{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T19:10:18Z","timestamp":1792782618393,"version":"4.5.0"},"reference-count":39,"publisher":"Springer Science and Business Media LLC","issue":"7","license":[{"start":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T00:00:00Z","timestamp":1776384000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0"},{"start":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T00:00:00Z","timestamp":1776384000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"funder":[{"name":"The University of Tokyo","id":[{"id":"https:\/\/ror.org\/057zh3y96","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Osteoporos Int"],"published-print":{"date-parts":[[2026,7]]},"DOI":"10.1007\/s00198-026-08026-1","type":"journal-article","created":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T08:05:02Z","timestamp":1776413102000},"page":"1867-1879","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Romosozumab versus teriparatide for risk of dementia in individuals with osteoporosis: a target trial emulation study"],"prefix":"10.1007","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7096-5604","authenticated-orcid":false,"given":"Masaki","family":"Hatano","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akira","family":"Okada","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yusuke","family":"Sasabuchi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuya","family":"Kimura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"So","family":"Sato","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hisatoshi","family":"Ishikura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takeyuki","family":"Tanaka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taku","family":"Saito","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sakae","family":"Tanaka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hideo","family":"Yasunaga","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,4,17]]},"reference":[{"key":"8026_CR1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arr.2023.102130","volume":"93","author":"C Ruggiero","year":"2024","unstructured":"Ruggiero C, Baroni M, Xenos D et al (2024) Dementia, osteoporosis and fragility fractures: intricate epidemiological relationships, plausible biological connections, and twisted clinical practices. Ageing Res Rev 93:102130","journal-title":"Ageing Res Rev"},{"key":"8026_CR2","doi-asserted-by":"publisher","first-page":"53","DOI":"10.5535\/arm.22027","volume":"46","author":"JH Shin","year":"2022","unstructured":"Shin JH (2022) Dementia epidemiology fact sheet 2022. Ann Rehabil Med 46:53\u201359","journal-title":"Ann Rehabil Med"},{"key":"8026_CR3","doi-asserted-by":"publisher","first-page":"967","DOI":"10.1007\/s11357-013-9608-x","volume":"36","author":"KH Chang","year":"2014","unstructured":"Chang KH, Chung CJ, Lin CL, Sung FC, Wu TN, Kao CH (2014) Increased risk of dementia in patients with osteoporosis: a population-based retrospective cohort analysis. Age Dordr 36:967\u2013975","journal-title":"Age Dordr"},{"key":"8026_CR4","unstructured":"(2021) Global, regional, and national burden of bone fractures in 204 countries and territories, 1990\u20132019: a systematic analysis from the Global Burden of Disease study 2019. Lancet Healthy Longev 2:e580-e592"},{"key":"8026_CR5","doi-asserted-by":"publisher","first-page":"2103","DOI":"10.1002\/jbmr.4431","volume":"36","author":"CW Lary","year":"2021","unstructured":"Lary CW, Rosen CJ, Kiel DP (2021) Osteoporosis and dementia: establishing a link. J Bone Miner Res 36:2103\u20132105","journal-title":"J Bone Miner Res"},{"key":"8026_CR6","doi-asserted-by":"publisher","first-page":"401","DOI":"10.3233\/JAD-180569","volume":"65","author":"K