Early initiation of statins after diagnosis of type 2 diabetes was associated with a lower risk of dementia, according to a study presented at the ESC Congress 2026 and published in The Lancet Regional Health – Europe.
The burden of dementia is projected to rise with the ageing population. With no effective treatments, prevention is an urgent priority. According to the Lancet Commission, nearly half of cases of dementia could be theoretically prevented by eliminating 14 risk factors.
“Detecting and treating high levels of low-density lipoprotein cholesterol (LDL-C) from midlife is one such highlighted risk factor,” explained presenter, Dr Tummas Ternhamar from Copenhagen University Hospital, Denmark. He noted that this could be particularly important in patients with type 2 diabetes since elevated LDL-C occurs frequently in these individuals and diabetes is a highlighted risk factor for cognitive decline and dementia.
“We hypothesised that early initiation of LDL-C-lowering statins following type 2 diabetes diagnosis could be associated with a lower risk of dementia,” said Dr Ternhamar.
“And we tested this in a large nationwide study using analysis methods to emulate a randomised trial and reduce some of the bias associated with observational studies,” he explained.
From Danish registers, 132,585 statin-naïve individuals were identified who developed type 2 diabetes from 2006 through to 2019, with follow-up until the end of 2021. Medical records were searched for diagnoses of all-cause dementia. A clone-censor-weight design was used to analyse dementia incidence in patients with no statin initiated within five years after diagnosis, in those with early statin initiation within one year, and in those with late statin initiation between one and five years after diagnosis.
During a median follow-up of 7.1 years, 2.7 per cent of patients developed dementia. Compared with no statin initiation, early statin treatment was associated with a 15 per cent lower relative risk of dementia over 10 years. Late statin initiation was associated with a 10 per cent lower relative risk of dementia over 10 years. The results were similar in women and men.
Dr 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.”
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
Commenting on the findings, Prof 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.”
Meanwhile, a separate study presented at ESC Congress 2026 found that an intensive blood-pressure lowering intervention (anti-hypertensives) reduced the incidence of dementia compared with usual care. This was according to results from the China Rural Hypertension Control Programme. The findings support the long-term sustainability of integrating structured blood pressure management into routine primary care for dementia prevention at the population level, the authors said.
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