The CV event rates in elderly subjects are proportionately higher than for younger subjects in primary and secondary prevention studies emphasizing increased absolute risk.

Multimorbidity, frailty, dementia and polypharmacy can affect the efficacy, safety and compliance with statin therapy among elderly patients. The decision to use statins for primary CV prevention in very old patients remains unclear, and a decision must be made on a case-to-case basis.

For secondary prevention, statin therapy is generally recommended except for those with severely impaired health, extreme frailty or a short life expectancy.