Impact of herpes zoster vaccination on incident dementia: A retrospective study in two patient cohorts
Herpes zoster (HZ) infection increases dementia risk, but it is not known if herpes zoster vaccination is associated with lower risk for dementia. We determined if HZ vaccination, compared to no HZ vaccination, is associated with lower risk for incident dementia. Data was obtained from Veterans Heal...
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| description | Herpes zoster (HZ) infection increases dementia risk, but it is not known if herpes zoster vaccination is associated with lower risk for dementia. We determined if HZ vaccination, compared to no HZ vaccination, is associated with lower risk for incident dementia.
Data was obtained from Veterans Health Affairs (VHA) medical records (10/1/2008-9/30/2019) with replication in MarketScan® commercial and Medicare claims (1/1/2009-12/31/2018). Eligible patients were ≥65 years of age and free of dementia for two years prior to baseline (VHA n = 136,016; MarketScan n = 172,790). Two index periods (either start of 2011 or 2012) were defined, where patients either had or did not have a HZ vaccination. Confounding was controlled with propensity scores and inverse probability of treatment weighting. Competing risk (VHA) and Cox proportional hazard (MarketScan) models estimated the association between HZ vaccination and incident dementia in all patients and in age (65-69, 70-74, ≥75) and race (White, Black, Other) sub-groups. Sensitivity analysis measured the association between HZ vaccination and incident Alzheimer's dementia (AD). HZ vaccination at index versus no HZ vaccination throughout follow-up. VHA patients mean age was 75.7 (SD±7.4) years, 4.0% were female, 91.2% white and 20.2% had HZ vaccination. MarketScan patients mean age was 69.9 (SD±5.7) years, 65.0% were female and 14.2% had HZ vaccination. In both cohorts, HZ vaccination compared with no vaccination, was significantly associated with lower dementia risk (VHA HR = 0.69; 95%CI: 0.67-0.72; MarketScan HR = 0.65; 95%CI:0.57-0.74). HZ vaccination was not related to dementia risk in MarketScan patients aged 65-69 years. No difference in HZ vaccination to dementia effects were found by race. HZ vaccination was associated with lower risk for AD.
HZ vaccination is associated with reduced risk of dementia. Vaccination may provide nonspecific neuroprotection by training the immune system to limit damaging inflammation, or specific neuroprotection that prevents viral cytopathic effects. |
| doi_str_mv | 10.1371/journal.pone.0257405 |
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Data was obtained from Veterans Health Affairs (VHA) medical records (10/1/2008-9/30/2019) with replication in MarketScan® commercial and Medicare claims (1/1/2009-12/31/2018). Eligible patients were ≥65 years of age and free of dementia for two years prior to baseline (VHA n = 136,016; MarketScan n = 172,790). Two index periods (either start of 2011 or 2012) were defined, where patients either had or did not have a HZ vaccination. Confounding was controlled with propensity scores and inverse probability of treatment weighting. Competing risk (VHA) and Cox proportional hazard (MarketScan) models estimated the association between HZ vaccination and incident dementia in all patients and in age (65-69, 70-74, ≥75) and race (White, Black, Other) sub-groups. Sensitivity analysis measured the association between HZ vaccination and incident Alzheimer's dementia (AD). HZ vaccination at index versus no HZ vaccination throughout follow-up. VHA patients mean age was 75.7 (SD±7.4) years, 4.0% were female, 91.2% white and 20.2% had HZ vaccination. MarketScan patients mean age was 69.9 (SD±5.7) years, 65.0% were female and 14.2% had HZ vaccination. In both cohorts, HZ vaccination compared with no vaccination, was significantly associated with lower dementia risk (VHA HR = 0.69; 95%CI: 0.67-0.72; MarketScan HR = 0.65; 95%CI:0.57-0.74). HZ vaccination was not related to dementia risk in MarketScan patients aged 65-69 years. No difference in HZ vaccination to dementia effects were found by race. HZ vaccination was associated with lower risk for AD.
