The PREVENTABLE trial aims to find out if a drug called atorvastatin (brand name Lipitor) can help older adults 75 years or older live well for longer by preventing dementia, disability, or heart disease. Research participants can be included if they do not have dementia, significant disability that limits their basic everyday activities, or heart disease. Participation in the study may last up to five year. You will be assigned by chance to receive either atorvastatin (study drug) or a matching placebo (a tablet that looks like atorvastatin but does not contain any medicine). At your study visit, the study team will also ask a few questions, draw blood, and perform memory, and physical tests. For most of the study duration, the study team will call you on a yearly basis to see how you are doing.

Inclusion Criteria

• Community-dwelling adults
• Age ≥75 years
• English or Spanish as primary language

Exclusion Criteria

• Clinically evident cardiovascular disease defined as prior myocardial Infarction (MI), prior stroke, prior revascularization procedure, or a secondary prevention indication for a statin (clinician determined)
• Hospitalization for a primary diagnosis of heart failure in the prior 12 months
• Dementia (clinically evident or previously diagnosed)
• Dependence in any Katz Basic Activities of Daily Living [ADL]
• Severe hearing impairment (preventing phone follow up)
• Severe visual impairment (preventing cognitive testing)
• Statin use in the past year or for longer than 5 years previously
• Ineligible to take atorvastatin 40 mg
• Documented intolerance to statins
• Active Liver Disease
• Long-term use of daily colchicine, verapamil at any dose, or diltiazem at a dose >240mg/day.