Observational studyCardiovascular diabetology2025

Lipoprotein levels and statin treatment related to dementia and cognitive decline in individuals with type 2 diabetes: an observational analysis from the ADVANCE study.

Peder Af Geijerstam, John Chalmers, Miriam Pikkemaat, Ruth Peters, Michel Marre, Giuseppe Mancia, Mark Woodward, Katie Harris

Abstract readMulticenter StudyObservational Study
In one paragraph

Observational study in Cardiovascular diabetology, 2025. The graph read 2 numbers from its abstract, feeding 1 cell of the map, but none could be read as for or against, so it casts no vote. Cited by 1 paper.

2numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
field-weighted citation impact
1 · What the graph read from 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.

Read, but not usablea number the graph found but could not read as for or against

Dementia/CDbaseline LDL cholesterol vs per standard deviation higheran association or prognostic statement, not a treatment comparison · dyslipidemia, t2dfeeds one cell of the map
OR 1.061.00 to 1.14
The OR (95% CI) of dementia/CD were 1.06 (1.00-1.14) per standard deviation higher in baseline LDL cholesterol and 0.90 (0.79-1.03) for participants with vs without statin treatment.
Dementia/CDstatin treatment vs without statin treatmentan association or prognostic statement, not a treatment comparison · dyslipidemia, t2dfeeds one cell of the map
OR 0.900.79 to 1.03
The OR (95% CI) of dementia/CD were 1.06 (1.00-1.14) per standard deviation higher in baseline LDL cholesterol and 0.90 (0.79-1.03) for participants with vs without statin treatment.

clause the extractor read what became the number

2 · Its place on the map

Where it lands on the map

Rows are treatments, columns are outcomes. The coloured squares are the cells this paper feeds, coloured by the vote it casts there. Click one to jump to what this paper adds to it.

supports the treatmentfavours the comparatorno clear differenceread, but no usable result
3 · What it changes

What it adds to each cell

For every cell the paper feeds: the belief in the claim with and without this paper, and this paper's estimate drawn against every other readable study in the cell. The ringed dot is this paper.

Statins×lipids

No readable resultOpen on the map →What to test next →

38 readable studies in this cell: 27 favour the treatment, 5 find no difference, 6 favour the comparator.

Belief with this paper
0.50contested · 21 families support, 7 contradict · against placebo
Without itNot a counted family in this claim, so removing it changes nothing.
← favours the treatmentfavours the comparator →
0 · no effect
NCT002899002,340 enrolled · 2006
Δ -13.2-16.8 to -9.60
reduced -66.0-73.0 to -58.0
NCT02546323543 enrolled · 2015
Δ -35.5-40.2 to -30.7
NCT01678820299 enrolled · 2012
Δ 0.50-4.80 to 5.80
NCT01218204287 enrolled · 2010
Δ 5.47-15.7 to 26.7
NCT0093525931 enrolled · 2009
Δ -51.7
reductions -33.6-38.8 to -28.4

This paper's own estimate is on a different scale from the rest of the cell, so it is not drawn here.

4 · The registry

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.

5 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
6 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

7 · Who and what money

Authors and funding

8 authors.

Peder Af GeijerstamPrimary Health Care Center Cityhälsan Centrum, and Department of Health, Medicine and Caring Sciences, Faculty of Medicine and Health Sciences, Linköping University, Linköping, Sweden. peder.af.geijerstam@liu.se.ORCID http://orcid.org/0000-0001-6038-5131
John ChalmersThe George Institute for Global Health, University of New South Wales, Sydney, Australia.ORCID http://orcid.org/0000-0002-9931-0580
Miriam PikkemaatThe George Institute for Global Health, University of New South Wales, Sydney, Australia.ORCID http://orcid.org/0000-0002-9808-207X
Ruth PetersThe George Institute for Global Health, University of New South Wales, Sydney, Australia.ORCID http://orcid.org/0000-0003-0148-3617
Michel MarreClinique Ambroise Paré, Neuilly-sur-Seine, France.ORCID http://orcid.org/0000-0002-3071-1837
Giuseppe ManciaUniversity of Milano-Bicocca, Milano, Italy.ORCID http://orcid.org/0000-0003-0942-3176
Mark WoodwardThe George Institute for Global Health, University of New South Wales, Sydney, Australia.ORCID http://orcid.org/0000-0001-9800-5296
Katie HarrisThe George Institute for Global Health, University of New South Wales, Sydney, Australia.ORCID http://orcid.org/0000-0003-2444-2869

Funding

No grant is acknowledged in the PubMed record.

8 · The paper itself

Abstract

The marked sentences are the ones the graph read a number from.

introductionStudies on the association between lipid levels and lipid-lowering treatment and the risk of dementia and/or cognitive decline (CD) have shown conflicting results and are few in individuals with type 2 diabetes (T2D). The aim was to evaluate the relationship of baseline LDL cholesterol levels and statin treatment with the development of dementia/CD in patients with T2D from the Action in Diabetes and Vascular Disease: Preterax and Diamicron Modified Release Controlled Evaluation trial.

methodsDementia was diagnosed using the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV), and CD was defined as at least a 3-point decrement in the Mini Mental State Examination score. Exposures were baseline LDL cholesterol levels, statin treatment at baseline, and statin treatment initiation during the first 18 months of follow-up. Multinomial logistic regression was used to estimate the odds ratio (OR) and 95% CI for the composite of dementia/CD.

resultsOf 11,140 participants, 1827 (16.4%) developed dementia/CD over the 5-year follow up. The OR (95% CI) of dementia/CD were 1.06 (1.00-1.14) per standard deviation higher in baseline LDL cholesterol and 0.90 (0.79-1.03) for participants with vs without statin treatment.

conclusionWe observed an association between LDL levels, but not statin treatment, and incident dementia/CD. Although causality cannot be determined by our study, the results are in line with multiple randomised controlled trials. However, to understand the long-term effects of lipid levels and statin treatment on dementia/CD, studies of longer follow-up are still needed.

Indexed as

Cholesterol, LDLCognitionCognitive DysfunctionDementiaDiabetes Mellitus, Type 2DyslipidemiasHydroxymethylglutaryl-CoA Reductase InhibitorsAgedBiomarkersFemaleHumansIncidenceMaleMiddle AgedRandomized Controlled Trials as TopicRisk AssessmentBiomarkersCholesterol, LDLHydroxymethylglutaryl-CoA Reductase InhibitorsCholesterolCognitive declineDementiaDiabetesDiabetes complicationsLipidsLipoproteinsType 2 diabetes

Identifiers

PMID40826451
PMCPMC12362958

What Socratic holds

Texttitle and abstract
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.