{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T06:01:08Z","timestamp":1790402468514,"version":"4.1.0"},"reference-count":46,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T00:00:00Z","timestamp":1790121600000},"content-version":"vor","delay-in-days":84,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["T32AG049663\u201006A1"],"award-info":[{"award-number":["T32AG049663\u201006A1"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["F31AG085965\u201001"],"award-info":[{"award-number":["F31AG085965\u201001"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["K24AG068312"],"award-info":[{"award-number":["K24AG068312"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["K23AI166030"],"award-info":[{"award-number":["K23AI166030"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["P01AG082653"],"award-info":[{"award-number":["P01AG082653"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["alz-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["A&amp;D Transl Res &amp; Clin Interv"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>INTRODUCTION<\/jats:title>\n                    <jats:p>We evaluated the effect of acetylcholinesterase inhibitors (AChEIs) and memantine on non\u2010cognitive outcomes by implementing emulated trials in electronic health records.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>Individuals diagnosed with cognitive impairment who initiated AChEIs or memantine were matched to up to five non\u2010initiators. Associations of medication initiation with 11 non\u2010cognitive outcomes were estimated using Cox proportional hazards models. We calculated e\u2010values for each hazard ratio (HR) and compared their magnitude to socioeconomic predictors of memantine and AChEI use in a US\u2010based cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>AChEI initiation was associated with nine of 11 adverse outcomes. For example, the HR for antipsychotic use\u00a0=\u00a01.67 (95% confidence interval [CI]: 1.51 to 1.84) and depression HR\u00a0=\u00a01.86 (1.67 to 2.06). Results for memantine were similar. E\u2010values varied from 1.45 to 2.11 for memantine and 1.40 to 2.44 for AChEIs. Many potential confounders had odds ratios (ORs) &gt; 1.4 for initiation, including marital status (ORs\u00a0=\u00a01.36 to 6.67).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>DISCUSSION<\/jats:title>\n                    <jats:p>Memantine and AChEIs were associated with adverse outcomes, and residual confounding was unlikely to fully account for all the observed associations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/trc2.70306","type":"journal-article","created":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T07:15:51Z","timestamp":1790147751000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Memantine, acetylcholinesterase inhibitors, and quality\u2010of\u2010care outcomes among patients with cognitive impairment: an emulated trial design"],"prefix":"10.1002","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3136-0001","authenticated-orcid":false,"given":"Erin L.","family":"Ferguson","sequence":"first","affiliation":[{"name":"Department of Epidemiology and Biostatistics University of California  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingxuan","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics University of California  San Francisco California USA"},{"name":"Department of Epidemiology Boston University School of Public Health  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justin S.","family":"White","sequence":"additional","affiliation":[{"name":"Department of Health Law, Policy and Management Boston University School of Public Health  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine","family":"Possin","sequence":"additional","affiliation":[{"name":"Memory and Aging Center Department of Neurology University of California  San Francisco California USA"},{"name":"Global Brain Health Institute University of California  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Chodos","sequence":"additional","affiliation":[{"name":"Division of Geriatrics Department of Medicine University of California  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fan","family":"Xia","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics University of California  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva","family":"Raphael","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics University of California  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander K.","family":"Smith","sequence":"additional","affiliation":[{"name":"Division of Geriatrics Department of Medicine University of California  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9644-3081","authenticated-orcid":false,"given":"M. Maria","family":"Glymour","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Boston University School of Public Health  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,23]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.14226"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jalz.2019.07.005"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000011832"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003\u20104819\u2010148\u20105\u2010200803040\u201000009"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.3233\/JAD\u2010200133"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD001190.pub3"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.54.12.2269"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.321.7274.1445"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.318.7184.633"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40266\u2010023\u201001065\u2010x"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0123289"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.291.3.317"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1106668"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.14283\/jpad.2021.49"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.14283\/jpad.2022.50"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jalz.2015.12.007"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/cpt.2364"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwv254"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2016.04.014"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/trc2.70080"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/trc2.70193"},{"key":"e_1_2_10_23_1","unstructured":"University of California Healthhttps:\/\/www.ucop.edu\/uc\u2010health\/departments\/center\u2010for\u2010data\u2010driven\u2010insights\u2010and\u2010innovations\u2010cdi2.html"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.0000000000000152"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12877\u2010020\u201001739\u2010w"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.12072"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532\u20105415.2000.tb04691.x"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1002\/gps.70195"},{"key":"e_1_2_10_29_1","first-page":"CD003154","volume-title":"Cochrane Database Syst Rev","author":"McShane R","year":"2019"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1177\/1533317514524813"},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12325\u2010022\u201002075\u20108"},{"key":"e_1_2_10_32_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.17776"},{"key":"e_1_2_10_33_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12911\u2010022\u201002006\u20101"},{"key":"e_1_2_10_34_1","volume-title":"Memantine, in StatPearls","author":"Kuns B","year":"2025"},{"key":"e_1_2_10_35_1","volume-title":"StatPearls","author":"Singh R","year":"2025"},{"key":"e_1_2_10_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2004.10.012"},{"key":"e_1_2_10_37_1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-publhealth-032315-021353"},{"key":"e_1_2_10_38_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12874\u2010021\u201001416\u20105"},{"key":"e_1_2_10_39_1","doi-asserted-by":"publisher","DOI":"10.7326\/M16\u20102607"},{"key":"e_1_2_10_40_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00415\u2010019\u201009583\u20108"},{"key":"e_1_2_10_41_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598\u2010023\u201034173\u20100"},{"key":"e_1_2_10_42_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinternmed.2009.43"},{"key":"e_1_2_10_43_1","unstructured":"FDA.Namenda (memantine hydrochloride) label.2018"},{"key":"e_1_2_10_44_1","unstructured":"FDA.Aricept (donepezil hydrochloride) label.2012."},{"key":"e_1_2_10_45_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2025.6637"},{"key":"e_1_2_10_46_1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev\u2010publhealth\u2010032315\u2010021644"},{"key":"e_1_2_10_47_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwaf118"}],"container-title":["Alzheimer's &amp; 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