5 ms·

Anyone skilled in the medical arts got a dumbed down synopsis of this? (I just had my first shingles vaccine 2 weeks ago)

jvanderbot 10mo ago
I'm not skilled, but it feels like a validation for the virus theory of dementia https://med.stanford.edu/news/all-news/2025/03/shingles-vaccination-dementia.html https://med.stanford.edu/news/all-news/2025/03/shingles-vacc... "The remarkable findings, published April 2 in Nature, support an emerging theory that viruses that affect the nervous system can increase the risk of dementia. If further confirmed, the new findings suggest that a preventive intervention for dementia is already close at hand."
- inglor_cz 10mo ago
  A lot of things can cause dementia. IIRC, men who use Cialis have a lower risk of dementia, which indicates that better blood flow is beneficial as well. Our skulls are hard for a reason. Brains are sensitive.
  - ortusdux 10mo ago
    The original study had a sample size of 10. A follow-up study with n = 13,000 did not find a correlation. https://www.alzheimers.gov/news/no-association-viagra-and-cialis-reduced-alzheimers-disease-risk https://www.alzheimers.gov/news/no-association-viagra-and-ci...
    - Mistletoe 10mo ago
      Isn’t it more accurate to say that people with pulmonary arterial hypertension had no dementia protection from viagra?
  - _alternator_ 10mo ago
    I don’t think that there are many things known to have as strong of an effect as HZ vaccines. The current evidence is that the vaccine eliminates like 20% of all cases, suggesting that HZ (aka chickenpox) is directly responsible for at least 20% of dementia cases, possibly much more.
  - btilly 10mo ago
    Yes, many things can cause dementia. Repeated traumatic brain injuries can cause dementia. But the leading form of dementia is Alzheimer's. Somewhere in the order of 40% of us are expected to get Alzheimer's before we die. The list of things that have been demonstrated to cause Alzheimer's is much, much shorter. For the last 40 years, the leading theory about Alzheimer's is that it is caused by the beta-amyloid plaques that are found in the brain after death. This theory has produced exactly zero treatments that meaningfully affect clinical symptoms, despite many drug trial and literally billions in research per year. Seriously, between various sources, we've spent something like a quarter of what it cost to put man on the Moon. (It is hard to make a precise comparison, because a lot of that funding was private.) This single study represents more progress on effective treatments of Alzheimer's than all of that work combined. The importance of the result should not be dismissed.
    - inglor_cz 10mo ago
      I didn't want to dismiss the results. Indeed, as you say, they are meaningfully better than everything that the amyloid theory was able to produce.
  - DANmode 10mo ago
    Oxygenation and infection-fighting. Top defense.
- shepardrtc 10mo ago
  Taking valacyclovir should help prevent or delay as well.
  - red-iron-pine 10mo ago
    aye. is likely the reason Trump's hands are showing serious bruises and band-aids; regular treatments to keep him from losing it
    - giardini 10mo ago
      I think the bruises are from pounding his desk in frustration. And WTF is wrong with wearing a Band-Aid? You're criticizing someone for wearing a f**ing Band-Aid!?* Are you nuts?! [pounds desk] Whassamattayou? Can't you stick to the point instead of talking about f**ing Band-Aids?*
  - John7878781 10mo ago
    > But the first clinical trial to test that theory has found that a common antiviral for herpes simplex infections, valacyclovir, does not change the course of the disease for patients in the early stages of Alzheimer's. https://www.cuimc.columbia.edu/news/antiviral-treatment-fails-slow-early-stage-alzheimers https://www.cuimc.columbia.edu/news/antiviral-treatment-fail...
    - shepardrtc 10mo ago
      Yeah they looked at 120 people age 71 and above for that study. By that point its a little late.
- shadowgovt 10mo ago
  Perhaps worth noting because I'm not sure how many people realize it: Chickenpox is actually a neurological disease; that's how it re-emerges as shingles later in life. The virus infects nerve cells but (as far as we know) hides out in them without damaging them. Because nerves are critical to bodily function and don't regenerate nearly as efficiently as (for example) skin, liver, or other "sheet tissues" (tissue made of small cells is easier to regenerate; nerves can be as long as a meter and regeneration involves growing a new cell that entire distance), the body has a pile of immunosuppressant signals to prevent killing the nerve while trying to fight an infection. "Hey white blood cells: I know we hate chickenpox, but we hate not being able to swallow more, so maybe lay off the throat nerves, right?" ... but as a result, one doesn't generally purge the chickenpox infection after it occurs. Breakouts into other tissue are swiftly suppressed by our immune systems our whole lives (so swiftly that you don't get symptoms or become contagious), but as we age and the immune system weakens, a breakout can become a full infection and the result is shingles. ... and now, it seems that the "infects nerves without damaging them" hypothesis should be up for question.
