I suspect the dementia reduction is a result of residual confounding as mentioned in the paper and your article. In other words the adjuvant/vaccine did not cause a reduction. There was no dose response to adjuvant from people who got multiple doses of adjuvant. The rapid separation of curves is suspect because dementia is a slow-moving process.
Fair points, and definitely one plausible interpretation! I think the authors argue the lack of an additive effect reflects a "ceiling" effect on how much an ajdvuvant could do, but I agree that is still speculation as well.
Thanks Jenn and I did see their explanation. In my field we call that ceiling "diminishing returns". The authors provided absolutely no rationale why the ceiling would be one dose. Yup, speculation is a good word for sure.
The residual confounding was the bigger deal for me. I can easily imagine that an early dementia (pre-diagnosis) patient would be more likely in the non-vax group. Matching by flu uptake doesn't cut it since flu shots are more habitual, which someone with early dementia would have no problem doing. Whereas shingrix is a relatively new and comparatively less frequent action — something a person with incipient dementia would struggle with or be less aware of due to their cognitive problems.
I suspect the dementia reduction is a result of residual confounding as mentioned in the paper and your article. In other words the adjuvant/vaccine did not cause a reduction. There was no dose response to adjuvant from people who got multiple doses of adjuvant. The rapid separation of curves is suspect because dementia is a slow-moving process.
Fair points, and definitely one plausible interpretation! I think the authors argue the lack of an additive effect reflects a "ceiling" effect on how much an ajdvuvant could do, but I agree that is still speculation as well.
Thanks Jenn and I did see their explanation. In my field we call that ceiling "diminishing returns". The authors provided absolutely no rationale why the ceiling would be one dose. Yup, speculation is a good word for sure.
The residual confounding was the bigger deal for me. I can easily imagine that an early dementia (pre-diagnosis) patient would be more likely in the non-vax group. Matching by flu uptake doesn't cut it since flu shots are more habitual, which someone with early dementia would have no problem doing. Whereas shingrix is a relatively new and comparatively less frequent action — something a person with incipient dementia would struggle with or be less aware of due to their cognitive problems.
Anyway, good article!
Thanks, and I appreciate your thoughts here!
That's something new thanks