HZ vaccination is associated with reduced risk of dementia. Vaccination may provide nonspecific neuroprotection by training the immune system to limit damaging inflammation, or specific neuroprotection that prevents viral cytopathic effects.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0257405</identifier><identifier>PMID: 34788293</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Age ; Aged ; Alzheimer's disease ; Alzheimers disease ; Biology and Life Sciences ; Chronic obstructive pulmonary disease ; Codes ; Complications and side effects ; Dementia ; Dementia - epidemiology ; Dementia - etiology ; Dementia disorders ; Female ; Follow-Up Studies ; Government programs ; Health insurance ; Health risk assessment ; Health risks ; Herpes viruses ; Herpes zoster ; Herpes Zoster - immunology ; Herpes Zoster - prevention & control ; Humans ; Immune system ; Immunology ; Incidence ; Infections ; Infectious diseases ; Internal medicine ; Jacobs, John ; Kidney diseases ; Laboratories ; Male ; Medical records ; Medicare ; Medicine ; Medicine and Health Sciences ; Neuroprotection ; Patients ; Prevention ; Proportional Hazards Models ; Race ; Retrospective Studies ; Risk factors ; Risk management ; Risk reduction ; Sensitivity analysis ; Shingles (Disease) ; Social Sciences ; Vaccination ; Vaccines ; Veterans Health Services ; Viral infections</subject><ispartof>PloS one, 2021-11, Vol.16 (11), p.e0257405-e0257405</ispartof><rights>COPYRIGHT 2021 Public Library of Science</rights><rights>2021 Scherrer et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2021 Scherrer et al 2021 Scherrer et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c692t-273481609b56229c623c973b1aa1e7078db3562ff7d4bc770f9aaee15a1b681f3</citedby><cites>FETCH-LOGICAL-c692t-273481609b56229c623c973b1aa1e7078db3562ff7d4bc770f9aaee15a1b681f3</cites><orcidid>0000-0002-9148-2863</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8597989/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8597989/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,2101,2927,23865,27923,27924,53790,53792,79471,79472</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34788293$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Wu, Ping-Hsun</contributor><creatorcontrib>Scherrer, Jeffrey F</creatorcontrib><creatorcontrib>Salas, Joanne</creatorcontrib><creatorcontrib>Wiemken, Timothy L</creatorcontrib><creatorcontrib>Hoft, Daniel F</creatorcontrib><creatorcontrib>Jacobs, Christine</creatorcontrib><creatorcontrib>Morley, John E</creatorcontrib><title>Impact of herpes zoster vaccination on incident dementia: A retrospective study in two patient cohorts</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Herpes zoster (HZ) infection increases dementia risk, but it is not known if herpes zoster vaccination is associated with lower risk for dementia. We determined if HZ vaccination, compared to no HZ vaccination, is associated with lower risk for incident dementia.
Data was obtained from Veterans Health Affairs (VHA) medical records (10/1/2008-9/30/2019) with replication in MarketScan® commercial and Medicare claims (1/1/2009-12/31/2018). Eligible patients were ≥65 years of age and free of dementia for two years prior to baseline (VHA n = 136,016; MarketScan n = 172,790). Two index periods (either start of 2011 or 2012) were defined, where patients either had or did not have a HZ vaccination. Confounding was controlled with propensity scores and inverse probability of treatment weighting. Competing risk (VHA) and Cox proportional hazard (MarketScan) models estimated the association between HZ vaccination and incident dementia in all patients and in age (65-69, 70-74, ≥75) and race (White, Black, Other) sub-groups. Sensitivity analysis measured the association between HZ vaccination and incident Alzheimer's dementia (AD). HZ vaccination at index versus no HZ vaccination throughout follow-up. VHA patients mean age was 75.7 (SD±7.4) years, 4.0% were female, 91.2% white and 20.2% had HZ vaccination. MarketScan patients mean age was 69.9 (SD±5.7) years, 65.0% were female and 14.2% had HZ vaccination. In both cohorts, HZ vaccination compared with no vaccination, was significantly associated with lower dementia risk (VHA HR = 0.69; 95%CI: 0.67-0.72; MarketScan HR = 0.65; 95%CI:0.57-0.74). HZ vaccination was not related to dementia risk in MarketScan patients aged 65-69 years. No difference in HZ vaccination to dementia effects were found by race. HZ vaccination was associated with lower risk for AD.
