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Cited by 107Herpesvirus Infections and TreatmentsDementia and Cognitive Impairment ResearchCytomegalovirus and herpesvirus research

Increased risk of dementia following herpes zoster ophthalmicus

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Tsai, Ming-Chieh, Cheng, Wan-Ling, Sheu, Jau-Jiuan, Huang, Chung-Chien, Shia, Ben-Chang, Kao, Li-Ting, Lin, Herng-Ching·2017·PLOS ONE
DOI 10.1371/journal.pone.0188490PMC PMC5699837
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Abstract

This retrospective cohort study aimed to examine the relationship between herpes zoster ophthalmicus (HZO) and the subsequent risk of dementia using a population-based database. We retrieved the study sample from the Taiwan Longitudinal Health Insurance Database 2005. The study group included 846 patients with HZO, and the comparison group included 2538 patients without HZO. Each patient was individually followed for a 5-year period to identify those patients who subsequently received a diagnosis of dementia. We performed a Cox proportional hazards regression to calculate the hazard ratios (HRs) along with 95% confidence intervals (CIs) for dementia during the follow-up period between patients with HZO and comparison patients. The respective incidence rates of dementia per 1000 person-years were 10.15 (95% CI: 7.22~13.87) and 3.61 (95% CI: 2.61~4.89) for patients with HZO and comparison patients. The Cox proportional analysis showed that the crude HR of dementia during the 5-year follow-up period was 2.83 (95% CI: 1.83-4.37) for patients with HZO than comparison patients. After adjusting for patients' characteristics and comorbidities, HZO patients were still at a 2.97-fold greater risk than comparison patients for developing dementia. Furthermore, we found that of sampled male patients, the crude HR of dementia for patients with HZO was as high as 3.35 (95% CI = 1.79-6.28) compared to comparison patients. This study demonstrated an association between HZO and dementia. Clinicians must be alert to suspect dementia in patients with cognitive impairment who had prior HZO.

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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 [40]

    The Discussion reports an association between herpes zoster ophthalmicus and subsequent dementia in a population-based cohort. It does not report separate VZV associations with Alzheimer’s disease or vascular dementia, and explicitly says the study did not compare antiviral treatment with subsequent dementia risk. No page numbers are provided in our copy. (LLM, conf=0.90)

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Authors
Tsai, M.-C., Cheng, W.-L., Sheu, J.-J., Huang, C.-C., Shia, B.-C., Kao, L.-T., & Lin, H.-C.
Affiliations
  • Cathay General Hospital (TW)
  • Taipei Medical University Hospital (TW)
  • Taipei Medical University (TW)
  • National Defense Medical Center (TW)
Corresponding author
Lin, Herng-Ching
ORCID
Venue
PLOS ONE
Publisher
Public Library of Science (PLoS)
Published
2017-11-22
Volume
12
Issue
11
Pages
e0188490
ISSN
1932-6203 (ISSN-L)
DOI
10.1371/journal.pone.0188490
PMC
PMC5699837
OpenAlex
W2769366783
Cited by
107
References
2
Citations by year
2026: 8 · 2025: 11 · 2024: 14 · 2023: 13 · 2022: 11 · 2021: 17 · 2020: 15 · 2019: 12 · 2018: 5 · 2016: 1
FWCI
6.86
Type
journal article
Language
en
Open access
Licence
Locations
  • PLoS ONE (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
  • Ministry of Health and Welfare
  • Health and Welfare Data Science Center
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 ophthalmicus, dementia, dementia risk, herpes zoster, cognitive impairment, sex differences, comorbidities
MeSH terms
Dementia, Demography, Female, Follow-Up Studies, Herpes Zoster Ophthalmicus, Humans, Male, Middle Aged, Risk Factors, Taiwan, Confidence Intervals

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