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more consistent and individualized approach toward parental engagement in decision-making. Individuals with total joint arthroplasty (TJA) have long-term exposure to metal-containing implants; however, whether long-term exposure to artificial implants is associated with cognitive function is unknown. To compare long-term cognitive trajectories in individuals with and without TJA. This population-based cohort study assessed serial cognitive evaluations of 5550 participants (≥50 years of age) from the Mayo Clinic Study of Aging between No
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