Warren-Gash, C;
Williamson, E;
Shiekh, SI;
Borjas-Howard, J;
Pearce, N;
Breuer, JM;
Smeeth, L;
(2022)
No evidence that herpes zoster is associated with increased risk of dementia diagnosis.
Annals of Clinical and Translational Neurology
10.1002/acn3.51525.
(In press).
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Abstract
Objective: To investigate whether herpes zoster (HZ) was associated with subsequent increased risk of dementia diagnosis. / Methods: We conducted a historical cohort study using primary care electronic health records from the Clinical Practice Research Datalink in the United Kingdom. Individuals with incident HZ aged ≥40 years from 2000 to 2017 were matched with up to four individuals without HZ by age, sex, primary care practise and calendar time. The primary outcome was a new diagnosis of all-cause dementia. We used the Cox proportional hazards regression adjusting for demographic, lifestyle and clinical confounders to assess any association between HZ and dementia. We investigated interactions with sex, frailty index and antiviral treatment and conducted various sensitivity analyses. / Results: The cohort comprised 177,144 individuals with HZ and 706,901 matched unexposed individuals (median age 65 years (IQR 55.1–75.0), 40% male) followed for a median duration of 4.6 years (IQR 2.0–8.1). In total, 26,585 (3%) patients had an incident dementia diagnosis recorded and 113,056 patients died (12.8%). HZ was associated with a small reduction in dementia diagnosis (adjusted HR 0.92 (95% CI 0.89–0.95)), occurring predominantly in frail individuals and females. For patients who were fit (578,115, 65%), no association was seen (adjusted HR 0.97, 95% CI 0.92–1.02). There was no association between HZ and a composite outcome of dementia or death (adjusted HR 1.00, 95% CI 0.99–1.02). Dementia risk did not vary by prescription of antiviral agents. Sensitivity analyses showed consistent results. / Interpretation: HZ was not associated with increased dementia diagnosis in a UK primary care-based cohort.
| Type: | Article |
|---|---|
| Title: | No evidence that herpes zoster is associated with increased risk of dementia diagnosis |
| Location: | United States |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1002/acn3.51525 |
| Publisher version: | https://doi.org/10.1002/acn3.51525 |
| Language: | English |
| Additional information: | Copyright © 2022 The Authors. Annals of Clinical and Translational Neurology published by Wiley Periodicals LLC on behalf of American Neurological Association. This is an open access article under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits use, distribution and reproduction in any medium, provided the original work is properly cited. |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Infection, Immunity and Inflammation Dept UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10144596 |
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