Statins and Dementia

Nassim Taleb, commenting on the Lindy Effect, wrote “…the only effective judge of things is time”. Since modern medicine has been around for at best 100-150 years, any medical intervention, whether a drug or procedure that has lasted for at least 3-4 decades and works well is likely to be around for a long, long time. That is why the whole “radiation causes cancer” is such a bogus argument after 128 years of the use of X-rays in medicine with not one study convincingly showing that radiation from medical imaging causes cancer.

Statins now have been in use for more than 35 years. They have conclusively been shown to improve survival. The challenges to statin use are related to the perception of side effects, mainly those related to muscle weakness, which in many instances as the N of 1 study showed are perhaps imagined or occur because of the nocebo effect.

One side effect of concern remains the issue of cognitive decline. I remember a cardiologist, a few years senior to me, many years ago decrying statins by saying that if they can reduce the fat in the blood, they can also leech away the fat from the myelin in the brain and cause premature dementia.

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