Purpose of Review <p>This review will evaluate current data on broadly used lipid lowering agents in relation to cognition in older adults and highlight key findings and research gaps to guide clinical practice and future guidelines.</p> Recent Findings <p>Evidence from observational studies and randomized controlled trials indicate no significant association between statin use and cognitive decline, with some data suggesting potential protective effects. While there is insufficient data on inclisaran’s effect on cognition, monoclonal antibodies PCSK9 inhibitors, ezetimibe and bempedoic acid appear neurocognitively safe.</p> Summary <p> Current literature does not conclusively elucidate the association between lipid-lowering therapies and cognitive outcomes in older adults, though existing data, particularly for statins, largely suggest neutral or potentially protective effects. Clinicians should continue prescribing LLT to eligible patients, and future research should prioritize long-term studies that incorporate cognitive outcomes in a diverse group of older adults to guide individualized care.</p>