Objective To investigate the efficacy of different dosages of atrovastatin calcium on very elderly sarcopenia patients with moderate to severe frailty. Methods Ninety-eight very elderly patients with moderate to severe frailty admitted to our Department of Rehabilitation Medicine from April 2016 to April 2018 were recruited in this study. They were randomly divided into 3 groups, taking 20 mg group (n=34), taking 10 mg group (n=33) and drug withdrawl group (n=31). The levels of triglycerides (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) in the peripheral blood, grip strength, 4.5-meter walking time, appendicular skeletal muscle mass index (ASMI), and frailty levels were detected and measured before and after treatment. SPSS statistics 19.0 was used to perform the statistical analysis. Student′s t test, analysis of variance, or Chi-square test was employed for intergroup comparison on different data types. Results After 24 months of treatment, the patients from the 20 mg group had significantly lower TC [(3.84±0.96) vs (4.36±0.95)mmol/L] and LDL-C levels [(2.48±1.33) vs (3.19±1.30)mmol/L], decreased grip strength [(15.77±3.71) vs (18.58±3.43)kg] and ASMI [(13.90±2.33) vs (15.27±3.16)kg/m²] than those from the drug withdrawl group, and the levels of TC and LDL-C were still lower when compared with those of the 10 mg group [(4.26±1.03), (3.47±1.41)mmol/L, all P<0.05]. The grip strength was significantly lower in the 10 mg group than the drug withdrawal group [(15.31±4.71) vs (18.58±3.43)kg, P<0.05]. Moreover, the incidence of frailty level increasing by at least 1 level was 35.3%(12/34) in the 20 mg group, 18.2% (6/33) in the 10 mg group, and 9.7% (3/31) in the withdraw group (P=0.036). Conclusion Statins may further exacerbate age-related declines in muscle function and accelerate frailty.