Kostev","year":"2018","unstructured":"Kostev K, Hadji P, Jacob L (2018) Impact of osteoporosis on the risk of dementia in almost 60,000 patients followed in general practices in Germany. J Alzheimers Dis 65:401\u2013407","journal-title":"J Alzheimers Dis"},{"key":"8026_CR7","doi-asserted-by":"publisher","first-page":"63","DOI":"10.1016\/j.neuron.2014.08.048","volume":"84","author":"CC Liu","year":"2014","unstructured":"Liu CC, Tsai CW, Deak F et al (2014) Deficiency in LRP6-mediated Wnt signaling contributes to synaptic abnormalities and amyloid pathology in Alzheimer\u2019s disease. Neuron 84:63\u201377","journal-title":"Neuron"},{"key":"8026_CR8","doi-asserted-by":"publisher","first-page":"142","DOI":"10.1007\/s12031-018-1219-7","volume":"67","author":"Y Hu","year":"2019","unstructured":"Hu Y, Chen W, Wu L, Jiang L, Liang N, Tan L, Liang M, Tang N (2019) TGF-\u03b21 restores hippocampal synaptic plasticity and memory in Alzheimer model via the PI3K\/Akt\/Wnt\/\u03b2-catenin signaling pathway. J Mol Neurosci 67:142\u2013149","journal-title":"J Mol Neurosci"},{"key":"8026_CR9","doi-asserted-by":"publisher","first-page":"332","DOI":"10.1007\/s00774-020-01176-0","volume":"39","author":"S Tanaka","year":"2021","unstructured":"Tanaka S, Matsumoto T (2021) Sclerostin: from bench to bedside. J Bone Miner Metab 39:332\u2013340","journal-title":"J Bone Miner Metab"},{"key":"8026_CR10","doi-asserted-by":"publisher","first-page":"531","DOI":"10.1038\/s42255-024-00989-x","volume":"6","author":"T Shi","year":"2024","unstructured":"Shi T, Shen S, Shi Y et al (2024) Osteocyte-derived sclerostin impairs cognitive function during ageing and Alzheimer\u2019s disease progression. Nat Metab 6:531\u2013549","journal-title":"Nat Metab"},{"key":"8026_CR11","doi-asserted-by":"publisher","first-page":"152","DOI":"10.1007\/s11914-023-00848-w","volume":"22","author":"TJ Margetts","year":"2024","unstructured":"Margetts TJ, Wang HS, Karnik SJ, Plotkin LI, Movila A, Oblak AL, Fehrenbacher JC, Kacena MA (2024) From the mind to the spine: the intersecting world of Alzheimer\u2019s and osteoporosis. Curr Osteoporos Rep 22:152\u2013164","journal-title":"Curr Osteoporos Rep"},{"key":"8026_CR12","doi-asserted-by":"publisher","first-page":"2592","DOI":"10.1002\/jbmr.1718","volume":"27","author":"MS Ardawi","year":"2012","unstructured":"Ardawi MS, Rouzi AA, Al-Sibiani SA, Al-Senani NS, Qari MH, Mousa SA (2012) High serum sclerostin predicts the occurrence of osteoporotic fractures in postmenopausal women: the Center of Excellence for Osteoporosis Research Study. J Bone Miner Res 27:2592\u20132602","journal-title":"J Bone Miner Res"},{"key":"8026_CR13","doi-asserted-by":"publisher","first-page":"758","DOI":"10.1093\/aje\/kwv254","volume":"183","author":"MA Hern\u00e1n","year":"2016","unstructured":"Hern\u00e1n MA, Robins JM (2016) Using big data to emulate a target trial when a randomized trial is not available. Am J Epidemiol 183:758\u2013764","journal-title":"Am J Epidemiol"},{"key":"8026_CR14","doi-asserted-by":"publisher","first-page":"1080","DOI":"10.1016\/S0140-6736(21)02646-5","volume":"399","author":"IR Reid","year":"2022","unstructured":"Reid IR, Billington EO (2022) Drug therapy for osteoporosis in older adults. Lancet 399:1080\u20131092","journal-title":"Lancet"},{"key":"8026_CR15","doi-asserted-by":"publisher","first-page":"230","DOI":"10.1016\/S0140-6736(17)32137-2","volume":"391","author":"DL Kendler","year":"2018","unstructured":"Kendler DL, Marin F, Zerbini CAF et al (2018) Effects of teriparatide and risedronate on new fractures in post-menopausal women with severe osteoporosis (VERO): a multicentre, double-blind, double-dummy, randomised