Routine vaccines may cut dementia risk—experts have startling hypothesis on how

raschumacher

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So if I read this correctly, getting an annual regular-strength flu shot for a decade is less beneficial1 than getting one extra-strength flu shot?

1 - Ignoring the whole "not getting the flu" thing, obviously
[Yo, downvoters: Asking a clarifying question is a Good Thing.]
 
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Another recent tidbit on the medical front: "study shows that conservative Americans experienced worsening health and higher mortality than liberals during the 2010s." Two apparent factors:
  • The simple statistical reality that conservatives tend to be older...which is nothing they've done that everybody else doesn't do in the passage of time
  • But what they have done: "declining trust in medical professionals among right-leaning individuals, including lower willingness to seek care, follow clinical advice or believe in medication effectiveness, even for issues unrelated to COVID-19."
 
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FranzJoseph

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The possible protective benefits of BCG - and the duration of any protection - might be something mineable from existing health care data, given BCG has been widely administered in the past outside of America.
Still glad BCG used to be mandatory for all infants until just a decade or two ago in my neck of the woods (most of Western Europe made it optional in the late 2000s / early 2010s because of lower TBC prevalence, but there is some talk of bringing it back as TBC is again on the rise, especially with extremely ABX resistant strains).
(I still have a pair of clearly visible scars on my left shoulder from BCG shots as a kid more than 40 years ago - a fairly common sign on Brits of my generation)
For those who aren't sure if they ever had a BCG jab or not as an infant, the injection location had mostly changed from the shoulder (due to scarring issues) to the infant's foot some time after your time in most places. So the absence of the typical shoulder scar doesn't necessarily mean absence of BCG vaccination.

And for those who travel to the US (who does these days, though?!?), where BCG can cause false positives on the mandatory tuberculin skin prick test for certain travellers, CDC mandated that the much more specific antigen lateral flow tests should be administered instead of tuberculin for those coming from BCG‑vaccinated countries. Of course, whether CDC even exists today is an open question, sadly...
 
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Another recent tidbit on the medical front: "study shows that conservative Americans experienced worsening health and higher mortality than liberals during the 2010s." Two apparent factors:
  • The simple statistical reality that conservatives tend to be older...which is nothing they've done that everybody else doesn't do in the passage of time
  • But what they have done: "declining trust in medical professionals among right-leaning individuals, including lower willingness to seek care, follow clinical advice or believe in medication effectiveness, even for issues unrelated to COVID-19."
There was a study some time back that suggested survivorship bias is the real reason "people get more conservative as they age."

Historically, people with more resources have tended to both be more conservative and to live longer. Which means that your second point may well end up negating your first point and in the future what most people now believe about a correlation between age and conservatism may be seen as a silly idea past generations had that makes no sense.
 
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numerobis

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So if I'm understanding this correctly, the basic idea is that by periodically using an artificial method (vaccines) of stimulating an immune response, we're basically keeping our immune system revved up and capable of reacting to all pathogens - not just the ones we've trained our system to recognize?

That makes a lot of sense, but also seems to imply that dementia is caused by a specific pathogen that might eventually be identified, and presumably we could then develop a specific vaccine against that, right? If that's correct, it seems to me like maybe the most revolutionary idea in this research.
I'm reading it precisely opposite --that lots of different pathogens each can cause brain damage.
 
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foofoo22

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If you're over the age of 50, please do. I'm in my 40's but I've had shingles twice. Unfortunately, the vaccine is only available in the US to adults over 50 or those with specific weakened/compromised immune systems/disease states. But shingles itself is so much worse than people tend to be aware. Crippling nerve pain and a risk of blindness if it gets in the ocular nerve. Even right now, I'm dealing with PHN (Postherpetic neuralgia) which is almost as bad as the shingles themselves and never really goes away.
You can get it, just pay for it out of pocket.

Several friends paid for vaccines when they didn't "qualify for coverage"
 
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What a terrific article!

The shingles vaccine made me feel quite ill for a day and a half, probably a bigger response than I've had from all other vaccines combined. I gather from people who have had shingles that 36 hours of a bad flu is a small price to pay, and a lower risk of dementia is a cherry on top.
I got shingles and tetanus in the same arm same trip. Don't do that. Bad time.

But I had 3 mild cases of shingles and they still sucked pretty hard. Vaccine definitely worth it.
 
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FranzJoseph

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The seasonal flu shot reducing dementia risk is intriguing but makes me wonder if the type of vaccine administered makes a difference. With mRNA flu vaccines arriving do they trigger the same innate immune response as the traditional vaccines?
IIRC there was some prelim evidence that the mRNA itself in mRNA vaccines (or more likely the complex of lipid nanoparticle carriers plus the mRNA) might accentuate some immune responses to other diseases (IIRC the study was about COVID‑19 mRNA vaccines seemingly helping with a certain immune med for cancer).

