{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T21:21:47Z","timestamp":1783027307829,"version":"3.54.6"},"reference-count":32,"publisher":"Elsevier BV","issue":"5","license":[{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001779","name":"Monash University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001779","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000765","name":"University College London","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000765","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007890","name":"University of North Carolina at Chapel Hill","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007890","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","thelancet.com","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["The Lancet Healthy Longevity"],"published-print":{"date-parts":[[2026,5]]},"DOI":"10.1016\/j.lanhl.2026.100852","type":"journal-article","created":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T22:41:06Z","timestamp":1781649666000},"page":"100852","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":1,"title":["Abrupt discontinuation and tapering of antipsychotics in older adults with dementia: a target trial emulation study"],"prefix":"10.1016","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2971-8713","authenticated-orcid":false,"given":"Olivia K","family":"Hopkinson","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-5904-1897","authenticated-orcid":false,"given":"Jan","family":"Chobanov","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6381-8745","authenticated-orcid":false,"given":"Darshna","family":"Goordeen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8645-1942","authenticated-orcid":false,"given":"Kenneth K C","family":"Man","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ian C K","family":"Wong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1405-999X","authenticated-orcid":false,"given":"Emily","family":"Reeve","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J Simon","family":"Bell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"Wei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Howard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2320-0470","authenticated-orcid":false,"given":"Wallis C Y","family":"Lau","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.lanhl.2026.100852_bib1","doi-asserted-by":"crossref","first-page":"73","DOI":"10.3389\/fneur.2012.00073","article-title":"Behavioral and psychological symptoms of dementia","volume":"3","author":"Cerejeira","year":"2012","journal-title":"Front Neurol"},{"key":"10.1016\/j.lanhl.2026.100852_bib2","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1001\/jamapsychiatry.2022.4448","article-title":"Rates of antipsychotic drug prescribing among people living with dementia during the COVID-19 pandemic","volume":"80","author":"Luo","year":"2023","journal-title":"JAMA Psychiatry"},{"key":"10.1016\/j.lanhl.2026.100852_bib3","doi-asserted-by":"crossref","DOI":"10.1136\/bmj-2023-076268","article-title":"Multiple adverse outcomes associated with antipsychotic use in people with dementia: population based matched cohort study","volume":"385","author":"Mok","year":"2024","journal-title":"BMJ"},{"key":"10.1016\/j.lanhl.2026.100852_bib4","doi-asserted-by":"crossref","first-page":"438","DOI":"10.1001\/jamapsychiatry.2014.3018","article-title":"Antipsychotics, other psychotropics, and the risk of death in patients with dementia: number needed to harm","volume":"72","author":"Maust","year":"2015","journal-title":"JAMA Psychiatry"},{"key":"10.1016\/j.lanhl.2026.100852_bib5","doi-asserted-by":"crossref","DOI":"10.1136\/bmj.a1227","article-title":"Exposure to antipsychotics and risk of stroke: self controlled case series study","volume":"337","author":"Douglas","year":"2008","journal-title":"BMJ"},{"key":"10.1016\/j.lanhl.2026.100852_bib6","author":"Banerjee"},{"key":"10.1016\/j.lanhl.2026.100852_bib7","doi-asserted-by":"crossref","first-page":"758","DOI":"10.1016\/S2215-0366(25)00261-5","article-title":"Antipsychotic prescriptions in people with dementia in primary care: a cohort study investigating adherence of dose and duration to UK clinical guidelines","volume":"12","author":"Smith","year":"2025","journal-title":"Lancet Psychiatry"},{"key":"10.1016\/j.lanhl.2026.100852_bib10","article-title":"Withdrawal versus continuation of long-term antipsychotic drug use for behavioural and psychological symptoms in older people with dementia","volume":"3","author":"Van