In the Journals

Statins may partially abate risk for dementia in concussed patients

Older adults who had a concussion, and also received statins, had a slightly reduced risk for developing dementia later in life, according to findings recently published in JAMA Neurology.

“The role of statins in recovery after a concussion has rarely been investigated. ... On the one hand, the potential neuroprotective associations of statin use may prevent subsequent dysfunction by neuron preservation and neural stem cell activation. On the other hand, the neurohazardous associations of statin use might contribute to memory difficulties from altered neurophysiology,” Donald A. Redelmeier, MD, MSHSR of the department of medicine at the University of Toronto, and colleagues wrote.

Researchers also noted how short follow-up periods, small sample sizes and selective enrollment restrict the soundness of past studies exploring this connection.

Redelmeier and colleagues analyzed records of 28,815 patients diagnosed with a concussion during a 20-year period (median age, 76 years; 61.3% women) and of whom 7,058 received a statin 90 days after the concussion. Hospitalized patients, or those with a previous diagnosis of dementia or delirium, and/or died within 90 days of their concussion were not included.

They found that 4,727 patients subsequently developed dementia during a mean follow-up of 3.9 years, corresponding to one case of dementia for every six patients. Those who received a statin had a 13% reduced risk for dementia vs. those who did not receive a statin (RR = 0.87; 95% CI, 0.81-0.93). The same lower risk for dementia was also observed in “diverse patient groups, remained independent of other cardiovascular medication use, intensified over time, was distinct from the risk of subsequent depression, and was not observed in patients after an ankle sprain,” Redelmeier and colleagues wrote.

“The findings of our study suggest a potential long-term protective association between statin use and the risk of dementia after a concussion that justifies future research. The study also provides estimates of event rates, time profiles, effect sizes and baseline frequencies needed for planning future trials,” they added.

Older adult looking confused 
Older adults who had a concussion, and also received statins, had a slightly reduced risk for developing dementia later in life, according to findings recently published in JAMA Neurology.
Source:Adobe

Rachel A. Whitmer, PhD, of the division of epidemiology at the University of California at Davis, discussed the “rigorous approach” and take-home message of Redelmeier and colleagues’ study in a related editorial. She also made suggestions for future research that builds on their findings.

“Trials of medications to treat concussion with a longstanding safety history that are commonly used to treat other chronic conditions, such as hyperlipidemia or hypertension, are greatly needed,” Whitmer wrote.

“While this study cannot infer causality, it is a first step in accumulating evidence for possible future therapeutic interventions post-[traumatic brain injury] and a call for further pharmacoepidemiologic harnessing of integrated health care systems to discover other potential protective or risk factors for dementia after brain injury,” she concluded. – by Janel Miller

Disclosures: The authors report no relevant financial disclosures.

 

Older adults who had a concussion, and also received statins, had a slightly reduced risk for developing dementia later in life, according to findings recently published in JAMA Neurology.

“The role of statins in recovery after a concussion has rarely been investigated. ... On the one hand, the potential neuroprotective associations of statin use may prevent subsequent dysfunction by neuron preservation and neural stem cell activation. On the other hand, the neurohazardous associations of statin use might contribute to memory difficulties from altered neurophysiology,” Donald A. Redelmeier, MD, MSHSR of the department of medicine at the University of Toronto, and colleagues wrote.

Researchers also noted how short follow-up periods, small sample sizes and selective enrollment restrict the soundness of past studies exploring this connection.

Redelmeier and colleagues analyzed records of 28,815 patients diagnosed with a concussion during a 20-year period (median age, 76 years; 61.3% women) and of whom 7,058 received a statin 90 days after the concussion. Hospitalized patients, or those with a previous diagnosis of dementia or delirium, and/or died within 90 days of their concussion were not included.

They found that 4,727 patients subsequently developed dementia during a mean follow-up of 3.9 years, corresponding to one case of dementia for every six patients. Those who received a statin had a 13% reduced risk for dementia vs. those who did not receive a statin (RR = 0.87; 95% CI, 0.81-0.93). The same lower risk for dementia was also observed in “diverse patient groups, remained independent of other cardiovascular medication use, intensified over time, was distinct from the risk of subsequent depression, and was not observed in patients after an ankle sprain,” Redelmeier and colleagues wrote.

“The findings of our study suggest a potential long-term protective association between statin use and the risk of dementia after a concussion that justifies future research. The study also provides estimates of event rates, time profiles, effect sizes and baseline frequencies needed for planning future trials,” they added.

Older adult looking confused 
Older adults who had a concussion, and also received statins, had a slightly reduced risk for developing dementia later in life, according to findings recently published in JAMA Neurology.
Source:Adobe

Rachel A. Whitmer, PhD, of the division of epidemiology at the University of California at Davis, discussed the “rigorous approach” and take-home message of Redelmeier and colleagues’ study in a related editorial. She also made suggestions for future research that builds on their findings.

“Trials of medications to treat concussion with a longstanding safety history that are commonly used to treat other chronic conditions, such as hyperlipidemia or hypertension, are greatly needed,” Whitmer wrote.

“While this study cannot infer causality, it is a first step in accumulating evidence for possible future therapeutic interventions post-[traumatic brain injury] and a call for further pharmacoepidemiologic harnessing of integrated health care systems to discover other potential protective or risk factors for dementia after brain injury,” she concluded. – by Janel Miller

Disclosures: The authors report no relevant financial disclosures.