After decades of searching, a change in tactics has put scientists a step closer to developing a treatment for dementia, according to a new study led by Stanford Medicine.
Research published in Nature found that older adults who received the shingles vaccine were 20% less likely to develop dementia over the succeeding seven years than those who did not get the vaccine.
The discovery was made after analyzing the health records of older adults in Wales. It adds to the idea that viruses influencing the nervous system may increase the likelihood of dementia.
What is shingles
The shingles virus is the same one that causes chicken pox. Once you contract chicken pox, it may take 10 to 21 days to appear. The telltale rash may last up to 10 days, according to the Mayo Clinic.
Most shingles sufferers contracted chicken pox as children and have not given the disease much thought since. However, once you acquire the varicella-zoster virus that causes chicken pox, you have it for life. It stays dormant in nerve cells. As a result, the virus may reawaken as we age or our immune system is weakened.
What Is Dementia
In the United States, 6.9 million people aged 65 or older are living with Alzheimer’s disease. It is the most common form of dementia, according to the Alzheimer’s Association.
Worldwide, it’s estimated that over 10 million new cases of dementia are diagnosed annually, and over 55 million people are currently living with dementia. These numbers are projected to rise significantly, with estimates suggesting that the number of people with dementia will almost double every 20 years, reaching 78 million by 2030 and 139 million by 2050. Of those 2050 cases, estimates are that 13 million will be Americans.
New Research
Dementia research has focused almost entirely on the accumulation of plaques and neurofibrillary tangles, which are found inside neurons. These tangles, or clumps of protein, damage the neuron’s internal structure. As a result, communication between brain cells is disrupted. Eventually, the cells die.
After decades of research not yielding a treatment, more researchers are turning to other areas of investigation. That includes the Stanford research on the impact of viral infections.
Previous Studies
Other studies exploring a connection between the shingles vaccine and a reduced risk of dementia did not have a control group. In research, a control group is a set of people who do not receive the same treatment as a similar group.
“All these associational studies suffer from the basic problem that people who get vaccinated have different health behaviors than those who don’t,” said Pascal Geldsetzer, MD, PhD, assistant professor of medicine and senior author of the new study. “In general, they’re seen as not being solid enough evidence to make any recommendations on.”
The Welsh Effect
Wales unknowingly established a perfect control group for the Stanford Medical study.
In 2013, the Welsh government established a shingles vaccine program that limited treatment to people 79 years old. The age restriction was due to a lack of vaccine. People who were 80 and above as of September 2 were not eligible for the shot.
Researchers focused on people born within a week before and a week after the eligibility date.
“We know that if you take a thousand people at random born in one week and a thousand people at random born a week later, there shouldn’t be anything different about them on average,” Geldsetzer said. “They are similar to each other apart from this tiny difference in age.”
The result was a near-perfect research storm.
“What makes the study so powerful is that it’s essentially like a randomized trial with a control group — those a little bit too old to be eligible for the vaccine — and an intervention group — those just young enough to be eligible,” Geldsetzer said.
Seven Years Later
By 2020, one in eight of the people in the Welsh study had been diagnosed with dementia. But those who received the shingles vaccine were 20% less likely to develop dementia than the unvaccinated.
“It was a really striking finding,” Geldsetzer said. “This huge protective signal was there, any which way you looked at the data.”
More Positive Results
To ensure that the Welsch study was not a one-off, the Stanford Medical team conducted similar research over the past several years. Results from those studies were similar to those of the Welsch project.
Countries where follow-up studies took place included England, Australia, New Zealand, and Canada. Each of those countries rolled out the shingles vaccine in a manner similar to the way Wales did. As a result, those studies created their own control groups.
“We just keep seeing this strong protective signal for dementia in dataset after dataset,” said Geldsetzer.
Unknowns Remain
How the vaccine protects against dementia is still unknown despite the positive results. The vaccine may boost overall immunity or protect through some other mechanism.
Another finding showed that women benefited from the vaccine more than men. Geldsetzer theorized that this may be a result of gender differences in immune response or in the way dementia develops.
Geldsetzer is advocating for more research to resolve these unknowns.
The Financial Cost of Dementia
Care costs for dementia patients can vary widely depending on the type of help needed.
“The median cost of a residential memory care community is about $6,450 per month, or $77,400 per year,” according to A Place For Mom, a senior living referral service. “This is comparable to the cost of full-time in-home dementia care, and significantly less expensive than 24/7 in-home care.”
A University of Southern California (USC) team is doing a deeper dive into all costs associated with dementia. Their goal is to create a dementia cost model that families can use to estimate costs and weigh care options.
Julie Zissimopoulos, a professor at the USC Price School of Public Policy and the USC Schaeffer Center for Health Policy & Economics, heads up the program. One of the problems is that treatment and associated costs can be a moving target.
Additional Costs
“We currently have estimates for a particular set of costs, but we’ve learned those estimates don’t encompass nearly all the costs to the person with dementia, their family, and to society. Everything about this disease affects the family’s pocketbook.”
The Alzheimer’s Association puts the cost of dementia treatment at $360 billion for 2024. By 2050, that figure may reach $1 trillion.
A report published by the National Institutes of Health (NIH) found that the average cost of treatment for an individual with dementia was $321,780. That figure was spent over 60 months from diagnosis to death. Of that, families spent an average of $89,840 out of pocket.
“Other consequences may include caregivers’ lower retirement savings or limited ability to send their children to college,” said project advisor Maria Aranda, a professor at the USC Suzanne Dworak-Peck School of Social Work. “In turn, this leads to an intergenerational transmission of inequality and financial vulnerability for families of persons with dementia.”
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