Leeuwen","year":"2018","journal-title":"Cochrane Database Syst Rev"},{"key":"10.1016\/j.lanhl.2026.100852_bib11","doi-asserted-by":"crossref","first-page":"827","DOI":"10.1093\/ije\/dyv098","article-title":"Data resource profile: Clinical Practice Research Datalink (CPRD)","volume":"44","author":"Herrett","year":"2015","journal-title":"Int J Epidemiol"},{"key":"10.1016\/j.lanhl.2026.100852_bib12","doi-asserted-by":"crossref","first-page":"1740","DOI":"10.1093\/ije\/dyz034","article-title":"Data resource profile: Clinical Practice Research Datalink (CPRD) Aurum","volume":"48","author":"Wolf","year":"2019","journal-title":"Int J Epidemiol"},{"key":"10.1016\/j.lanhl.2026.100852_bib13","doi-asserted-by":"crossref","DOI":"10.1093\/ije\/dyaf077","article-title":"Data resource profile update: CPRD GOLD","volume":"54","author":"Sanchez-Santos","year":"2025","journal-title":"Int J Epidemiol"},{"key":"10.1016\/j.lanhl.2026.100852_bib14","doi-asserted-by":"crossref","first-page":"758","DOI":"10.1093\/aje\/kwv254","article-title":"Using big data to emulate a target trial when a randomized trial is not available","volume":"183","author":"Hern\u00e1n","year":"2016","journal-title":"Am J Epidemiol"},{"key":"10.1016\/j.lanhl.2026.100852_bib15","doi-asserted-by":"crossref","first-page":"1719","DOI":"10.1093\/ije\/dyaa057","article-title":"Reflection on modern methods: trial emulation in the presence of immortal-time bias. Assessing the benefit of major surgery for elderly lung cancer patients using observational data","volume":"49","author":"Maringe","year":"2020","journal-title":"Int J Epidemiol"},{"key":"10.1016\/j.lanhl.2026.100852_bib16","doi-asserted-by":"crossref","DOI":"10.1016\/j.jinf.2024.106367","article-title":"Characteristics, risk factors and clinical impact of penicillin and other antibiotic allergies in adults in the UK General Practice: a population-based cohort study","volume":"90","author":"Jani","year":"2025","journal-title":"J Infect"},{"key":"10.1016\/j.lanhl.2026.100852_bib17","doi-asserted-by":"crossref","DOI":"10.1136\/bmj-2021-068005","article-title":"Association between age at onset of multimorbidity and incidence of dementia: 30 year follow-up in Whitehall II prospective cohort study","volume":"376","author":"Ben Hassen","year":"2022","journal-title":"BMJ"},{"key":"10.1016\/j.lanhl.2026.100852_bib18","doi-asserted-by":"crossref","first-page":"1121","DOI":"10.1001\/jamainternmed.2024.2781","article-title":"Prescription medication use among older adults in the US","volume":"184","author":"Innes","year":"2024","journal-title":"JAMA Intern Med"},{"key":"10.1016\/j.lanhl.2026.100852_bib19","doi-asserted-by":"crossref","DOI":"10.1002\/cam4.70461","article-title":"De-mystifying the clone-censor-weight method for causal research using observational data: a primer for cancer researchers","volume":"13","author":"Gaber","year":"2024","journal-title":"Cancer Med"},{"key":"10.1016\/j.lanhl.2026.100852_bib20","doi-asserted-by":"crossref","first-page":"656","DOI":"10.1093\/aje\/kwn164","article-title":"Constructing inverse probability weights for marginal structural models","volume":"168","author":"Cole","year":"2008","journal-title":"Am J Epidemiol"},{"key":"10.1016\/j.lanhl.2026.100852_bib21","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1097\/EDE.0b013e3181c1ea43","article-title":"The hazards of hazard ratios","volume":"21","author":"Hern\u00e1n","year":"2010","journal-title":"Epidemiology"},{"key":"10.1016\/j.lanhl.2026.100852_bib22","article-title":"Timing of dialysis initiation to reduce mortality and cardiovascular events in advanced chronic kidney disease: nationwide cohort study","volume":"375","author":"Fu","year":"2021","journal-title":"BMJ"},{"key":"10.1016\/j.lanhl.2026.100852_bib23","first-page":"39","article-title":"Causal survival analysis: a guide to estimating intention-to-treat and per-protocol effects from randomized clinical trials with non-adherence","volume":"2","author":"Murray","year":"2021","journal-title":"Res Methods Med Health Sci"},{"key":"10.1016\/j.lanhl.2026.100852_bib24","doi-asserted-by":"crossref","first-page":"3083","DOI":"10.1002\/sim.3697","article-title":"Balance diagnostics for comparing the distribution of baseline covariates between treatment groups in propensity-score matched samples","volume":"28","author":"Austin","year":"2009","journal-title":"Stat Med"},{"key":"10.1016\/j.lanhl.2026.100852_bib25","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1007\/s40266-022-00992-5","article-title":"Implications