Observational studyNeurology2020
Emulating a target trial of statin use and risk of dementia using cohort data.
Observational study in Neurology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
32 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Pooled it
- Reporting of Observational Studies Explicitly Aiming to Emulate Randomized Trials: A Systematic Review.JAMA network open · 2023Pooled it
- Statin use and the risk of hepatocellular carcinoma among patients with chronic hepatitis B: an emulated target trial using longitudinal nationwide population cohort data.BMC gastroenterology · 2023Trial
- Emulating a target trial of surgical removal of uterine fibroids on atherosclerotic cardiovascular disease.Fertility and sterility · 2026Article
- Sodium-Glucose Cotransporter 2 Inhibitors and Dementia Risk in Patients With Psychiatric Disorders.JAMA network open · 2026Article
- One- and Two-Year Outcomes of Switching to a Dolutegravir-Based ART Regimen: An Observational Emulation of Sequential Target Trials.Open forum infectious diseases · 2026Article
- Design and Implementation of Observational Studies Emulating a Target Trial.JAMA network open · 2026Article
- The heterogeneous treatment effects of statins on dementia: a target trial emulation with causal machine learning using integrated genetic and real-world data.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2026Article
- Safety of Antihypertensive Medication for the Management of Non-Severe Gestational Hypertension Among Pregnant Individuals in Botswana-Emulating a Series of Target Trials.Paediatric and perinatal epidemiology · 2026Article
- Opportunities, challenges and future perspectives for target trial emulation in critical care clinical research.Critical care (London, England) · 2025Review
- Measuring the population attributable fraction and the potential impact fraction of dementia risk factors in Malta: A population based secondary data analysis.Journal of public health research · 2025Article
- Statin Initiation and Dementia Incidence in a Large Health Care System From 1997 to 2020: A Target Trial Emulation Study.Neurology · 2025Article
- Effect of initiation of invasive ventilation in acute hypoxemic respiratory failure using sequential trials: treatment efficacy instead of timing.Critical care (London, England) · 2025Article
- Use of β-adrenoreceptor drugs and Parkinson's disease incidence in women from the French E3N cohort study.Journal of Parkinson's disease · 2025Article
- Methodologies for the Emulation of Biomarker-Guided Trials Using Observational Data: A Systematic Review.Journal of personalized medicine · 2025Review
- Uncertainty in the estimated effects of statin initiation on risk of dementia: using a multiverse analysis to assess sources of variability.European journal of epidemiology · 2025Article
- Nonbenzodiazepine hypnotics and police-reported motor vehicle crash risk among older adults: a sequential target trial emulation.American journal of epidemiology · 2025Article
- The Associations of Sensory Impairment With 10-Year Risk of Dementia and Alzheimer's Disease: The Health and Retirement Study, 2010-2020.Journal of geriatric psychiatry and neurology · 2025Article
- Sociodemographic modifiers of effects of statin initiation on dementia incidence: An emulated trial design in a large health care member population with 10+ years of follow-up.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2025Article
- Publication of observational studies making claims of causation over time.Contemporary clinical trials communications · 2024Article
Corrections and comments
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Authors and funding
8 authors.
Funding
Abstract
objectiveObservational data can be used to attempt to emulate a target trial of statin use and estimate analogues of intention-to-treat and per protocol effects on dementia risk.
methodsUsing data from a prospective cohort study in the Netherlands, we conceptualized a sequence of "trials" in which eligible individuals ages 55-80 years were classified as statin initiators or noninitiators for every consecutive month between 1993 and 2007 and were followed until diagnosis of dementia, death, loss to follow-up, or the end of follow-up. We estimated 2 types of effects of statin use on dementia and a combined endpoint of dementia or death: the effect of initiation vs no initiation and the effect of sustained use vs no use. We estimated risk by statin treatment strategy over time via pooled logistic regression. We used inverse-probability weighting to account for treatment-confounder feedback in estimation of per-protocol effects.
resultsOf 233,526 eligible person-trials (6,373 individuals), there were 622 initiators and 232,904 noninitiators. Comparing statin initiation with no initiation, the 10-year risk differences (95% confidence interval) were -0.1% (-2.3% to 1.8%) for dementia and 0.3% (-2.7% to 3.3%) for dementia or death. Comparing sustained statin use vs no use, the 10-year risk differences were -2.2% (-5.2% to 1.6%) for dementia and -5.1% (-10.5% to -1.1%) for dementia or death.
conclusionsIndividuals with sustained statin use, but not statin initiation alone, had reduced 10-year risks of dementia and dementia or death. Our results should be interpreted with caution due to the small number of initiators and events and potential for residual confounding.
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