Objectives: This meta-analysis investigated the relationship between herpes zoster and the risk of dementia or Parkinson's disease by analyzing published clinical studies.
Methods: We systematically searched PubMed, Cochrane, Embase, and Web of Science Core Collection databases on April 25, 2024. Hazard ratios (HR) were used for statistical analyses. Random-effects models were applied, and heterogeneity was assessed using the I2 statistic.
Results: Herpes zoster was associated with a non-significant trend toward increased dementia risk (HR = 1.11, 95% CI 0.99-1.24, p = 0.07) but significantly increased Parkinson's disease risk (HR = 1.15, 95% CI 1.03-1.30, p = 0.02). Subgroup analyses revealed that herpes zoster significantly elevated the risk of the prospective study subgroup (HR = 1.08, 95% CI 1.02-1.13, p = 0.004) and vascular dementia subgroup (HR = 1.17, 95% CI 1.00-1.37, p = 0.05). Significant heterogeneity was observed for both outcomes (dementia: I 2 = 98%, p < 0.00001; Parkinson's disease: I 2 = 94%, p < 0.00001).
Conclusion: Herpes zoster raises the risk of Parkinson's disease and vascular dementia, with a potential causal link to dementia. Early vaccination against herpes zoster is recommended over post-infection antiviral treatment to mitigate risks.
Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/ and our registration number is CRD42024555620.
Keywords: Parkinson’s disease; dementia; herpes zoster; meta-analysis; systematic review; vascular dementia.
Copyright © 2024 Zhang, Liu and Xu.