HZ vaccination is associated with reduced risk of dementia. Vaccination may provide nonspecific neuroprotection by training the immune system to limit damaging inflammation, or specific neuroprotection that prevents viral cytopathic effects.</description><subject>Age</subject><subject>Aged</subject><subject>Alzheimer's disease</subject><subject>Alzheimers disease</subject><subject>Biology and Life Sciences</subject><subject>Chronic obstructive pulmonary disease</subject><subject>Codes</subject><subject>Complications and side effects</subject><subject>Dementia</subject><subject>Dementia - epidemiology</subject><subject>Dementia - etiology</subject><subject>Dementia disorders</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Government programs</subject><subject>Health insurance</subject><subject>Health risk assessment</subject><subject>Health risks</subject><subject>Herpes viruses</subject><subject>Herpes zoster</subject><subject>Herpes Zoster - immunology</subject><subject>Herpes Zoster - prevention & control</subject><subject>Humans</subject><subject>Immune system</subject><subject>Immunology</subject><subject>Incidence</subject><subject>Infections</subject><subject>Infectious diseases</subject><subject>Internal medicine</subject><subject>Jacobs, John</subject><subject>Kidney diseases</subject><subject>Laboratories</subject><subject>Male</subject><subject>Medical records</subject><subject>Medicare</subject><subject>Medicine</subject><subject>Medicine and Health Sciences</subject><subject>Neuroprotection</subject><subject>Patients</subject><subject>Prevention</subject><subject>Proportional Hazards Models</subject><subject>Race</subject><subject>Retrospective Studies</subject><subject>Risk factors</subject><subject>Risk management</subject><subject>Risk reduction</subject><subject>Sensitivity analysis</subject><subject>Shingles (Disease)</subject><subject>Social Sciences</subject><subject>Vaccination</subject><subject>Vaccines</subject><subject>Veterans Health 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Scherrer, Jeffrey F</au><au>Salas, Joanne</au><au>Wiemken, Timothy L</au><au>Hoft, Daniel F</au><au>Jacobs, Christine</au><au>Morley, John E</au><au>Wu, Ping-Hsun</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Impact of herpes zoster vaccination on incident dementia: A retrospective study in two patient cohorts</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2021-11-17</date><risdate>2021</risdate><volume>16</volume><issue>11</issue><spage>e0257405</spage><epage>e0257405</epage><pages>e0257405-e0257405</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Herpes zoster (HZ) infection increases dementia risk, but it is not known if herpes zoster vaccination is associated with lower risk for dementia. We determined if HZ vaccination, compared to no HZ vaccination, is associated with lower risk for incident dementia.
Data was obtained from Veterans Health Affairs (VHA) medical records (10/1/2008-9/30/2019) with replication in MarketScan® commercial and Medicare claims (1/1/2009-12/31/2018). Eligible patients were ≥65 years of age and free of dementia for two years prior to baseline (VHA n = 136,016; MarketScan n = 172,790). Two index periods (either start of 2011 or 2012) were defined, where patients either had or did not have a HZ vaccination. Confounding was controlled with propensity scores and inverse probability of treatment weighting. Competing risk (VHA) and Cox proportional hazard (MarketScan) models estimated the association between HZ vaccination and incident dementia in all patients and in age (65-69, 70-74, ≥75) and race (White, Black, Other) sub-groups. Sensitivity analysis measured the association between HZ vaccination and incident Alzheimer's dementia (AD). HZ vaccination at index versus no HZ vaccination throughout follow-up. VHA patients mean age was 75.7 (SD±7.4) years, 4.0% were female, 91.2% white and 20.2% had HZ vaccination. MarketScan patients mean age was 69.9 (SD±5.7) years, 65.0% were female and 14.2% had HZ vaccination. In both cohorts, HZ vaccination compared with no vaccination, was significantly associated with lower dementia risk (VHA HR = 0.69; 95%CI: 0.67-0.72; MarketScan HR = 0.65; 95%CI:0.57-0.74). HZ vaccination was not related to dementia risk in MarketScan patients aged 65-69 years. No difference in HZ vaccination to dementia effects were found by race. HZ vaccination was associated with lower risk for AD.
HZ vaccination is associated with reduced risk of dementia. Vaccination may provide nonspecific neuroprotection by training the immune system to limit damaging inflammation, or specific neuroprotection that prevents viral cytopathic effects.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>34788293</pmid><doi>10.1371/journal.pone.0257405</doi><tpages>e0257405</tpages><orcidid>https://orcid.org/0000-0002-9148-2863</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1932-6203 |
| ispartof | PloS one, 2021-11, Vol.16 (11), p.e0257405-e0257405 |
| issn | 1932-6203 1932-6203 |
| language | eng |
| recordid | cdi_plos_journals_2598510768 |
| source | MEDLINE; DOAJ Directory of Open Access Journals; Public Library of Science (PLoS); EZB-FREE-00999 freely available EZB journals; PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Age Aged Alzheimer's disease Alzheimers disease Biology and Life Sciences Chronic obstructive pulmonary disease Codes Complications and side effects Dementia Dementia - epidemiology Dementia - etiology Dementia disorders Female Follow-Up Studies Government programs Health insurance Health risk assessment Health risks Herpes viruses Herpes zoster Herpes Zoster - immunology Herpes Zoster - prevention & control Humans Immune system Immunology Incidence Infections Infectious diseases Internal medicine Jacobs, John Kidney diseases Laboratories Male Medical records Medicare Medicine Medicine and Health Sciences Neuroprotection Patients Prevention Proportional Hazards Models Race Retrospective Studies Risk factors Risk management Risk reduction Sensitivity analysis Shingles (Disease) Social Sciences Vaccination Vaccines Veterans Health Services Viral infections |
| title | Impact of herpes zoster vaccination on incident dementia: A retrospective study in two patient cohorts |
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