Antiherpetic medication and incident dementia: observational cohort studies in four countries

Christian Schnier*, Janet Janbek, Linda Williams, Tim Wilkinson, Thomas M. Laursen, Gunhild Waldemar, Hartmut Richter, Karel Kostev, Richard Lathe, Jürgen G Haas

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

29 Citations (Scopus)

Abstract

Background and purpose
Several epidemiological studies from Taiwan, all using the same data resource, found significant associations between herpes virus infection, antiherpetic medication, and subsequent dementia. We conducted a multicenter observational cohort study using health registry data from Wales, Germany, Scotland, and Denmark to investigate potential associations between antiherpetic medication and incident dementia, and also to comprehensively investigate such associations broken down according to medication type and dose, type of herpes virus, and dementia subtype.

Methods
A total of 2.5 million individuals aged 65 years or more were followed up using linked electronic health records in four national observational cohort studies. Exposure and outcome were classified using coded data from primary and secondary care. Data were analyzed using survival analysis with time-dependent covariates.

Results
Results were heterogeneous, with a tendency toward decreased dementia risk in individuals exposed to antiherpetic medication. Associations were not affected by treatment number, herpes subtype, dementia subtype, or specific medication. In one cohort, individuals diagnosed with herpes but not exposed to antiherpetic medication were at higher dementia risk.

Conclusions
Short-term antiherpetic medication is not markedly associated with incident dementia. Because neither dementia subtype nor herpes subtype modified the association, the small but significant decrease in dementia incidence with antiherpetic administration may reflect confounding and misclassification.

Original languageEnglish
Pages (from-to)1840-1848
Number of pages9
JournalEuropean Journal of Neurology
Volume28
Issue number6
Early online date19 Mar 2021
DOIs
Publication statusPublished - Jun 2021
Externally publishedYes

Keywords

  • Alzheimer disease
  • antiviral
  • cognitive decline
  • herpes
  • vascular dementia

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

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