controlled trial. Lancet 391:230\u2013240","journal-title":"Lancet"},{"key":"8026_CR16","doi-asserted-by":"publisher","first-page":"46","DOI":"10.37737\/ace.25006","volume":"7","author":"H Yasunaga","year":"2025","unstructured":"Yasunaga H (2025) DeSC database. Ann Clin Epidemiol 7:46\u201349","journal-title":"Ann Clin Epidemiol"},{"key":"8026_CR17","first-page":"190","volume":"5","author":"A Okada","year":"2022","unstructured":"Okada A, Yasunaga H (2022) Prevalence of noncommunicable diseases in Japan using a newly developed administrative claims database covering young, middle-aged, and elderly people. Jma j 5:190\u2013198","journal-title":"Jma j"},{"key":"8026_CR18","doi-asserted-by":"publisher","first-page":"106","DOI":"10.37737\/ace.24015","volume":"6","author":"H Yasunaga","year":"2024","unstructured":"Yasunaga H (2024) Updated information on the diagnosis procedure combination data. Ann Clin Epidemiol 6:106\u2013110","journal-title":"Ann Clin Epidemiol"},{"key":"8026_CR19","doi-asserted-by":"publisher","first-page":"557","DOI":"10.1007\/s10654-019-00499-1","volume":"34","author":"T Wilkinson","year":"2019","unstructured":"Wilkinson T, Schnier C, Bush K et al (2019) Identifying dementia outcomes in UK Biobank: a validation study of primary care, hospital admissions and mortality data. Eur J Epidemiol 34:557\u2013565","journal-title":"Eur J Epidemiol"},{"key":"8026_CR20","doi-asserted-by":"publisher","first-page":"854","DOI":"10.1002\/pds.5037","volume":"29","author":"LJ McGrath","year":"2020","unstructured":"McGrath LJ, Spangler L, Curtis JR, Ehrenstein V, S\u00f8rensen HT, Saul B, Levintow SN, Reams D, Bradbury BD, Brookhart MA (2020) Using negative control outcomes to assess the comparability of treatment groups among women with osteoporosis in the United States. Pharmacoepidemiol Drug Saf 29:854\u2013863","journal-title":"Pharmacoepidemiol Drug Saf"},{"key":"8026_CR21","doi-asserted-by":"publisher","first-page":"373","DOI":"10.1016\/0021-9681(87)90171-8","volume":"40","author":"ME Charlson","year":"1987","unstructured":"Charlson ME, Pompei P, Ales KL, MacKenzie CR (1987) A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis 40:373\u2013383","journal-title":"J Chronic Dis"},{"key":"8026_CR22","doi-asserted-by":"publisher","first-page":"1130","DOI":"10.1097\/01.mlr.0000182534.19832.83","volume":"43","author":"H Quan","year":"2005","unstructured":"Quan H, Sundararajan V, Halfon P, Fong A, Burnand B, Luthi JC, Saunders LD, Beck CA, Feasby TE, Ghali WA (2005) Coding algorithms for defining comorbidities in ICD-9-CM and ICD-10 administrative data. Med Care 43:1130\u20131139","journal-title":"Med Care"},{"key":"8026_CR23","doi-asserted-by":"publisher","first-page":"112","DOI":"10.2188\/jea.JE20220310","volume":"34","author":"K Nakatsuka","year":"2024","unstructured":"Nakatsuka K, Ono R, Murata S, Akisue T, Fukuda H (2024) Claims-based frailty index in Japanese older adults: a cohort study using LIFE study data. J Epidemiol 34:112\u2013118","journal-title":"J Epidemiol"},{"key":"8026_CR24","doi-asserted-by":"publisher","first-page":"101","DOI":"10.37737\/ace.22013","volume":"4","author":"Y Hashimoto","year":"2022","unstructured":"Hashimoto Y, Yasunaga H (2022) Theory and practice of propensity score analysis. Ann Clin Epidemiol 4:101\u2013109","journal-title":"Ann Clin Epidemiol"},{"key":"8026_CR25","doi-asserted-by":"publisher","first-page":"1393","DOI":"10.1093\/jbmr\/zjae119","volume":"39","author":"F Cosman","year":"2024","unstructured":"Cosman F, Lewiecki EM, Eastell R et al (2024) Goal-directed osteoporosis treatment: ASBMR\/BHOF task force position statement 2024. J Bone Miner Res 39:1393\u20131405","journal-title":"J