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PREVENTABLE, a double\u2010blind, placebo\u2010controlled randomized pragmatic clinical trial, will compare high\u2010intensity statin therapy (atorvastatin 40\u2009mg) with placebo in 20,000 community\u2010dwelling adults aged \u226575\u2009years without cardiovascular disease, disability, or dementia at baseline. Exclusion criteria include statin use in the prior year or for &gt;5\u2009years and inability to take a statin. Potential participants are identified using computable phenotypes derived from the electronic health record and local referrals from the community. Participants will undergo baseline cognitive testing, with physical testing and a blinded lipid panel if feasible. Cognitive testing and disability screening will be conducted annually. Multiple data sources will be queried for cardiovascular events, dementia, and disability; survival is site\u2010reported and supplemented by a National Death Index search. The primary outcome is survival free of new dementia or persisting disability. Co\u2010secondary outcomes are a composite of cardiovascular death, hospitalization for unstable angina or myocardial infarction, heart failure, stroke, or coronary revascularization; and a composite of mild cognitive impairment or dementia. Ancillary studies will offer mechanistic insights into the effects of statins on key outcomes. Biorepository samples are obtained and stored for future study. These results will inform the benefit of statins for increasing survival free of dementia and disability among older adults. This is a pioneering pragmatic study testing important questions with low participant burden to align with the needs of the growing population of older adults.<\/jats:p>","DOI":"10.1111\/jgs.18312","type":"journal-article","created":{"date-parts":[[2023,4,21]],"date-time":"2023-04-21T02:48:35Z","timestamp":1682045315000},"page":"1701-1713","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":84,"title":["Pragmatic evaluation of events and benefits of lipid lowering in older adults (\n                    <scp>PREVENTABLE<\/scp>\n                    ): Trial design and rationale"],"prefix":"10.1111","volume":"71","author":[{"given":"Jacob","family":"Joseph","sequence":"first","affiliation":[{"name":"VA Providence Healthcare System  Providence Rhode Island USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4447-6196","authenticated-orcid":false,"given":"Nicholas M.","family":"Pajewski","sequence":"additional","affiliation":[{"name":"Wake Forest University School of Medicine  Winston\u2010Salem North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rowena J.","family":"Dolor","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute Duke University School of Medicine  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary Ann","family":"Sellers","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute Duke University School of Medicine  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Letitia H.","family":"Perdue","sequence":"additional","affiliation":[{"name":"Wake Forest University School of Medicine  Winston\u2010Salem North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheronda R.","family":"Peeples","sequence":"additional","affiliation":[{"name":"VA Boston Healthcare System  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam M.","family":"Henrie","sequence":"additional","affiliation":[{"name":"Cooperative Studies Program Clinical Research Pharmacy Coordinating Center Office of Research and Development, Department of Veterans Affairs  Albuquerque New Mexico USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3900-6410","authenticated-orcid":false,"given":"Nancy","family":"Woolard","sequence":"additional","affiliation":[{"name":"Wake Forest University School of Medicine  Winston\u2010Salem North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W. 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