Authors: Turner JP et al., J Am Geriatr Soc 2014 Oct 62:1900
In patients older than 80, statin use was associated with higher odds of general pain.
Determining whether statins are responsible for nonspecific aches and pains can be difficult, especially in elders. Australian researchers explored this association in a cohort of 385 older cancer patients (age, greater than 70) who were referred to a geriatric oncology outpatient unit. Half the patients were referred for palliative care, 36% were taking statins, and half the statin use was for primary prevention.
Self-reported general pain was assessed on a 10-point visual analog scale. In the oldest patients (age, greater than 80), having a pain score greater than 5 was associated significantly with statin use (odds ratio, 4.1), after adjustment for variables including age, comorbidities, and analgesic use. In the younger group (age range, 70–79), no significant association was observed.
Two points emerge from this study. First, many older cancer patients were receiving statins — often for primary prevention. This observation suggests therapeutic inertia, in which clinicians fail to stop unnecessary medications; indeed, it’s not clear that statins should be prescribed for primary prevention even in 80-year-old patients without cancer. Second, although this study doesn’t prove causality, it supports the clinical impression of many clinicians that older patients are especially prone to musculoskeletal side effects of statins.