Dementia is a progressive neurological syndrome characterised by impairments in memory, cognition, behaviour, and activities of daily living, constituting a leading cause of mortality and morbidity in the UK. The rising prevalence underscores the urgent need for preventive interventions. However, the heterogeneous nature of dementia pathophysiology presents significant challenges to prevention strategies.
Recent research by Maxine Taquet and colleagues, published in Nature Medicine in June 2024, has unveiled an unexpected connection between the shingles vaccine and reduced dementia risk, offering new hope in the fight against cognitive decline. Varicella-zoster virus (VZV), also known as shingles, causes inflammation and damage to neural pathways, which may contribute to the neurodegeneration seen in dementia, by affecting blood vessels in the brain and triggering inflammatory responses that damage neurons.
The study by Taquet and colleagues utilised US electronic health records and leveraged a natural experiment opportunity in the US, created by the rapid uptake of the recombinant vaccine and the concurrent disuse of the live vaccine after October 2017. Individuals in the group that predominantly received the recombinant vaccine were at a lower risk of developing dementia over the next six years (restricted mean time lost (RMTL) ratio, 0.83; 95% confidence interval (CI), 0.80–0.87; P < 0.0001) than were those in the group that predominantly received the live vaccine, translating into 17% more time lived diagnosis-free, or 164 (95% CI 124–202) additional diagnosis-free days among those affected. By comparing the incidence of dementia in those who received a shingles vaccine just after versus just before this step change, Taquet and colleagues estimated there is an association between exposure to the recombinant vaccine and subsequent incidence of dementia diagnosis.
Currently, adults aged 65-80 years are offered the Shingrix recombinant sub-unit vaccine through the National Health Service (NHS), as are those aged 50 and over with a severely weakened immune system. However, as of September 2025, eligibility is being expanded to immunocompromised people ages 18 and over.
While these findings are encouraging, researchers emphasise that the shingles vaccine should not be viewed as a definitive dementia prevention strategy. However, the potential cognitive protection represents an additional compelling reason for older adults to pursue vaccination as recommended by health authorities. GlobalData epidemiologists currently forecast that there will be 1,674,000 total prevalent cases of dementia among men and women over the age of 60 in the UK in 2025. The total prevalent cases were initially expected to increase to 1,971,000 cases by 2032—but if the uptake of the recombinant shingles vaccine increases, it is likely that over time there will be a reduction in the cases of dementia.