Statin use does not impair muscle health in older adults: findings from the SCOPE study

Background: Statins are used for cardiovascular prevention, but their potential impact on muscle health in adults aged ≥ 75 years remains unclear. Aims: To assess whether statin use is associated with adverse changes in muscle strength, skeletal muscle mass, and physical performance in older adults. Methods: Data were drawn from the SCOPE study including 2,282 participants aged ≥ 75 years with complete baseline data on statin use and muscle outcomes. Muscle strength was assessed via handgrip strength, muscle mass via skeletal muscle index (SMI), and physical performance via the Short Physical Performance Battery (SPPB). Outcomes were measured at baseline and after two years. Associations with statin use were analysed cross-sectionally and longitudinally, stratified by sex, and adjusted for confounders. Results: At baseline, 1,107 participants (48.5%) used statins (median age 79 years). Cross-sectional analyses showed no association between statin use and handgrip strength, SMI, or SPPB scores in either sex. Over two years, there were no significant between-group differences in changes over time in handgrip strength (men: − 3.1 vs. − 2.6 kg, p = 0.8; women: − 1.5 vs. − 2.5 kg, p = 0.6), SMI (men: +1.0 vs. − 0.6 kg/m², p = 0.1; women: +0.4 vs. − 0.1 kg/m², p = 0.4), or risk of SPPB decline (men: OR 1.3, 95% CI 0.9–1.8; women: OR 1.0, 95% CI 0.8–1.4). Discussion: These findings support muscular safety of statins in well-functioning older adults, reducing concerns about potential harm. Conclusions: In this large cohort of adults aged ≥ 75 years, statin use was not associated with adverse changes in muscle strength, muscle mass, or physical performance over two years.