Due to the financial burden, RCTs of longer duration probably are not feasible. Therefore, long-term observational studies are necessary to evaluate whether longterm Pazopanib statin use prevents cognitive decline. However, confounding by indication can be an important limitation of observational studies as, generally, statin users have a different cardiovascular risk profile than non-users, and this type of bias needs to be addressed. The aim of this observational study was to evaluate the association between statin use and cognitive function in a large community-based population aged 35– 82 years with.10 year follow-up data on statin use, and to study whether duration of treatment influences this association. All participants underwent a detailed assessment of cardiovascular risk factors that was used to adjust for confounding by indication. In this large cross-sectional study, statin use was not associated with cognitive function. This was not only found in persons with low cardiovascular risk but also in persons with high cardiovascular risk, and in younger as well as older subjects. Even statin users who used high doses of statins or used statins for more than 8 years had a similar cognitive performance as non-users. Thus, it is unlikely that the lack of effect in previous RCTs was due to the relatively short treatment period. So far, the underlying mechanisms by which statins might affect cognitive function are not unraveled. Studies on lipid profile and cognitive function yield contradictory results. When measured in midlife, high cholesterol levels associate with an increased risk of late-life dementia and cognitive decline. However, late-life elevated cholesterol levels are not related to cognitive function, or inversely related. Similarly, studies on statin use and cognitive function also showed diverting results. Several observational studies demonstrated that statin users had less cognitive decline or lower risk of developing dementia, while others found no differences. Moreover, in some positive studies, the effect of statin use was inconsistent for different statins as well as for different outcome measures. These contradictory results have been attributed to various limitations of the studies such as highly selected study samples, varying statin types, short treatment durations or other possible confounders. Although many of these limitations were overcome in our study, we still did not find a beneficial effect of statins of cognitive function. Despite plausible neuroprotective benefits of statins through improved cholesterol metabolism, stroke reduction and pleiotropic effects evidence for sustained cognitive benefit is restricted. In general, neurodegenerative pathologies probably have multifactorial determinants which separately add to cognitive impairment. It could be hypothesized that among these multifactorial determinants, the effect of statins may be too small to make a difference in cognitive function. Some limitations of this study must be acknowledged.