Statin therapy and physical performance in older hospitalized adults

Background The major reason for statin therapy discontinuation and increased cardiovascular disease (CVD) risk are statin-associated muscle symptoms (SAMS) defined as all muscle-related complaints such as muscle pain and strength or function decline. The reduced muscle strength leading to reduced physical activity is one of the most frequent complaints reported by older patients. Purpose The aim of the study was to assess the relation between the statin therapy and physical performance in a older hospitalized patients. Methods The study was conducted from June 2022 to March 2025 and included consecutive, patients over 65 years, hospitalized in a department of internal medicine and geriatric cardiology. Patients with severe functional decline, who could not perform any physical performance test, were excluded from the study. Patients taking a statin within a month preceding the hospitalization were considered as taking statins. The research questionnaires included medical data, frailty was assessed according to L. Fried phenotype criteria, and physical performance tests were proceeded including the muscle grip strength measured with a dynamometer, measured in kilograms, the Back Scratch Test (BST), measured in centimetres, the Timed Up and Go Test (TUGT), measured in seconds and the five Times Sit to Stand Test (5xSST), measured in seconds. The physical performance of the study participants was assessed when health status was optimized, one day before discharge. Results The study group consisted of 219 participants, 141 (64%) women, including 106 individuals taking a statin and 113 individuals not taking any statin (median age: 82 [76-85] years vs. 83 [78-87] years, p=0.07; women: 61.3% vs. 69.0%, p=0.23). Altogether, 58 patients (54.7%) were taking atorvastatin (median dose 20 [10-20]), 43 (40.6%) rosuvastatin (median dose 10 [10-20]) and 5 patients (4.7%) simvastatin (median dose 10 [10-20]). Patients with statin had higher muscle grip strength than those without statin (20.7 [15.47-26.75] kg vs 17.58 [12.77-25.07] kg, p=0.049), no differences between groups in BST, lower limb function or frailty were found (Table1). In univariable regression analysis the 5xSST was associated with statin therapy (β Coefficient -0.19 [95% CI -0.37 - -0.01]), such association was not found for muscle grip strength, BST and TUGT, while any short physical performance test wasn’t significantly related to statins use when adjusted for age, sex, NYHA class, frailty syndrome coronary artery disease and diabetes mellitus (Table 2). Conclusion In conclusion, statin therapy is not independently related to physical performance decline, neither to the muscle strength nor to the muscle function in the older hospitalized patients.For image description, please refer to the figure legend and surrounding text. For image description, please refer to the figure legend and surrounding text.