hannob 10mo ago
It looks like the shingles vaccine has positive effects that prevent dementia. (Well, that's in the title.) This study was possible due to a "natural experiment" where one country gave people from a very specific birth date the vaccine (so people born right before and right after that date were very similar, except for the vaccine). It's not clear why this is the case. It might be that the virus the vaccine supresses plays a role in dementia development, or it might be that the vaccine causes an immune response that has other indirect positive impacts.
jibal 10mo ago
Statistics show that in some populations there is less dementia among those who received the shingles vaccine than among those who didn't.
busyant 10mo ago
This is probably a key sentence: "...the effect of actually receiving the HZ vaccination was a 3.1 (95% CI: 1.0–6.2, p = 0.007) percentage point reduction in new diagnoses of MCI over 9 years." MCI = mild cognitive impairment What's interesting to me is that the effect doesn't appear to be specific to Alzheimer's--rather they see a reduction in all forms of dementia diagnosis. I suspect the thinking is something along the lines of ... dementia is either caused or heavily influenced by inflammation. Reactivation of HZ virus causes neurological inflammation. So, HZ vaccination is gonna prevent some forms of inflammation and help you avoid dementia--a little bit. FWIW, I'm trained as a molecular biologist and have a some knowledge of clinical trials, dementia, etc., but I am far from an expert on this.
_alternator_ 10mo ago
The highlights are a good start. (I’m a doctor, just a nerd who likes to read papers.) My comments in brackets. - Herpes zoster vaccination reduced dementia diagnosis in our prior natural experiments. [Previous work. I’m familiar with the Wales experiment where they had a sharp age cutoff for getting the vaccine in their national health system. Comparing those just below and just beyond the cutoff allows for analysis similar to a randomized controlled trial (aka ‘natural experiment’). The results showed a ~20% decrease in dementia due to vaccine, so the results were already pretty strong.] - Here, we find a lower occurrence of MCI and dementia deaths among dementia patients [MCI = ‘mild cognitive impairment’. This is a more refined result than prior work, harder to see in the data than a clear dementia diagnosis.] - Herpes zoster vaccination appears to act along the entire clinical course of dementia. [This is not surprising given the earlier results, but the demonstration is harder, and it may lead to recommendations for earlier HZ vaccination, IIRC currently at 50 or 55 in the US.] - This study’s approach avoids the common confounding concerns of observational data [Basically they are improving their methods and getting stronger results, classic good science.]
- jjtheblunt 10mo ago
  Months ago when this research was showing up (not on HN) there was a disclaimer that the benefit differed for Shingrix vs Zostavax (discontinued in the United States around 2017), and that Zostavax was shown to cause these benefits (Wales study for example). Shingrix had a potential side effect of Guillain-Barre https://en.wikipedia.org/wiki/Guillain–Barré_syndrome#Vaccine_onset https://en.wikipedia.org/wiki/Guillain–Barré_syndrome#Vaccin... It's interesting that the linked article references, in different terms, the distinction, obliquely. Zostavax is attentuated; Shingrix recombinant. "Our findings suggest that live-attenuated HZ vaccination prevents or delays mild cognitive impairment and dementia and slows the disease course among those already living with dementia."
  - botro 10mo ago
    Is it known or suspected whether Shingrix offers the same benefits as Zostavax for dementia?
hedora 10mo ago
Shingles attacks your nervous system. Avoiding shingles prevents it from damaging your brain, so it isn’t surprising the vaccine reduces dementia. There are multiple causes for dementia. If I read figure 2 right, the vaccine slightly reduces the chance of mild cognitive impairment, but cuts the chances of dying from dementia by about a third(!) Also interesting: The vaccine helps at different phases of disease progression. The simplest explanation is that dementia is due to cumulative damage, not a single event, and that getting shingles is a big hit. The vaccine probably prevents dementia in the same way staying out of planes makes you invulnerable to parachute failures.
- jtbayly 10mo ago
  A lot of dead BASE jumpers disagree...
- _alternator_ 10mo ago
  The emerging evidence, taken together, shows a ~20% reduction in dementia over 7 years. So it’s actually pretty dramatic. https://med.stanford.edu/news/all-news/2025/03/shingles-vaccination-dementia.html https://med.stanford.edu/news/all-news/2025/03/shingles-vacc...
- wdb 10mo ago
  What do they mean with 'dying from dementia'? As typically you don't die from dementia but something like pneumonia or something else. Personally, I wouldn't wish dementia on anyone and definitely wouldn't want to extend my life while having dementia.
  - jjtheblunt 10mo ago
    not eating is an example, i believe, from my father who had chemo induced neurotoxicity predicted well over a decade earlier.

