Association of herpes zoster with dementia and effect of antiviral therapy on dementia: a population-based cohort study
Abstract
We investigated the association between herpes zoster (HZ) and dementia, and the effects of antiviral therapy on the risk of dementia. We used the National Health Insurance Service-National Sample Cohort in South Korea to identify individuals that were followed from January 1, 2002, to December 31, 2013. Occurrences of HZ and dementia were identified using the relevant diagnostic codes. Dementia was defined as the presence of diagnostic codes and history of anti-dementia drug prescription. Propensity score matching (1:1) was carried out among HZ patients according to antiviral therapy. A total of 229,594 individuals aged ≥50 years were analyzed. The incidences of the first-diagnosed HZ and dementia were 16.69 and 4.67 per 1000 person-years (PY), respectively. HZ patients had a higher risk of dementia (incidence rate ratio [IRR], 1.94 [95% CI 1.83-2.06]; adjusted hazard ratio [HR], 1.12 [95% CI 1.05-1.19]). Of the 34,505 patients with HZ, 28,873 (84%) had received antiviral treatment. The crude incidence rates of subsequent dementia in the treated and untreated groups were 7.79 and 12.27 per 1000 PY, respectively, resulting in an IRR of 0.64 (95% CI 0.56-0.72) and covariate-adjusted HR of 0.79 (95% CI 0.69-0.90). After propensity score matching, the treated group showed a significantly lower risk of dementia (HR 0.76; 95% CI 0.65-0.90). In this large population-based cohort study, HZ was associated with a higher risk of dementia. The use of antiviral agents in HZ patients was…
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Studies using electronic health records have found a link between VZV and risk of all-cause dementia, AD, vascular dementia, with antivirals decreasing all-cause dementia risk.
“Studies using electronic health records have found a link between VZV and risk of all-cause dementia, AD, vascular dementia, with antivirals decreasing all-cause dementia risk [23,36–40].”
From What would it take to prove that a chronic infection is a causal agent in Alzheimer’s disease? (2025) · cites this paper as [36]
Cites
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Herpes Zoster and Dementia: A Nationwide Population-Based Cohort Study
Chen, V. C.-H., Wu, S.-I., Huang, K.-Y., Yang, Y.-H., Kuo, T.-Y., Liang, H.-Y., Huang, K.-L., & Gossop, M. (2018) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.16m11312 · Cited by 142 · see citing works
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Herpesvirus infections and Alzheimer's disease: a mendelian randomization study
Huang, S.-Y., Yang, Y.-X., Kuo, K., Li, H.-Q., Shen, X.-N., Chen, S.-D., Cui, M., Tan, L., Dong, Q., & Yu, J.-T. (2021) · Alzheimer's Research & Therapy · doi:10.1186/s13195-021-00905-5 · Cited by 82 · see citing works
Vojtechova, I., Machacek, T., Kristofikova, Z., Stuchlik, A., & Petrasek, T. (2022) · PLOS Pathogens · doi:10.1371/journal.ppat.1010929 · Cited by 92 · see citing works
Duggan, M. R., Peng, Z., An, Y., Kitner Triolo, M. H., Shafer, A. T., Davatzikos, C., Erus, G., Karikkineth, A., Lewis, A., Moghekar, A., et al. (2022) · Neurology · doi:10.1212/wnl.0000000000201036 · Cited by 24 · see citing works
What would it take to prove that a chronic infection is a causal agent in Alzheimer’s disease?
Brutkiewicz, R. R., Cao, W., Morgan, D., Reis, R. S. D., Suryadevara, V., Willette, A. A., Willette, S. A., Wyatt-Johnson, S. K., & Duggan, M. R. (2025) · Trends in Neurosciences · doi:10.1016/j.tins.2025.05.009 · Cited by 3 · see citing works
- Authors
- Bae, S., Yun, S.-C., Kim, M.-C., Yoon, W., Lim, J. S., Lee, S.-O., Choi, S.-H., Kim, Y. S., Woo, J. H., Kim, S. Y., & Kim, S.-H.
- Affiliations
- Asan Medical Center (KR)
- Chung-Ang University Hospital (KR)
- Corresponding author
- Kim, Sung-Han
- ORCID
- Venue
- European Archives of Psychiatry and Clinical Neuroscience
- Published
- 2020-07-01
- Volume
- 271
- Issue
- 5
- Pages
- 987-997
- ISSN
- 0003-9373 (ISSN-L)
- 0940-1334
- 1433-8491
- OpenAlex
- W3039292619
- Cited by
- 94
- References
- 4
- Citations by year
- 2026: 8 · 2025: 19 · 2024: 19 · 2023: 9 · 2022: 18 · 2021: 21
- FWCI
- 8.59
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- European Archives of Psychiatry and Clinical Neuroscience (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Ministry of Health and Welfare (HI15C1763)
- Topics
- Health Sciences › Medicine › Epidemiology › Herpesvirus Infections and Treatments
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Epidemiology › Cytomegalovirus and herpesvirus research
- Keywords
- herpes zoster, dementia, antiviral therapy, dementia risk, older adults
- MeSH terms
- Antiviral Agents, Dementia, Herpes Zoster, Humans, Middle Aged, Cohort Studies, Incidence, Risk Assessment
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