AHA Scientific Sessions 2026 Abstract · Nov 2, 2026
Comparative Dementia Outcomes of Rosuvastatin and Atorvastatin in Adults with Type 2 Diabetes
By Khurana S, Al-Nusair M, Al-Nusair J
Background: Adults with type 2 diabetes (T2D) are at increased risk of cognitive decline and dementia. Statins are recommended for cardiovascular risk reduction in patients with T2D and have been associated with potential neuroprotective effects. However, whether dementia risk differs between individual statins remains incompletely characterized. We compared dementia outcomes among adults with T2D receiving rosuvastatin or atorvastatin. Methods: Using the TriNetX Research Network, we identified adults aged ≥40 years with T2D who received rosuvastatin or atorvastatin between January 1, 2020 and April 12, 2026. Patients were stratified by statin exposure and propensity score matched 1:1 for demographics, comorbidities, medications, laboratory values, body mass index, and blood pressure. The primary outcome was incident dementia. Secondary outcomes included Alzheimer dementia and vascular dementia. Time-to-event analyses were performed and hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated. Results: After propensity score matching, 304,845 patients were included in each cohort. Compared with atorvastatin users, rosuvastatin users had a lower incidence of dementia (1.6% vs 2.2%; ARD -0.65%, 95% CI -0.72 to -0.58; HR 0.77, 95% CI 0.74-0.80). Rosuvastatin use was also associated with lower risks of Alzheimer dementia (0.5% vs 0.6%; ARD -0.18%, 95% CI -0.22 to -0.15; HR 0.78, 95% CI 0.72-0.83) and vascular dementia (0.4% vs 0.6%; ARD -0.20%, 95% CI -0.23 to -0.16; HR 0.70, 95% CI 0.65-0.76). See table. Conclusions: Among adults with T2D, rosuvastatin use was associated with significantly lower risks of incident dementia including Alzheimer dementia, and vascular dementia compared with atorvastatin. These findings suggest potential differences in neurocognitive outcomes among commonly prescribed statins and warrant confirmation in prospective observational studies and randomized clinical trials.