jvanderbot 10mo ago

I'm not skilled, but it feels like a validation for the virus theory of dementia https://med.stanford.edu/news/all-news/2025/03/shingles-vaccination-dementia.html https://med.stanford.edu/news/all-news/2025/03/shingles-vacc... "The remarkable findings, published April 2 in Nature, support an emerging theory that viruses that affect the nervous system can increase the risk of dementia. If further confirmed, the new findings suggest that a preventive intervention for dementia is already close at hand."

inglor_cz 10mo ago
A lot of things can cause dementia. IIRC, men who use Cialis have a lower risk of dementia, which indicates that better blood flow is beneficial as well. Our skulls are hard for a reason. Brains are sensitive.
- ortusdux 10mo ago
  The original study had a sample size of 10. A follow-up study with n = 13,000 did not find a correlation. https://www.alzheimers.gov/news/no-association-viagra-and-cialis-reduced-alzheimers-disease-risk https://www.alzheimers.gov/news/no-association-viagra-and-ci...
  - Mistletoe 10mo ago
    Isn’t it more accurate to say that people with pulmonary arterial hypertension had no dementia protection from viagra?
- _alternator_ 10mo ago
  I don’t think that there are many things known to have as strong of an effect as HZ vaccines. The current evidence is that the vaccine eliminates like 20% of all cases, suggesting that HZ (aka chickenpox) is directly responsible for at least 20% of dementia cases, possibly much more.
- btilly 10mo ago
  Yes, many things can cause dementia. Repeated traumatic brain injuries can cause dementia. But the leading form of dementia is Alzheimer's. Somewhere in the order of 40% of us are expected to get Alzheimer's before we die. The list of things that have been demonstrated to cause Alzheimer's is much, much shorter. For the last 40 years, the leading theory about Alzheimer's is that it is caused by the beta-amyloid plaques that are found in the brain after death. This theory has produced exactly zero treatments that meaningfully affect clinical symptoms, despite many drug trial and literally billions in research per year. Seriously, between various sources, we've spent something like a quarter of what it cost to put man on the Moon. (It is hard to make a precise comparison, because a lot of that funding was private.) This single study represents more progress on effective treatments of Alzheimer's than all of that work combined. The importance of the result should not be dismissed.
  - inglor_cz 10mo ago
    I didn't want to dismiss the results. Indeed, as you say, they are meaningfully better than everything that the amyloid theory was able to produce.
- DANmode 10mo ago
  Oxygenation and infection-fighting. Top defense.
shepardrtc 10mo ago
Taking valacyclovir should help prevent or delay as well.
- red-iron-pine 10mo ago
  aye. is likely the reason Trump's hands are showing serious bruises and band-aids; regular treatments to keep him from losing it
  - giardini 10mo ago
    I think the bruises are from pounding his desk in frustration. And WTF is wrong with wearing a Band-Aid? You're criticizing someone for wearing a f**ing Band-Aid!?* Are you nuts?! [pounds desk] Whassamattayou? Can't you stick to the point instead of talking about f**ing Band-Aids?*
- John7878781 10mo ago
  > But the first clinical trial to test that theory has found that a common antiviral for herpes simplex infections, valacyclovir, does not change the course of the disease for patients in the early stages of Alzheimer's. https://www.cuimc.columbia.edu/news/antiviral-treatment-fails-slow-early-stage-alzheimers https://www.cuimc.columbia.edu/news/antiviral-treatment-fail...
  - shepardrtc 10mo ago
    Yeah they looked at 120 people age 71 and above for that study. By that point its a little late.
shadowgovt 10mo ago
Perhaps worth noting because I'm not sure how many people realize it: Chickenpox is actually a neurological disease; that's how it re-emerges as shingles later in life. The virus infects nerve cells but (as far as we know) hides out in them without damaging them. Because nerves are critical to bodily function and don't regenerate nearly as efficiently as (for example) skin, liver, or other "sheet tissues" (tissue made of small cells is easier to regenerate; nerves can be as long as a meter and regeneration involves growing a new cell that entire distance), the body has a pile of immunosuppressant signals to prevent killing the nerve while trying to fight an infection. "Hey white blood cells: I know we hate chickenpox, but we hate not being able to swallow more, so maybe lay off the throat nerves, right?" ... but as a result, one doesn't generally purge the chickenpox infection after it occurs. Breakouts into other tissue are swiftly suppressed by our immune systems our whole lives (so swiftly that you don't get symptoms or become contagious), but as we age and the immune system weakens, a breakout can become a full infection and the result is shingles. ... and now, it seems that the "infects nerves without damaging them" hypothesis should be up for question.

