Effect of Statin on All-Cause Mortality in the Older Adults: A Population-based Cohort Study

Background:The evidence on the effect of statin on the mortality of older adults with and without diabetes remains controversial.This study analysed the mortality risk according to statin and diabetes mellitus (DM) status in elderly Korean subjects.Methods: From 2009 through 2013, we enrolled subjects from the National Health Insurance Service-Senior Cohort (NHIS-SC).Participants aged 67 years without a previous diagnosis of cardio-cerebrovascular disease and cancer were included.All-cause mortality was analysed until 5 years of follow-up according to statin use and diabetes status.Results: The risk of death from any causes were 0.021, 0.039, 0.075, and 0.096 events per 1,000 person-years for the statin users of non-DM, statin users of DM, statin non-users of non-DM and statin non-users of DM groups, respectively.The hazard ratio (HR) of any cause of death (non-DM: HR, 3.53; 95% confidence interval [CI], 3.09-4.0and DM: HR, 2.51; 95%CI, 2.20-2.87)was increased in statin non-users compared with statin users in both the DM and non-DM groups.The results were consistent after the adjustment of confounding factors. Conclusion:In elderly Koreans, a higher all-cause mortality rate was observed in the nonstatin user group regardless of DM.Therefore, when treating the elderly in clinical practice, clinicians should actively consider statin therapy for the elderly to reduce mortality.