Statin use in people over 65 years of age is high. A meta-analysis of older patients included in randomised trials found good evidence that statins reduce vascular events and mortality in people with existing coronary heart disease. In older adults, exposure to higher doses of statins or higher potency statins does not increase their effectiveness, but does increase the risk of adverse effects such as myopathy and cognitive impairment. Increasing age is a risk factor for adverse events with statins. Older patients may be less resilient to these effects. Older patients may have more comorbidities and be taking more concomitant drugs than the study populations in statin trials. Applying the evidence for statins to older individuals therefore requires frequent review and consideration of the therapeutic goals and potential benefits and harms.