TL;DR: Those on that immune med for cancer who also had a mRNA COVID‑19 vaccine fared better
 
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EvolvedMonkey

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Have they checked for causality in the opposite direction: people who don't have dementia take better care of themselves (including requesting shots)?
I would imagine that countries with wide scale state vaccine programs would avoid some of that self selection, along with a lot of these vaccines being administered well before dementia onset.
 
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If pretty much all vaccines will protect against dementia, and they all have adjuvants but wildly different targets, then maybe a yearly shot of adjuvant with no antigen would work as well? (For the dementia, not for protection to the diseases those vaccines are targeting.) Also, for the Shingles vaccine it is possible that both the general "any vaccine effect" and the specific viral targeting are in play. That vaccine seems to work especially well to protect against dementia, maybe because it employs two separate mechanisms?
 
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numerobis

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If pretty much all vaccines will protect against dementia, and they all have adjuvants but wildly different targets, then maybe a yearly shot of adjuvant with no antigen would work as well? (For the dementia, not for protection to the diseases those vaccines are targeting.) Also, for the Shingles vaccine it is possible that both the general "any vaccine effect" and the specific viral targeting are in play. That vaccine seems to work especially well to protect against dementia, maybe because it employs two separate mechanisms?
If you're getting an injection you might as well get inoculated for a disease at the same time as your adjuvent injection.
 
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MoranJ2000

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I got my first shingles vaccine in the fall of 2020 which of course was the early days of CoVID. When I had the second shot three months later I had such a bad reaction (chills, sweating, dizziness, but of a fever) I was certain I had Covid. I believe the Covid vaccine had been released by then, but was still in short supply.

Good times.
 
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Random_stranger

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So if I'm understanding this correctly, the basic idea is that by periodically using an artificial method (vaccines) of stimulating an immune response, we're basically keeping our immune system revved up and capable of reacting to all pathogens - not just the ones we've trained our system to recognize?

It seems to say that, yes.

That makes a lot of sense, but also seems to imply that dementia is caused by a specific pathogen that might eventually be identified, and presumably we could then develop a specific vaccine against that, right? If that's correct, it seems to me like maybe the most revolutionary idea in this research.

IANA biologist. Dementia seems like a slow breakdown in multiple system, like a car rusting / wires corroding / rubber hardening / metal wearing out / oil pan leaking, etc. Just like cancer, it may be 25 different things all causing a bit more wear-and-tear. The more of them we slow down (with multiple vaccines), the less likely the symptoms happen. It seems VERY unlike to me that it'll be exactly one pathogen.
 
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Random_stranger

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What a terrific article!

The shingles vaccine made me feel quite ill for a day and a half, probably a bigger response than I've had from all other vaccines combined. I gather from people who have had shingles that 36 hours of a bad flu is a small price to pay, and a lower risk of dementia is a cherry on top.

I got it like the month after I turned 50 (had been waiting / prepping for it), and it gave me a fever and a bit dizzy for 2-3 hours - again, the worst response ever to any vaccine.. I expected the 2nd dose to be similar, but it was a nothingburger.
 
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norton_I

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I doubt it would be hard to find a physician that would approve a course of Shingrix despite being outside the approved study group. It certainly wouldn't hurt to at least ask.

I asked my physician about this. It's not covered by insurance if you aren't in the approved group, and they don't recommend it as a matter of course, but at least he would give a prescription to anyone who thought they were in a higher risk.
 
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I asked my physician about this. It's not covered by insurance if you aren't in the approved group, and they don't recommend it as a matter of course, but at least he would give a prescription to anyone who thought they were in a higher risk.
My bad luck was that Shingrix was approved in the US in October, 2017 and being 51 I was in the approved group but they were pushing to vaccinate older people first so it wasn't recommended to me until after I had shingles wipe me out for all of February and March 2018. Lousy timing on my part.
 
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DNA_Doc

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Have they checked for causality in the opposite direction: people who don't have dementia take better care of themselves (including requesting shots)?
They do explicitly address "healthcare-seeking behavior" and selection bias, yes. While they acknowledge that those who get vaccinated may generally just be more health conscious, they argue that three types of evidence from natural experiments strongly suggest the effect is biological rather than just behavioral:

  1. "Quasi-randomization": studies of people born days apart where "observed and unobserved factors, such as healthcare-seeking behavior and personal motivation, were balanced across the groups" (making them less vulnerable to confounding/selection bias), show differences in dementia risk.
  2. "Test-negative" controlled study designs comparing vaccinated people who got the disease vs vaccinated people who didn't get the disease (to control for healthcare access)
  3. Inconsistent vaccine effects: if being more health conscious was the explanation, we'd expect all vaccines to be protective. But while some definitely appear to be (eg, AS01-adjuvanted shingles) there is at least one study mentioned in the paper (Douros et al, reference 40 in the paper) that showed an increase in dementia risk with influenza and pneumococcal vaccines. That suggests a biological mechanism rather than general health behavior, though this was a small cohort study.
Collectively, I do think this probably points to a biological (immunological) mechanism rather than to a behavioral one.
 
