Antiherpetic medication and incident dementia: Observational cohort studies in four countries
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Antiherpetic medication and incident dementia : Observational cohort studies in four countries. / Schnier, Christian; Janbek, Janet; Williams, Linda; Wilkinson, Tim; Laursen, Thomas M.; Waldemar, Gunhild; Richter, Hartmut; Kostev, Karel; Lathe, Richard; G Haas, Jürgen.
I: European Journal of Neurology, Bind 28, Nr. 6, 2021, s. 1840-1848.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Antiherpetic medication and incident dementia
T2 - Observational cohort studies in four countries
AU - Schnier, Christian
AU - Janbek, Janet
AU - Williams, Linda
AU - Wilkinson, Tim
AU - Laursen, Thomas M.
AU - Waldemar, Gunhild
AU - Richter, Hartmut
AU - Kostev, Karel
AU - Lathe, Richard
AU - G Haas, Jürgen
PY - 2021
Y1 - 2021
N2 - 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.
AB - 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.
KW - Alzheimer disease
KW - antiviral
KW - cognitive decline
KW - herpes
KW - vascular dementia
U2 - 10.1111/ene.14795
DO - 10.1111/ene.14795
M3 - Journal article
C2 - 33657269
AN - SCOPUS:85102616511
VL - 28
SP - 1840
EP - 1848
JO - European Journal of Neurology
JF - European Journal of Neurology
SN - 1351-5101
IS - 6
ER -
ID: 259103088