Bone Miner Res"},{"key":"8026_CR26","doi-asserted-by":"publisher","first-page":"579","DOI":"10.1007\/s00774-013-0451-z","volume":"31","author":"HP Bhattoa","year":"2013","unstructured":"Bhattoa HP, Wamwaki J, Kalina E, Foldesi R, Balogh A, Antal-Szalmas P (2013) Serum sclerostin levels in healthy men over 50 years of age. J Bone Miner Metab 31:579\u2013584","journal-title":"J Bone Miner Metab"},{"key":"8026_CR27","doi-asserted-by":"publisher","first-page":"2812","DOI":"10.1002\/jbmr.479","volume":"26","author":"MS Ardawi","year":"2011","unstructured":"Ardawi MS, Al-Kadi HA, Rouzi AA, Qari MH (2011) Determinants of serum sclerostin in healthy pre- and postmenopausal women. J Bone Miner Res 26:2812\u20132822","journal-title":"J Bone Miner Res"},{"key":"8026_CR28","doi-asserted-by":"publisher","first-page":"1221","DOI":"10.1002\/ana.26064","volume":"89","author":"DD Ward","year":"2021","unstructured":"Ward DD, Wallace LMK, Rockwood K (2021) Frailty and risk of dementia in mild cognitive impairment subtypes. Ann Neurol 89:1221\u20131225","journal-title":"Ann Neurol"},{"key":"8026_CR29","doi-asserted-by":"publisher","first-page":"R9","DOI":"10.1093\/ejendo\/lvae076","volume":"191","author":"AD Anastasilakis","year":"2024","unstructured":"Anastasilakis AD, Yavropoulou MP, Palermo A, Makras P, Paccou J, Tabacco G, Naciu AM, Tsourdi E (2024) Romosozumab versus parathyroid hormone receptor agonists: which osteoanabolic to choose and when? Eur J Endocrinol 191:R9-r21","journal-title":"Eur J Endocrinol"},{"key":"8026_CR30","doi-asserted-by":"publisher","first-page":"512","DOI":"10.1097\/EDE.0b013e3181a663cc","volume":"20","author":"S Schneeweiss","year":"2009","unstructured":"Schneeweiss S, Rassen JA, Glynn RJ, Avorn J, Mogun H, Brookhart MA (2009) High-dimensional propensity score adjustment in studies of treatment effects using health care claims data. Epidemiology 20:512\u2013522","journal-title":"Epidemiology"},{"key":"8026_CR31","doi-asserted-by":"publisher","first-page":"1391","DOI":"10.1056\/NEJMsm1605385","volume":"377","author":"MA Hern\u00e1n","year":"2017","unstructured":"Hern\u00e1n MA, Robins JM (2017) Per-protocol analyses of pragmatic trials. N Engl J Med 377:1391\u20131398","journal-title":"N Engl J Med"},{"key":"8026_CR32","doi-asserted-by":"publisher","DOI":"10.1038\/s41514-023-00114-4","volume":"9","author":"J Yuan","year":"2023","unstructured":"Yuan J, Pedrini S, Thota R et al (2023) Elevated plasma sclerostin is associated with high brain amyloid-\u03b2 load in cognitively normal older adults. NPJ Aging 9:17","journal-title":"NPJ Aging"},{"key":"8026_CR33","doi-asserted-by":"publisher","DOI":"10.1186\/s13041-019-0525-5","volume":"12","author":"L Jia","year":"2019","unstructured":"Jia L, Pi\u00f1a-Crespo J, Li Y (2019) Restoring Wnt\/\u03b2-catenin signaling is a promising therapeutic strategy for Alzheimer\u2019s disease. Mol Brain 12:104","journal-title":"Mol Brain"},{"key":"8026_CR34","doi-asserted-by":"publisher","first-page":"357","DOI":"10.1007\/164_2021_532","volume":"269","author":"NC Inestrosa","year":"2021","unstructured":"Inestrosa NC, Tapia-Rojas C, Cerpa W, Cisternas P, Zolezzi JM (2021) Wnt signaling is a key player in Alzheimer\u2019s disease. Handb Exp Pharmacol 269:357\u2013382","journal-title":"Handb Exp Pharmacol"},{"key":"8026_CR35","doi-asserted-by":"publisher","first-page":"148","DOI":"10.1016\/j.bone.2005.03.018","volume":"37","author":"H Keller","year":"2005","unstructured":"Keller H, Kneissel M (2005) SOST is a target gene for PTH in bone. Bone 37:148\u2013158","journal-title":"Bone"},{"key":"8026_CR36","doi-asserted-by":"publisher","first-page":"E1848","DOI":"10.1210\/jc.2011-1534","volume":"96","author":"EW