***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Objectives Possible association between diabetes mellitus ( DM ) and Alzheimer ’s disease ( AD ) has been controversial . This study used a nationwide population -based data set to investigate the relationship between DM and subsequent AD incidence . Methods Data were collected from Taiwan ’s National Health Insurance Research Data base , which released a cohort data set of 1,000,000 r and omly sample d people and confirmed it to be representative of the Taiwanese population . We identified 71,433 patients newly diagnosed with diabetes ( age 58.74±14.02 years ) since January 1997 . Using propensity score , we matched them with 71,311 non-diabetic subjects by time of enrollment , age , gender , hypertension , hyperlipidemia , and previous stroke history . All the patients were followed up to December 31 , 2007 . The endpoint of the study was occurrence of AD . Results Over a maximum 11 years of follow-up , diabetic patients experienced a higher incidence of AD than non-diabetic subjects ( 0.48 % vs. 0.37 % , p<0.001 ) . After Cox proportional hazard regression model analysis , DM ( hazard ratio [ HR ] , 1.76 ; 95 % confidence interval [ CI ] , 1.50–2.07 , p<0.001 ) , age ( HR , 1.11 ; 95 % CI , 1.10–1.12 , p<0.001 ) , female gender ( HR , 1.24 ; 95 % CI , 1.06–1.46 , p = 0.008 ) , hypertension ( HR , 1.30 ; 95 % CI , 1.07–1.59 , p = 0.01 ) , previous stroke history ( HR , 1.79 ; 95 % CI , 1.28–2.50 , p<0.001 ) , and urbanization status ( metropolis , HR , 1.32 ; 95 % CI , 1.07–1.63 , p = 0.009 ) were independently associated with the increased risk of AD . Neither monotherapy nor combination therapy with oral antidiabetic medications were associated with the risk of AD after adjusting for underlying risk factors and the duration of DM since diagnosis . However , combination therapy with insulin was found to be associated with greater risk of AD ( HR , 2.17 ; 95 % CI , 1.04–4.52 , p = 0.039 ) . Conclusion Newly diagnosed DM was associated with increased risk of AD . Use of hypoglycemic agents did not ameliorate the risk Background : Several lines of evidence have linked cholesterol to dementia . Objective : To investigate lipid-lowering drug use and dementia development in a Finnish population . Methods : FINRISK is a large population -based survey of cardiovascular risk factors carried out since 1972 every 5 years using independent , r and om and representative population sample s from different parts of Finl and . Several cohorts were part of the WHO-MONICA study . Data from cohorts 1972–2002 were linked to the Hospital Discharge Registry and Drug Reimbursement Registry ( 1995–2007 ) to ascertain dementia diagnoses and lipid-lowering treatment . Selection criteria for the study were : ( 1 ) alive and without dementia in 1995 ; ( 2 ) age ≧60 years ( in 1995 for earlier cohorts and in 1997 or 2002 for later cohorts ; ( 3 ) treatment prescribed at least 1 year before dementia diagnosis . Results : 17,597 persons were included in the study .  Lipid-lowering treatment was related to decreased dementia risk . In Cox proportional hazards model , hazard ratio ( 95 % CI ) was 0.42 ( 0.37–0.49 ; controlled for age , sex , education , survey region , survey year , baseline cholesterol , body mass index and systolic blood pressure ) . Conclusion : Preliminary results from the FINRISK study indicate that lipid-lowering drugs may have a beneficial effect in dementia prevention . Further data linkage is ongoing in order to investigate the roles of different types of lipid-lowering drugs The aim of this prospect i ve cohort study was to evaluate the effects of lipid lowering agent ( LLA ) intake on cognitive function in 6,830 community-dwelling elderly persons .  Cognitive performance ( global cognitive functioning , visual memory , verbal fluency , psychomotor speed , and executive function ) , clinical diagnosis of dementia , and fibrate and statin use , were evaluated at baseline , and 2 , 4 , and 7 year follow-up . Multivariate Cox models were stratified by gender and adjusted for sociodemographic characteristics , mental and physical health including vascular risk factors , and genetic vulnerability ( apolipoprotein E and cholesteryl ester transfer protein ) . For women but not men , fibrate use was specifically associated with an increased risk over 7 years of decline in visual memory only ( HR = 1.29 , 95 % CI = 1.09 - 1.54 , p = 0.004 ) , and did not increase risk for incident dementia . This association was independent of genetic vulnerability related to apolipoprotein E and cholesteryl exchange transfer protein polymorphisms and occurred only in women with higher low density lipoprotein (LDL)-cholesterol levels and treated with fibrate ( HR = 1.39 , 95 % CI = 1.08 - 1.79 , p = 0.01 ) and not in those with lower LDL-cholesterol levels irrespective of fibrate treatment . For both genders , no significant associations were found between statins ( irrespective of their lipophilicity ) and either cognitive decline or dementia incidence . This prospect i ve study , adjusting for multiple confounders , found no evidence that LLA given in late life reduced the risk of cognitive decline and dementia , but did raise the possibility that women with treatment-resistant high LDL-cholesterol may be at increased risk of decline in visual memory Background : Previously reported associations between statin use and incident dementia or cognitive decline  have been inconsistent . We report the results from a 3-year prospect i ve study on the association of statin use on cognitive decline  and incident dementia in elderly African Americans . Methods : A community-based cohort of 1,146 African Americans aged 70 and older living in Indianapolis , Indiana , was evaluated in 2001 and 2004 . The instrument used for cognitive assessment was the Community Screening Interview for Dementia ( CSI-D ) . Cognitive decline was defined as CSI-D scores measured at 2001 minus scores at 2004 . Measurements of low-density lipoprotein cholesterol ( LDL-C ) and C-reactive protein ( CRP ) were obtained from baseline blood sample s. Results : Adjusting for age at baseline , gender , education , and the possession of ApoE ε4 allele , baseline statin use was associated with less cognitive decline ( p = 0.0177 ) . There were no significant interactions of statin use when LDL-C and CRP were included . Logistic regression with the four independent variables showed that statin use may be associated with a reduction in incident dementia ( OR = 0.32 ; p = 0.0673 ) . Association with cognitive decline was less clear when investigating statin use over time . Significance remained only for those who discontinued prior to follow-up compared to continuous users or users who started after baseline . Conclusions : The relationship between statin use and cognitive decline is complex and subjected to unknown confounders . This effect may not be associated with the cholesterol lowering or anti-inflammatory action of statins . GLOSSARY : AD = Alzheimer disease ; ANCOVA = analysis of covariance ; BMI = body mass index ; CAMDEX = Cambridge Examination for Mental Disorders of the Elderly informant interview ; CERAD = Consortium to Establish a Registry for Alzheimer ’s Disease ; CHIF = Clinician Home-based Interview to assess Function ; CRP = C-reactive protein ; CSI-D = Community Screening Instrument for Dementia ; HDL = high-density lipoprotein ; HMG-CoA = 3-hydroxy-3-methylglutaryl-coenzyme A ; LDL-C = low-density lipoprotein cholesterol ; LLAs = lipid-lowering agents ; NSAIDs = nonsteroidal anti-inflammatory drugs BACKGROUND Prior reports suggest reduced occurrence of dementia and Alzheimer disease ( AD ) in  statin users , but , to our knowledge , no prospect i ve studies relate statin use and dementia incidence . OBJECTIVE To examine the association of statin use with both prevalence and incidence of dementia and AD . DESIGN Cross-sectional studies of prevalence and incidence and a prospect i ve study of incidence of dementia and AD among 5092 elderly residents ( aged 65 years or older ) of a single county . Participants were assessed at home in 1995 - 1997 and again in 1998 - 2000 . A detailed visual inventory of medicines  , including statins and other lipid-lowering agents  , was collected at both assessment s. MAIN OUTCOME MEASURES Diagnosis of dementia and of AD . RESULTS From 4895 participants with data sufficient to determine cognitive status , we identified 355 cases of prevalent dementia ( 200 with AD ) at initial assessment . Statin use was inversely associated with prevalence of dementia ( adjusted odds ratio , 0.44 ; 95 % confidence interval , 0.17 - 0.94 ) . Three years later , we identified 185 cases of incident dementia ( 104 with AD ) among 3308 survivors at risk .  Statin use at baseline did not predict incidence of dementia or AD ( adjusted hazard ratio for dementia , 1.19 ; 95 % confidence interval , 0.53 - 2.34 ; adjusted hazard ratio for AD , 1.19 ; 95 % confidence interval , 0.35 - 2.96 ) , nor did statin use at follow-up ( adjusted odds ratio for dementia , 1.04 ; 95 % confidence interval , 0.56 - 1.81 ; adjusted odds ratio for AD , 0.85 ; 95 % confidence interval , 0.32 - 1.88 ) . CONCLUSIONS Although statin use might be less frequent in those with prevalent dementia , we found no association between statin use and subsequent onset of dementia or AD . Further research is warranted before costly dementia prevention trials with statins are undertaken We investigated whether angiotensin II receptor blockers ( ARBs ) and angiotensin converting enzyme inhibitors ( ACE-Is ) are more strongly associated with Alzheimer 's disease ( AD ) , vascular dementia ( VaD ) , and other dementias , than other anti-hypertensive drugs . We conducted a nested case-control analysis within the UK general practice research data base , with prospect ively recorded anti-hypertensive prescribing data . We sample d cases aged ≥60 years and diagnosed between 1997 - 2008 ( 5,797 with AD , 2,186 with VaD , 1,214 with unspecified/other dementia ) which were matched to up to four controls by age , general practice and gender . We computed odds-ratios and dose response effects for AD , vascular and unspecified/other dementia , comparing those prescribed ARBs or ACE-Is for at least six months with patients prescribed other anti-hypertensives . We controlled for matching factors , co-morbidities , smoking status , an area measure of socioeconomic status , consultation rate and blood pressure and accounted for reverse causality by introducing time-lags of up to eight years prior to diagnosis/index date . Patients diagnosed with AD , vascular and unspecified/other dementia had fewer prescriptions for ARBs and ACE-Is . Inverse associations with AD were strongest for ARBs ( odds-ratio ; 0.47 , 95%CI , 0.37 - 0.58 ) compared with ACE-Is ( odds-ratio ; 0.76 , 95%CI , 0.69 - 0.84 ) ( p(difference ) < 0.001 ) . Associations of ARBs with AD were stronger than for vascular dementia ( p(difference ) = 0.01 ) and unspecified/other dementia ( p(difference ) = 0.23 ) . There were inverse dose-response relationships between ARBs and ACE-Is with AD ( both p(trend ) < 0.01 ) . The inverse association of ACE-Is with AD diminished when using longer time lags but the ARB-AD association persisted . Patients with AD were around half as likely to be prescribed ARBs . Further r and omized controlled trial evidence is required to rigorously test these findings BACKGROUND Dementia affects an estimated 10 % of the population older than 65 years . Because vascular and lipid-related mechanisms are thought to have a role in the pathogenesis of Alzheimer 's disease and vascular dementia , we did an epidemiological study of the potential effect of HMGCoA ( 3 hydroxy-3methylglutaryl-coenzyme A ) reductase inhibitors ( statins ) and other lipid-lowering agents on dementia . METHODS We used a nested case-control design with information derived from  
    Output:
    
CONCLUSION Current evidence indicates that antihypertensives and statins might reduce the incidence of dementia and AD .