A Canadian panel of 10 clinicians, including family physicians, pharmacists, a geriatrician, a cardiologist and a neurologist, with patient representation, developed a GRADE-based guideline on deprescribing statins in adults aged 65 or older. It drew on evidence reviews of benefits and harms of stopping versus continuing, patient preferences, equity and resource use.
The panel suggests deprescribing statins in older adults at the end of life. It suggests continuing statins for both primary and secondary prevention in older adults who are not at the end of life, and offering selected patients a conversation about continuing or stopping. Decisions should consider function, mobility, cognition, frailty, social circumstances, life expectancy, pill burden and the patient's goals.
Statins are among the drugs most often stopped purely because a patient has reached a certain age. This guideline makes clear that age alone is not a reason: outside the end of life, the default is to continue.
The conversation, not the birthday, is the trigger for review.
- Do not stop statins solely because a patient is over 75 or 80.
- Deprescribe statins for patients at the end of life.
- Offer a discussion about stopping to patients with severe frailty, high pill burden or goals focused on comfort.
- Record the patient's preference and review it when health status changes.
Why it matters
It replaces age-based statin withdrawal with a default of continuing, reserving deprescribing for the end of life and shared decisions.
Don't overread it
The recommendations are conditional ('suggests'), reflecting limited trial evidence on stopping statins in older adults.
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