhtar O, Abramovic S, et al. Changes in statin prescription patterns in patients admitted to an Australian geriatric subacute unit. Heart Lung Circ. 2018. Scholar
  27. 27.
    Strandberg TE, Urtamo A, Kähärä J, Strandberg AY, Pitkälä KH, Kautiainen H. Statin treatment is associated with a neutral effect on health-related quality of life among community-dwelling octogenarian men. J Gerontol A Biol Sci Med Sci. 2018. Scholar
  28. 28.
    Todd A, Husband A, Andrew I, Pearson SA, Lindsey L, Holmes H. Inappropriate prescribing of preventative medication in patients with life-limiting illness: a systematic review. BMJ Support Palliat Care. 2017;7(2):113–21. Scholar
  29. 29.
    Tibrewala A, Jivan A, Oetgen WJ, Stone NJ. A comparative analysis of current lipid treatment guidelines: nothing stands still. J Am Coll Cardiol. 2018;71(7):794–9. Scholar
  30. 30.
    Stone NJ, Robinson JG, Lichtenstein AH, et al. 2013 ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults. Circulation. 2014;129(25 suppl 2):S1–45. Scholar
  31. 31.
    Redberg RF, Katz MH. Statins for primary prevention: the debate is intense, but the data are weak. JAMA. 2016;316(19):1979–81. Scholar
  32. 32.
    Sanchis-Gomar F, Perez-Quilis C, Leischik R, Lucia A. Epidemiology of coronary heart disease and acute coronary syndrome. Ann Transl Med. 2016;4(13):256. Scholar
  33. 33.
    Korhonen MJ, Ilomäki J, Sluggett JK, et al. Selective prescribing of statins and the risk of mortality, hospitalizations, and falls in aged care services. J Clin Lipidol. 2018. Scholar
  34. 34.
    Clegg A, Bates C, Young J, et al. Development and validation of an electronic frailty index using routine primary care electronic health record data. Age Ageing. 2016;45(3):353–60. Scholar
  35. 35.
    Kaehr E, Visvanathan R, Malmstrom TK, Morley JE. Frailty in nursing homes: the FRAIL-NH scale. J Am Med Dir Assoc. 2015;16(2):87–9. Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Research Unit of General Practice, Department of Public HealthUniversity of Southern DenmarkOdense CDenmark
  2. 2.Research Unit of Clinical Pharmacology and Pharmacy, Department of Public HealthUniversity of Southern DenmarkOdenseDenmark

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