This supplement was written by William T. Elliott, MD, FACP, Chair, Formulary Committee, Kaiser Permanente, California Division; Assistant Clinical Professor of Medicine, University of California-San Francisco. In order to reveal any potential bias in this publication, we disclose that Dr. Elliott reports no consultant, stockholder, speaker’s bureau, research, or other financial relationships with companies having ties to this field of study. Questions and comments, call: (404) 262-5404. E-mail:


In 2012, the FDA expanded warnings on statins to include cognitive impairment, such as memory loss, forgetfulness, and confusion, based on adverse event reports from some statin users. There have been few data to confirm cognitive changes or other neurologic side effects associated with these drugs other than case reports. But still, many media outlets have reported that this warning is evidence of increased risk for Alzheimer’s disease and other brain disorders. To the contrary, in last year’s warning, the FDA specifically stated that memory changes are reversible when the medication is stopped. Other studies have suggested that highly lipophilic statins such as simvastatin, which crosses the blood-brain barrier easily, may in fact protect against d