Yu","year":"2011","unstructured":"Yu EW, Kumbhani R, Siwila-Sackman E, Leder BZ (2011) Acute decline in serum sclerostin in response to PTH infusion in healthy men. J Clin Endocrinol Metab 96:E1848-1851","journal-title":"J Clin Endocrinol Metab"},{"key":"8026_CR37","doi-asserted-by":"publisher","first-page":"532","DOI":"10.1016\/j.jos.2018.10.028","volume":"24","author":"T Ikeda","year":"2019","unstructured":"Ikeda T, Kaji H, Tamura Y, Akagi M (2019) Once-weekly teriparatide reduces serum sclerostin levels in postmenopausal women with osteoprosis. J Orthop Sci 24:532\u2013538","journal-title":"J Orthop Sci"},{"key":"8026_CR38","doi-asserted-by":"publisher","first-page":"1302","DOI":"10.1210\/jc.2017-00283","volume":"103","author":"F Gossiel","year":"2018","unstructured":"Gossiel F, Scott JR, Paggiosi MA, Naylor KE, McCloskey EV, Peel NFA, Walsh JS, Eastell R (2018) Effect of teriparatide treatment on circulating periostin and its relationship to regulators of bone formation and BMD in postmenopausal women with osteoporosis. J Clin Endocrinol Metab 103:1302\u20131309","journal-title":"J Clin Endocrinol Metab"},{"key":"8026_CR39","doi-asserted-by":"publisher","first-page":"476","DOI":"10.1016\/j.je.2016.09.009","volume":"27","author":"H Yamana","year":"2017","unstructured":"Yamana H, Moriwaki M, Horiguchi H, Kodan M, Fushimi K, Yasunaga H (2017) Validity of diagnoses, procedures, and laboratory data in Japanese administrative data. J Epidemiol 27:476\u2013482","journal-title":"J Epidemiol"}],"container-title":["Osteoporosis International"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00198-026-08026-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00198-026-08026-1","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00198-026-08026-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T21:01:40Z","timestamp":1792270900000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00198-026-08026-1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,17]]},"references-count":39,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2026,7]]}},"alternative-id":["8026"],"URL":"https:\/\/doi.org\/10.1007\/s00198-026-08026-1","relation":{},"ISSN":["0937-941X","1433-2965"],"issn-type":[{"value":"0937-941X","type":"print"},{"value":"1433-2965","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,17]]},"assertion":[{"value":"9 October 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"3 April 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 April 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"This study was approved by the Institutional Review Board at the University of Tokyo (approval number: 2021010NI [April 23, 2021]). The requirement for informed consent was waived as all data were de-identified.","order":1,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"H. Yasunaga reports receiving an institutional grant from the Ministry of Health, Labour and Welfare, Japan (23AA2003). Y. Sasabuchi discloses that DeSC Healthcare, Inc. provided financial support for the present manuscript. T. Tanaka has a collaborative research agreement with Amgen, Inc. on a project involving the development and validation to identify hip and vertebral fractures in claims database. The other authors have disclosed no conflicts of interest.","order":3,"name":"Ethics","label":"Conflicts of interest","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Masaki Hatano is the guarantor and accepts full responsibility for the work and\/or the conduct of the study, has full access to the data, and controls the decision to publish.","order":4,"name":"Ethics","label":"Guarantor","group":{"name":"EthicsHeading","label":"Declarations"}}]}}