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Fatesrider

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The seasonal flu shot reducing dementia risk is intriguing but makes me wonder if the type of vaccine administered makes a difference. With mRNA flu vaccines arriving do they trigger the same innate immune response as the traditional vaccines?
Medically speaking, I'd say yes, they should.

This is because of HOW the vaccines work rather than how they're made. The immune response is what apparently does the job. Kind of like it doesn't matter how one breaks an arm, it's still going to generate the same kind of "healing" that a fracture would cause.

The immune system is one of the more arcane ones in the body that people in general don't know a lot about. Immunology is also still a bit of an emerging science in the whys of things. But the long-term nature of these particular effects tell me that the type of vaccine used isn't nearly as important as the immune response it generates. And since mRNA does a BETTER job of stimulating that response overall, it should provide the same or better level of protection that immune responses consequently causes much later in life.

The caveat is that this is not RELIABLY applicable to the individual. Only to a group majority. So individual results will vary, as with any vaccine, though the majority should see the benefits.
 
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norton_I

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What about the relationship between viruses and hearing, and then hearing and social interaction, and interaction and dementia? And then a vicious cycle between dementia, forgetfulness, not using hearing aids, lack of social interaction…

That might be a factor in the flu vaccine data. As far as I understand, the studies of Shingrix and it's protection against dementia specifically exclude people who had diagnosed cases of shingles. So it's not the case that preventing shingles is the only mechanism. Although it could be preventing low level damage that doesn't rise to the level of a diagnosable shingles case?
 
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This article makes me feel really good about being a vaccine junky. In nursing school, I read that BCG was only used in America for cancer patients. Why? To boost their immune system. That was all I needed to hear to get the idea that every time you got a vaccine, your immune system receives a generalized boost. So every time a vaccine was offered to me over the last 35 years, I said yes. A stint of working in Britain even got me the BCG shot. Full doses of both old and new variants of shingles vaccines. Annual flu vaccines were required in my acute care hospital workplace - I was completely OK with that.

Anecdotally, my mother has dementia at 94 (and doesn't recognize any of her five children or her 97 year old husband), so as someone who avoided physicians and conventional medicine for herself (this didn't take hold until her children were grown), she preferred alternative healthcare and I assume did not receive vaccines until required by her nursing home in 2021.

I might actually have been right about vaccines although of course dementia prevention was not on my radar. Good story to repeat over and over again for my future tenancy in a nursing home.
 
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Observations related to shingles and other viral infections/vaccinations align well with other observations about oral health and dementia wherein bacteria responsible for gingivitis have been spotted in the brain of Alzheimer's patients and correlates with severity. Both of these combined with the hallmark of compromised blood-brain barrier in Alzheimers seem to point to pathogens leaking into the brain, and the brain drowning itself in inflammation trying to deal with it. There's still a massive chicken and egg problem. Neuroinflammation can compromise the blood-brain barrier so its not yet clear if neuroinflammation comes first, or if leaky barrier is first and ramps inflammation leading to a feedback loop. Studying dementia is extremely difficult. My spouse did their dissertation work on dementia, and now works in pharma on dementias. I've worked a bit on dementia in pharma as well. One thing is for certain, neuroscience needs to break free of dogma. The brain is difficult to study, you can't just biopsy living people's brains like you can with skin, liver, lungs, muscle, etc. Nonetheless, the brain cannot be studied in a vacuum. And the amyloid focused approach has yet to bear fruit after decades. The amyloid mafia is very real. There are some experts in the field (who sit on committees to review and approve grants for the NIH) that will shut down anything that goes against their decades of research on the amyloid theory of alzheimers. So I'm glad to see other disciplines making progress and chipping away at the dogma.
It is good that you have it all figured out, especially that part about NOTHING bearing any fruit, which sounds rather ABSOLUTE.
 
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Stupidly Confident

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Tuberculosis vaccine is "far from routine" in US. My head exploded.
There's actually a good reason for this, which is that the BCG vaccine isn't always reliable and can cause false positives on skin tests. Instead, TB is controlled by aggressive monitoring, contact tracing, and treatment.

And I do mean aggressive. People with active TB can literally be detained and forced into treatment if they don't cooperate. Yes, even in the US, even with the lunatics now running HHS.
 
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