HMG-CoA reductase inhibitors (Statins) have been associated with improved outcomes in animal models of induced brain damage and improved outcomes in epidemiologic studies examining victims of stroke. In each of the above situations, neuro-inflammatory processes can increase physical damage in the brain, which may lead to poorer outcomes. Inflammation in the central nervous system is not limited to acute conditions but is also present in chronic progressive conditions leading to dementia. From the time of Alois Alzheimer, neuro-inflammation has also been implicated as a factor in dementia. At this point, population-based studies are equivocal as to a potential moderating role for Statins in late life dementia.

Using data collected for the National Study of the Costs and Outcomes of Trauma, this dissertation explores for the first time the relationship between Statin use, survival and functional outcomes in a population of older patients with well-documented head trauma followed for one year. Additionally, using data from the Women's Health and Aging Study II, this dissertation examines Statin use and cognitive change in a cohort of initially healthy older women.

Among individuals aged 65 and up with multiple traumas including a head injury, Statin use was associated with lower odds of in-hospital death (adjusted O.R. = 0.49, p = 0.04). Among the head trauma survivors, Statin use was associated with higher odds of achieving a good functional recovery at 12 months post injury (adjusted O.R. = 3.54, p = 0.03). In a cohort of initially healthy community-dwelling older women, Statin use was associated with both reduced odds and reduced hazard of developing cognitive impairment on a test of delayed recall (unadjusted O.R. = 0.40, p = 0.05; H.R. = 0.26, p = 0.06) as well as trending toward reduced hazard of developing impairment in executive function (unadjusted H.R. = 0.50, p = 0.07).

Both studies are limited by sample size and especially by the number of Statin users in each sample; however, the results suggest that Statins may play a role in preserving cognition, function and even life itself in individuals with acute or chronic neuro-inflammatory disorders. Further study is warranted.