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May 20, 2019

Concussions and Dementia—Are Statins the Salve in the Wound?

Author Affiliations
  • 1Division of Epidemiology, Department of Public Health Sciences, University of California, Davis, Davis
JAMA Neurol. 2019;76(8):883-884. doi:10.1001/jamaneurol.2019.0846

Traumatic brain injury (TBI) is a major cause of death and disability in the United States, where 1.4 million people sustain a TBI annually and 3 to 5 million are currently living with a TBI-associated disability.1 Concussions are a common component of TBI. Severe TBI, such as events that involve a loss of consciousness, has received a lot of attention; it is known that athletes who experience a high rate of these events have an increased risk of chronic traumatic encephalopathy. What is less known is the short-term and long-term effects of events that do not involve a loss of consciousness. One of the most feared long-term consequences of TBI is dementia. Numerous studies conducted in the Veterans Affairs population suggest an association between TBI overall and a higher risk of dementia.2 However, some studies report no association between self-reported TBI and Alzheimer disease pathology, and a recent meta-analysis3 of 18 articles did not establish TBI as a risk factor for Alzheimer disease when most of the TBI exposures were gleaned from self-report. The association between concussion specifically and dementia is not well known and, to my knowledge, the potential differences in this association by status of medication is unknown. Currently it is unknown whether an association between TBI and dementia may be amplified or mitigated among those taking common daily medications.