Herpes Zoster Not Linked to a Higher Risk of Dementia Diagnosis

Pavankumar Kamat

Disclosures

March 02, 2022

Takeaway

  • Herpes zoster (HZ) infection was not associated with an increased risk of dementia diagnosis.

Why This Matters

  • A better understanding of the complex relationships between infection, immune system modulation, and chronic disease risk may aid the identification of susceptible individuals and the development of interventional strategies.

Study Design

  • A historical cohort study used data from the Clinical Practice Research Datalink (CPRD), UK (2000-2017).

  • 177,144 patients with HZ (age, ≥40 years) and 706,901 matched participants without HZ were included.

  • Median follow-up duration was 4.6 years

  • Primary outcome: incident all-cause dementia.

  • Secondary outcomes: dementia subtypes (Alzheimer’s disease [AD], vascular dementia, other specified dementia, and mixed/unspecified dementia).

  • Funding: None disclosed.

Key Results

  • The overall incidence rate of dementia was 5.58 (95% CI 5.51 to 5.65)/1000 person-years.

  • After adjustment for confounders, HZ was associated with a marginal reduction in the risk of dementia diagnosis (adjusted HR [aHR] 0.92; 95% CI 0.89 to 0.95), which was predominantly reported in patients with frailty and women.

  • HZ was not associated with an increased risk of dementia diagnosis in patients who were fit (aHR 0.97; 95% CI 0.92 to 1.02).

  • No association was observed between HZ and (aHR; 95% CI):

    • composite outcome of dementia or death (1.00; 0.99 to 1.02);

    • AD (0.94; 0.89 to 1.00);

    • vascular dementia (0.95; 0.90 to 1.02); and

    • other specified dementia subtypes (0.91; 0.77 to 1.07).

  • A marginal protective association was seen between HZ and mixed or unspecified dementia (aHR 0.88; 95% CI 0.83 to 0.92).

Limitations

  • Risk of residual confounding.

Warren-Gash C, Williamson E, Shiekh SI, Borjas-Howard J, Pearce N, Breuer JM, Smeeth L. No evidence that herpes zoster is associated with increased risk of dementia diagnosis. Ann Clin Transl Neurol. 2022 Feb 16 [Epub ahead of print]. doi: 10.1002/acn3.51525. PMID: 35170873 View Full Text.

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