2026-06-15 ブラウン大学
＜関連情報＞
- https://www.brown.edu/news/2026-06-15/shingles-vaccine-lowers-dementia-risk
- https://www.acpjournals.org/doi/10.7326/ANNALS-25-04689
最近介護施設に入所した高齢者における組換え帯状疱疹ワクチン接種後の認知症リスク：ターゲット試験のエミュレーション Dementia Risk After Recombinant Herpes Zoster Vaccination in Older Adults With a Recent Skilled-Nursing Facility Stay: A Target Trial Emulation
Kaleen N. Hayes, PharmD, PhD, Daniel A. Harris, PhD, Kevin W. McConeghy, PharmD, PhD, Lexie R. Grove, PhD, Richa Joshi, MBA, Lisa Han, MPH, H. Edward Davidson, PharmD, … , and Stefan Gravenstein, MD
Annals of Internal Medicine Published:16 June 2026
DOI:https://doi.org/10.7326/ANNALS-25-04689
Abstract
Background:
Observational studies report a protective association between herpes zoster (HZ) vaccination and dementia, but they have methodological limitations or examined a live attenuated vaccine no longer available in the United States.
Objective:
Among older adults recently admitted to a skilled-nursing facility for postacute or long-term care, to estimate the association between dementia and receipt of the recombinant HZ vaccine (RZV) within 12 months of entering the facility or after discharge.
Design:
The researchers conducted a cohort study using target trial emulation and the clone–censor–weight approach. Participants were followed for up to 4 years until the outcome of dementia, Medicare disenrollment, or death. Inverse probability of clone-censoring weights were applied to pooled logistic regression models to estimate effects.
Setting:
Medicare claims linked to nursing home electronic health record (EHR) data.
Participants:
Medicare fee-for-service beneficiaries aged 66 years or older who were admitted to a skilled-nursing facility between 1 January 2017 and 31 December 2022, had linked EHR data, had no diagnosed dementia, and were eligible for RZV.
Intervention:
Receipt of at least 1 RZV in the facility or, if discharged, by 12 months after admission versus no receipt of RZV.
Measurements:
Validated dementia diagnosis and 57 baseline and time-varying covariates.
Results:
The study cohort included 509 926 participants (mean age, 79 years); 8843 (1.73%) received at least 1 RZV dose within 12 months after admission, and of these, 87.0% received RZV after discharge. Receipt of RZV was associated with risk for dementia being 5.8 percentage points lower (95% CI, 3.9 to 7.5 percentage points lower; risk ratio, 0.76 [CI, 0.69 to 0.84]; 4-year risk, 18.8% with ≥1 RZV vs. 24.6% with no RZV). Associations were attenuated in men and those with prior live HZ vaccination.
Limitation:
Negative control analyses suggest some residual confounding.
Conclusion:
Receipt of RZV during admission to a skilled-nursing facility or within 12 months was associated with lower dementia risk.
Primary Funding Source:
GlaxoSmithKline.
