By simply putting two and two together, this statement from here and this earlier research, your doctor should come to the conclusion that statins should be immediately prescribed post stroke. Statins have known effects as antioxidants and may preserve brain microcirculation and modify neuroinflammation.
Statins:
tested in rats from 2003
http://oc1dean.blogspot.com/2011/09/statins-induce-angiogenesis.html
tested in humans, March, 2011
http://www.medwirenews.com/39/91658/Stroke/Acute_statin_therapy_improves_survival_after_ischemic_stroke.html This is not available any longer, not even in the wayback machine.
But I know nothing, I'm not medically trained. You'll just have to let your neurons die by your doctors inaction.
Concussion and Dementia: Do Statins Help?
Cohort study follows older adults with concussions for 4 years
Older adults taking a statin within 90 days of a concussion had a 13% reduced risk of dementia over about 4 years compared with those not taking a statin, reported Donald Redelmeier, MD, of Sunnybrook Health Sciences Center in Toronto, and co-authors in JAMA Neurology.
Moreover, people over age 65 who had a concussion had a 100% relative risk of dementia: "On average, a concussion doubled a person's risk of subsequent dementia," Redelmeier told MedPage Today. "That was particularly true if you had a lot of risk factors."
Although many people in the study used other drugs, "none of those medications made any difference -- they didn't make things better, they didn't make things worse -- with one exception: being on a statin at the time of the concussion led to about a 10% to 15% reduction in the long-term risk of subsequent dementia," Redelmeier said. "This was distinct to statins; it was not found with any other lipid-lowering medication or any other cardiovascular medication."
Traumatic brain injuries (TBI) among military veterans and professional athletes have garnered much attention, but little is known about the relationship between concussion and dementia in other populations, he noted. "To do this type of research, you really need to identify thousands and thousands of patients and follow them up for years and years before you can find out anything, simply because the onset of dementia has such a time lag," he said in a JAMA Neurology podcast interview.
"Furthermore, you have to do all that fighting against the standard stereotypes that are propagated in the popular media -- such as James Bond, who gets knocked out in one scene and is cracking jokes in the next scene, as if to imply these injuries to the brain have no lasting damage at all," he added.
Statins have known effects as antioxidants and may preserve brain microcirculation and modify neuroinflammation, he noted. Smaller studies have shown a weak signal supporting a neuroprotective benefit of statins in concussion: "Of four randomized trials, two showed a positive benefit, two showed no significant difference, and none showed a detrimental problem," he said. Of 11 observational studies, five showed a positive benefit on neurocognitive outcomes and six showed a negligible association.
In this study, Redelmeier and colleagues identified 28,815 people ages 66 and older from the Ontario Health Insurance Plan who had been diagnosed with a concussion from April 1993 through April 2013. They excluded people with a prior diagnosis of dementia or delirium, as well as people admitted to the hospital within 2 days of concussion or who died within 90 days. They obtained prescription information from the Ontario Drug Benefit Program database.
In total, 61.3% of the sample was female and the median age in the study was 76. About a quarter (7,058 people or 24.5%) had received a statin within 90 days of the concussion and 75.5% did not.
Over a mean follow-up of 3.9 years, 4,727 people developed dementia. People who received a statin had a 13% reduced risk of dementia compared with people who did not receive a statin (RR 0.87, 95% CI 0.81-0.93; P<0.001). After adjusting for baseline characteristics, statin use was tied to a 16% (95% CI 10%-22%; P<0.001) drop in the risk of overall dementia.
This decreased dementia risk was independent of other cardiovascular medications. Higher statin doses were not more beneficial. Low dementia risk was greatest among people taking rosuvastatin (Crestor).
In this study, people with concussions who received statins had an annual incidence of 37 cases of dementia per 1,000 versus 43 cases per 1,000 in the no-statin group. By contrast, the annual incidence of dementia in Ontario was 19 cases per 1,000 adults ages 65 and older in the general population, Redelmeier and colleagues noted.
The researchers tested similar models in older adults in the Ontario Health Insurance Plan who had been diagnosed with an ankle sprain instead of concussion; the link between statin use and reduced dementia was not seen. In another analysis, they looked at depression instead of dementia and found insignificant results.
This study has a number of strengths, observed Rachel Whitmer, PhD, of the University of California Davis, in an accompanying editorial. "This was a large group of individuals followed up for up to 20 years, enough time to accumulate a large enough group of patients with concussions; this enabled the statistical power to test if a prescribed medication was associated with the outcome," she wrote. Concussion was based on diagnoses and statin exposure on filled prescriptions, eliminating the problems of self-reported data.
"While this study cannot infer causality, it is a first step in accumulating evidence for possible future therapeutic interventions post-TBI," and a call for further work to discover more about potentially protective factors or risks for dementia after brain injury, she added.
The study has several limitations, Redelmeier and co-authors noted. Associations may reflect confounding due to earlier indications for statin use. The researchers could not adjust for smoking, drug adherence, or other factors that might influence dementia risk. The study also lacked sufficient power to determine whether statins contributed to lower dementia risk before, during, or after a concussion. The total number of concussions an individual sustained over a lifetime was unknown. In addition, median follow-up in this study was 4 years; dementia trajectories often span decades of subclinical changes.
Last Updated May 20, 2019
This study was supported by a
Canada Research Chair in Medical Decision Sciences, the Canadian
Institutes of Health Research, the Bright Focus Foundation, and the
Comprehensive Research Experience for Medical Students at the University
of Toronto.
The researchers reported no conflicts of interest. The editorialist also reported no conflicts.
The researchers reported no conflicts of interest. The editorialist also reported no conflicts.
Primary Source
JAMA Neurology
Secondary Source
JAMA Neurology
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