of adverse outcomes associated with antipsychotics in older patients with dementia: a 2011\u20132022 update","volume":"40","author":"Rogowska","year":"2023","journal-title":"Drugs Aging"},{"key":"10.1016\/j.lanhl.2026.100852_bib26","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1177\/2040622316658463","article-title":"Antipsychotic use in dementia: a systematic review of benefits and risks from meta-analyses","volume":"7","author":"Tampi","year":"2016","journal-title":"Ther Adv Chronic Dis"},{"key":"10.1016\/j.lanhl.2026.100852_bib27","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2019.0828","article-title":"Assessment of reported comparative effectiveness and safety of atypical antipsychotics in the treatment of behavioral and psychological symptoms of dementia: a network meta-analysis","volume":"2","author":"Yunusa","year":"2019","journal-title":"JAMA Network Open"},{"key":"10.1016\/j.lanhl.2026.100852_bib28","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1016\/S1474-4422(08)70295-3","article-title":"The dementia antipsychotic withdrawal trial (DART-AD): long-term follow-up of a randomised placebo-controlled trial","volume":"8","author":"Ballard","year":"2009","journal-title":"Lancet Neurol"},{"key":"10.1016\/j.lanhl.2026.100852_bib29","doi-asserted-by":"crossref","first-page":"1497","DOI":"10.1056\/NEJMoa1114058","article-title":"Relapse risk after discontinuation of risperidone in Alzheimer\u2019s disease","volume":"367","author":"Devanand","year":"2012","journal-title":"N Engl J Med"},{"key":"10.1016\/j.lanhl.2026.100852_bib30","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1080\/13607863.2012.717255","article-title":"The effects of abrupt antipsychotic discontinuation in cognitively impaired older persons: a pilot study","volume":"17","author":"Azermai","year":"2013","journal-title":"Aging Ment Health"},{"key":"10.1016\/j.lanhl.2026.100852_bib31","article-title":"Systematic review and meta-analysis of antipsychotic discontinuation in dementia","volume":"11","author":"Roche","year":"2025","journal-title":"Alzheimers Dement (N Y)"},{"key":"10.1016\/j.lanhl.2026.100852_bib32","doi-asserted-by":"crossref","first-page":"671","DOI":"10.1001\/jamapsychiatry.2025.0702","article-title":"Health outcomes of discontinuing antipsychotics after hospitalization in older adults","volume":"82","author":"Yang","year":"2025","journal-title":"JAMA Psychiatry"},{"key":"10.1016\/j.lanhl.2026.100852_bib33","doi-asserted-by":"crossref","first-page":"484","DOI":"10.1186\/s12916-025-04304-7","article-title":"Effect of discontinuing antipsychotic medications on the risk of hospitalization in long-term care: a machine learning-based analysis","volume":"23","author":"Nuutinen","year":"2025","journal-title":"BMC Med"},{"key":"10.1016\/j.lanhl.2026.100852_bib34","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1016\/j.jclinepi.2016.04.014","article-title":"Specifying a target trial prevents immortal time bias and other self-inflicted injuries in observational analyses","volume":"79","author":"Hern\u00e1n","year":"2016","journal-title":"J Clin Epidemiol"}],"container-title":["The Lancet Healthy Longevity"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S266675682600036X?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S266675682600036X?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T20:54:16Z","timestamp":1783025656000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S266675682600036X"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5]]},"references-count":32,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,5]]}},"alternative-id":["S266675682600036X"],"URL":"https:\/\/doi.org\/10.1016\/j.lanhl.2026.100852","relation":{},"ISSN":["2666-7568"],"issn-type":[{"value":"2666-7568","type":"print"}],"subject":[],"published":{"date-parts":[[2026,5]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Abrupt discontinuation and tapering of antipsychotics in older adults with dementia: a target trial emulation study","name":"articletitle","label":"Article Title"},{"value":"The Lancet Healthy Longevity","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.lanhl.2026.100852","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"https:\/\/doi.org\/10.1016\/j.lanhl.2026.100860","name":"associatedlink","label":"CrossRef DOI link to the associated document"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2026 The Author(s). Published by Elsevier Ltd.","name":"copyright","label":"Copyright"}],"article-number":"100852"}}