Association between herpes zoster and cognitive impairment among Chinese community-dwelling elderly: a...

Cognitive impairment (CI) and herpes zoster (HZ) are prevalent among elderly individuals, however, the association between these two conditions has not been studied.

We conducted a cross-sectional study between April 1, 2023, to June 17, 2024, comparing nine communities in Haikou, Hainan Province, China. Participants were aged 60 and above and had resided in Haikou for at least six months. Participants were interviewed to obtain questionnaire data on age, sex, highest education level obtained, marital status, body weight and height, residence location, current smoker and daily alcohol drinker, history of HZ and antiviral treatment, and presence of other chronic diseases (hypertension, diabetes, dyslipidemia, and depression). CI was assessed using the Chinese Mini-Mental Status (CMMS) with education-specific cut-off values. Associations between HZ and CI were examined using univariate and multivariate logistic regression analyses in SPSS software (version 27.0).

Among 1233 participants (mean age ± SD: 72.4 ± 7.4 years; 41.8% males; 61.6% married; 66.0% with middle school education or less; 22.9% rural residence), 133 (10.8%) reported having an HZ history, of whom 37 (27.8%) received antiviral treatment. CI was identified in 430 participants (34.9%) based on education-specific CMMS scores. Multivariate logistic regression analysis showed that a history of HZ was associated with an increased risk of CI (OR = 1.69, 95% CI: 1.14-2.51) after adjusting for age, sex, residence location, body mass index (BMI), and depression. Additionally, participants aged over 80 years (OR = 1.89, 95% CI: 1.31-2.73) and those living in rural areas (OR = 1.35, 95% CI: 1.00-1.81) were found to have significantly increased odds of CI. Although antiviral treatment appeared to reduce the risk of CI (OR = 0.61, 95% CI: 0.18-2.06), the result was not statistically significant.

Our findings suggest a potential association between HZ and CI in the elderly population. Further large-scale cohort studies are needed to establish the causality and to assess the impact of antiviral treatment on the development of CI and dementia.