hannob 10mo ago

It looks like the shingles vaccine has positive effects that prevent dementia. (Well, that's in the title.) This study was possible due to a "natural experiment" where one country gave people from a very specific birth date the vaccine (so people born right before and right after that date were very similar, except for the vaccine). It's not clear why this is the case. It might be that the virus the vaccine supresses plays a role in dementia development, or it might be that the vaccine causes an immune response that has other indirect positive impacts.

jibal 10mo ago

Statistics show that in some populations there is less dementia among those who received the shingles vaccine than among those who didn't.

busyant 10mo ago

This is probably a key sentence: "...the effect of actually receiving the HZ vaccination was a 3.1 (95% CI: 1.0–6.2, p = 0.007) percentage point reduction in new diagnoses of MCI over 9 years." MCI = mild cognitive impairment What's interesting to me is that the effect doesn't appear to be specific to Alzheimer's--rather they see a reduction in all forms of dementia diagnosis. I suspect the thinking is something along the lines of ... dementia is either caused or heavily influenced by inflammation. Reactivation of HZ virus causes neurological inflammation. So, HZ vaccination is gonna prevent some forms of inflammation and help you avoid dementia--a little bit. FWIW, I'm trained as a molecular biologist and have a some knowledge of clinical trials, dementia, etc., but I am far from an expert on this.

_alternator_ 10mo ago

The highlights are a good start. (I’m a doctor, just a nerd who likes to read papers.) My comments in brackets. - Herpes zoster vaccination reduced dementia diagnosis in our prior natural experiments. [Previous work. I’m familiar with the Wales experiment where they had a sharp age cutoff for getting the vaccine in their national health system. Comparing those just below and just beyond the cutoff allows for analysis similar to a randomized controlled trial (aka ‘natural experiment’). The results showed a ~20% decrease in dementia due to vaccine, so the results were already pretty strong.] - Here, we find a lower occurrence of MCI and dementia deaths among dementia patients [MCI = ‘mild cognitive impairment’. This is a more refined result than prior work, harder to see in the data than a clear dementia diagnosis.] - Herpes zoster vaccination appears to act along the entire clinical course of dementia. [This is not surprising given the earlier results, but the demonstration is harder, and it may lead to recommendations for earlier HZ vaccination, IIRC currently at 50 or 55 in the US.] - This study’s approach avoids the common confounding concerns of observational data [Basically they are improving their methods and getting stronger results, classic good science.]

jjtheblunt 10mo ago
Months ago when this research was showing up (not on HN) there was a disclaimer that the benefit differed for Shingrix vs Zostavax (discontinued in the United States around 2017), and that Zostavax was shown to cause these benefits (Wales study for example). Shingrix had a potential side effect of Guillain-Barre https://en.wikipedia.org/wiki/Guillain–Barré_syndrome#Vaccine_onset https://en.wikipedia.org/wiki/Guillain–Barré_syndrome#Vaccin... It's interesting that the linked article references, in different terms, the distinction, obliquely. Zostavax is attentuated; Shingrix recombinant. "Our findings suggest that live-attenuated HZ vaccination prevents or delays mild cognitive impairment and dementia and slows the disease course among those already living with dementia."
- botro 10mo ago
  Is it known or suspected whether Shingrix offers the same benefits as Zostavax for dementia?

hedora 10mo ago

Shingles attacks your nervous system. Avoiding shingles prevents it from damaging your brain, so it isn’t surprising the vaccine reduces dementia. There are multiple causes for dementia. If I read figure 2 right, the vaccine slightly reduces the chance of mild cognitive impairment, but cuts the chances of dying from dementia by about a third(!) Also interesting: The vaccine helps at different phases of disease progression. The simplest explanation is that dementia is due to cumulative damage, not a single event, and that getting shingles is a big hit. The vaccine probably prevents dementia in the same way staying out of planes makes you invulnerable to parachute failures.

jtbayly 10mo ago
A lot of dead BASE jumpers disagree...
_alternator_ 10mo ago
The emerging evidence, taken together, shows a ~20% reduction in dementia over 7 years. So it’s actually pretty dramatic. https://med.stanford.edu/news/all-news/2025/03/shingles-vaccination-dementia.html https://med.stanford.edu/news/all-news/2025/03/shingles-vacc...
wdb 10mo ago
What do they mean with 'dying from dementia'? As typically you don't die from dementia but something like pneumonia or something else. Personally, I wouldn't wish dementia on anyone and definitely wouldn't want to extend my life while having dementia.
- jjtheblunt 10mo ago
  not eating is an example, i believe, from my father who had chemo induced neurotoxicity predicted well over a decade earlier.