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Association between vaccinations and risk of dementia: a systematic review and meta-analysis
Maggi S, Fulöp T, De Vita E, Limongi F, Pizzol D, Di Gennaro F, Veronese N. Age and Ageing, 2025-10-30
Topic: Risk, prevention and care in population studies
Importance Dementia is a highly prevalent issue in older people. Whilst the prevention of dementia is a public health priority, the role of vaccinations is still largely unexplored. Objective The aim of this systematic review is to evaluate whether common adult vaccinations are associated with a reduced risk of dementia. Data sources PubMed, Embase and Web of Science were searched from inception to 1 January 2025. Study selection Observational studies comparing dementia and mild cognitive impairment incidence between vaccinated and unvaccinated adults aged ≥50 years. Data extraction and synthesis Four reviewers independently extracted data and assessed study quality using the Newcastle-Ottawa Scale. Risk ratios (RRs) and 95% confidence intervals (CIs) were pooled using a random-effects model. Main outcomes and measures Incidence of dementia, including its subtypes. Results Twenty-one studies (n = 104 031 186 participants) were included. Vaccination against herpes zoster was associated with a reduced risk of any dementia (RR 0.76, 95% CI 0.69-0.83) and Alzheimer's disease (RR 0.53, 95% CI 0.44-0.64). Influenza vaccination was linked to a reduction in dementia risk (RR 0.87, 95% CI 0.77-0.99), as was pneumococcal vaccination (RR 0.64, 95% CI 0.47-0.87) for Alzheimer's disease. Tetanus, diphtheria, pertussis (Tdap) vaccination was also associated with a significant reduction for any dementia (RR 0.67, 95% CI 0.54-0.83). Conclusions and relevance Adult vaccinations, particularly against herpes zoster, influenza, pneumococcus and Tdap, are associated with a lower risk of dementia. Vaccination strategies should be incorporated into public health initiatives for dementia prevention. Registration https://osf.io/x3d4f/.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Maggi, S., Fulöp, T., De Vita, E., Limongi, F., Pizzol, D., Di Gennaro, F., et al. (2025). Association between vaccinations and risk of dementia: a systematic review and meta-analysis. Age and Ageing. https://doi.org/10.1093/ageing/afaf331
Vancouver
Maggi S, Fulöp T, De Vita E, Limongi F, Pizzol D, Di Gennaro F, et al. Association between vaccinations and risk of dementia: a systematic review and meta-analysis. Age and Ageing. 2025. doi:10.1093/ageing/afaf331. PMID: 41269248.
BibTeX
@article{maggi2025-41269248,
author = {Maggi, S. and Fulöp, T. and De Vita, E. and Limongi, F. and Pizzol, D. and Di Gennaro, F. and Veronese, N.},
title = {{Association between vaccinations and risk of dementia: a systematic review and meta-analysis}},
journal = {Age and Ageing},
year = {2025},
doi = {10.1093/ageing/afaf331},
pmid = {41269248},
url = {https://doi.org/10.1093/ageing/afaf331}
}
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record names 7 authors; APA and Vancouver show the first six, BibTeX and the downloads carry all of them. Check the citation against the original before you use it.
Key findings
- Objective The aim of this systematic review is to evaluate whether common adult vaccinations are associated with a reduced risk of dementia.
- Results Twenty-one studies (n = 104 031 186 participants) were included.
- Vaccination against herpes zoster was associated with a reduced risk of any dementia (RR 0.76, 95% CI 0.69-0.83) and Alzheimer's disease (RR 0.53, 95% CI 0.44-0.64).
- Tetanus, diphtheria, pertussis (Tdap) vaccination was also associated with a significant reduction for any dementia (RR 0.67, 95% CI 0.54-0.83).
- Conclusions and relevance Adult vaccinations, particularly against herpes zoster, influenza, pneumococcus and Tdap, are associated with a lower risk of dementia.
Why it matters
This meta-analysis of 21 observational studies found that herpes zoster, influenza, pneumococcal and Tdap vaccinations were associated with reduced dementia risk. Because the included studies were observational, these associations do not prove that vaccination prevents dementia.
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Study details
- Study designmeta-analysis
- Participants104,031,186
- Effect sizeHerpes zoster vaccination RR 0.76 (95% CI 0.69-0.83) for any dementia
- Evidence strengthModerate
Limitations
All included studies were observational and prone to healthy-vaccinee bias; substantial heterogeneity; effect sizes larger than in quasi-experimental studies suggest residual confounding.
How this study scored 69/100
Published in a peer-reviewed journal, and it is a meta-analysis pooling many studies. We have no data on free to read, so that was left out: it earned 68 of the 98 points we could judge it on, which is 69 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Age and Ageing) |
| Journal's citation record | 2 / 4 | Age and Ageing: journal h-index 231 (OpenAlex, 2026-10-29) |
| Study design | 12 / 12 | A meta-analysis pooling many studies |
| Strength of evidence | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 4 / 5 | 2025 — within 3 year(s) of the newest study here |
| Sample size | 4 / 4 | 104,031,186 participants |
| Effect reported | 3 / 3 | Effect reported with a statistic (interval, p-value, ratio or similar) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | A review of other studies — randomisation is not credited here |
| Times cited | 3 / 7 | Cited 24 times (OpenAlex, 2026-10-10) |
| Citations per year | 3 / 5 | 8.0 citations a year over 3 year(s) since 2025 |
| Impact for its field and year | 3 / 6 | Cited 5.8× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 2 / 4 | Cited 24 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 4 / 4 | Last-listed author Nicola Veronese: h-index 107 (OpenAlex, whole career) |
| Institution's track record | 1 / 3 | National Research Council: institution h-index 840 (OpenAlex) |
| Multi-centre collaboration | 2 / 3 | OpenAlex lists 5 institution(s) in 2 countries |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 41269248) |
| Free to read | — / 2 | Access not recorded — left out of this score |
| Points | 68 / 98 | Scored on 19 of 20 parts. We have no data for the rest, so they are left out: 68 of the 98 points we could judge it on is 69 out of 100. |
| Total | 69 / 100 | — |
What each of these 20 components measures, and what this score is not →
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