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Reduced Dementia Incidence Following Neck Dissection: A Population-based Matched Cohort Study
Chiarella LS, Acar L, Dahmann S, Jin L, Otto T, Marschall U, Nzomo MM, Hirsch T et al.. Research Square, 2026-08-31
Topic: Inflammation, microglia and astrocytes
Among 9,386 propensity score-matched pairs of ND patients and controls, covariates were well balanced. During seven years of follow-up, ND patients had a 38.4% lower dementia incidence despite higher mortality. The cumulative incidence of dementia was 7.8% in the ND cohort versus 12.3% in controls (Fine-Gray-sHR 0.62, 95%-CI 0.57–0.68). This pattern persisted when controls were stratified by baseline malignacy status, with the ND cohort showing the lowest incidence (7.8%) compared with controls with cancer (9.9%) and without cancer (14.1%), despite the highest mortality. ND was also associated with a lower incidence of Alzheimer’s disease-related dementia (sHR 0.66, p < 0.0001). These findings suggest a previously overlooked potential link between disrupted cervical lymphatics and neurodegenerative pathophysiology in contrast to the present drainage hypothesis. These findings are relevant to current debates on lymphosurgical interventions and underscore the need for mechanistic studies examining the lymph-brain axis.
Key findings
- Among 9,386 propensity score-matched pairs of ND patients and controls, covariates were well balanced.
- During seven years of follow-up, ND patients had a 38.4% lower dementia incidence despite higher mortality.
- The cumulative incidence of dementia was 7.8% in the ND cohort versus 12.3% in controls (Fine-Gray-sHR 0.62, 95%-CI 0.57–0.68).
- This pattern persisted when controls were stratified by baseline malignacy status, with the ND cohort showing the lowest incidence (7.8%) compared with controls with cancer (9.9%) and without cancer (14.1%), despite the highest mortality.
- ND was also associated with a lower incidence of Alzheimer’s disease-related dementia (sHR 0.66, p < 0.0001).
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Study details
- Study designretrospective cohort
- Effect size38.4%; 7.8%; 12.3%
- Evidence strengthModerate
How this study scored 16/100
Preprint — not yet peer-reviewed. It scored 39 on the same rubric, but non-peer-reviewed sources are capped at 16, so it shows as 16. Scored zero for sample size, studied in people and randomised / blinded because the record does not state it. We have no data on times cited, citations per year, impact for its field and year, cited by studies here, still being cited, senior author's track record, institution's track record and multi-centre collaboration, so those were left out: it earned 24 of the 62 points we could judge it on, which is 39 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 2 / 10 | Tier 4 — not a peer-reviewed journal (Research Square) |
| Journal's citation record | 0 / 4 | Not a journal article, so the journal's record does not count |
| Study design | 7 / 12 | A retrospective cohort study, reconstructed from past records |
| Strength of evidence | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 4 / 10 | Preprint — not yet peer-reviewed. Hosted on a preprint server. |
| How recent | 5 / 5 | 2026 — within 1 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 2 / 3 | Effect reported as a number, without an interval or test |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | — / 7 | No citation count (not found in OpenAlex) — left out of this score |
| Citations per year | — / 5 | No citation count or no year — left out of this score |
| Impact for its field and year | — / 6 | No field-weighted citation impact (OpenAlex has none yet) — left out of this score |
| Cited by studies here | — / 6 | Not yet checked against this library's citation graph — left out of this score |
| Still being cited | — / 4 | No yearly citation counts — left out of this score |
| Senior author's track record | — / 4 | Senior author's record not available — left out of this score |
| Institution's track record | — / 3 | No institution listed in OpenAlex — left out of this score |
| Multi-centre collaboration | — / 3 | Institutions not listed — left out of this score |
| Indexed in PubMed | 1 / 2 | Not in PubMed, but has a DOI |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Points | 24 / 62 | Scored on 12 of 20 parts. We have no data for the rest, so they are left out: 24 of the 62 points we could judge it on is 39 out of 100. |
| Total | 39 / 100 | Capped to 16 because this is not a peer-reviewed article. |
What each of these 20 components measures, and what this score is not →
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Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record's author list ends in “et al.”, so not every author is named. Check the citation against the original before you use it.
APA 7th
Chiarella, L. S., Acar, L., Dahmann, S., Jin, L., Otto, T., Marschall, U., et al. (2026). Reduced Dementia Incidence Following Neck Dissection: A Population-based Matched Cohort Study. Research Square. https://doi.org/10.21203/rs.3.rs-10718409/v1
Vancouver
Chiarella LS, Acar L, Dahmann S, Jin L, Otto T, Marschall U, et al. Reduced Dementia Incidence Following Neck Dissection: A Population-based Matched Cohort Study. Research Square. 2026. doi:10.21203/rs.3.rs-10718409/v1.
BibTeX
@article{chiarella2026-eb5bfb2c,
author = {Chiarella, L. S. and Acar, L. and Dahmann, S. and Jin, L. and Otto, T. and Marschall, U. and Nzomo, M. M. and Hirsch, T. and others},
title = {{Reduced Dementia Incidence Following Neck Dissection: A Population-based Matched Cohort Study}},
journal = {Research Square},
year = {2026},
doi = {10.21203/rs.3.rs-10718409/v1},
url = {https://doi.org/10.21203/rs.3.rs-10718409/v1}
}
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