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The shingles vaccine may reduce the risk of dementia

economist.com

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Re: The shingles vaccine may reduce the risk of dementia

#221

Post by sarchertech »

hereme888 wrote: post #218
sarchertech wrote: post #213

Earlier quoted context omitted.

That’s not what that sentence says though. >Among physicians, pediatricians seemed to have higher rates. Not just pediatricians, but physicians that work at hospitals and clinics. Which is nearly all of them. I think what you’re dealing with is a low quality, low effort survey study from Taiwan, which was poorly written, so there is no point trying to figure out what they meant.

It's not a strong study, and the demographic group was very particular, but it involved 30k physicians, which is something. I would have no problem conceding that I misread the study, but ChatGPT, which is obviously never wrong (joking of course), agreed with me: https://chatgpt.com/share/6a550f00-d174-83ea-b111-0369a8e4db...

I was wrong calling it a survey study, because I didn’t realize Taiwan had such detailed information on every citizen.

But looking at the specific data the naive ratio for pediatricians is lower than several other specialities. It was only higher when they adjusted for confounding factors. But the list of confounders was limited by the data available.

In addition they found that for some reason working at a large hospital was protective, but they didn’t adjust for hospital size when comparing specialities. In general pediatricians are less likely to work at large hospitals than the average specialty (wife is a pediatrician).

The result is essentially a cherry picked result that only adjust for some confounders. Add to that only 19 cases of dementia among pediatricians. Then the CI for pedestrians overlaps every other listed speciality. The study is essentially meaningless for your purposes.

Also the paper is actually saying that older doctors are more likely to have dementia than younger doctors, not that doctors develop dementia later than the general population.

Re: The shingles vaccine may reduce the risk of dementia

#222

Post by hereme888 »

sarchertech wrote: post #221
hereme888 wrote: post #218

Earlier quoted context omitted.

It's not a strong study, and the demographic group was very particular, but it involved 30k physicians, which is something. I would have no problem conceding that I misread the study, but ChatGPT, which is obviously never wrong (joking of course), agreed with me: https://chatgpt.com/share/6a550f00-d174-83ea-b111-0369a8e4db...

I was wrong calling it a survey study, because I didn’t realize Taiwan had such detailed information on every citizen. But looking at the specific data the naive ratio for pediatricians is lower than several other specialities. It was only higher when they adjusted for confounding factors. But the list of confounders was limited by the data available. In addition they found that for some reason working at a large hos…

Let me try to paint a picture:

Academic and ongoing challenging education results in greater number of connections between nerves. In normal population, as plaque accumulates, it causes loss of transmission and deterioration of nerve connections.

In physicians, because they have more "density" and more pathways in which nerves are connected than the general population, dementias like Alzheimer's show no symptoms until there's even more plaque accumulated, because they can compensate with extra pathways, similar to the study on nuns who showed no signs of alzheimer's at an old age because they kept so active, even though post-mortem they had horrible alzheimer's on biopsy. At the late stage physicians finally manifest the dementia, it's stronger and progresses quicker. It's like "catching it late" for doctors.

Re: The shingles vaccine may reduce the risk of dementia

#223

Post by throwaway2037 »

robot_jesus wrote: post #5

I'm in my 40s with genetic predisposition for Alzheimer's. Been seriously considering the past year or two paying out of pocket for Shingrix. I think it would be ~$500 total for two doses. Sure, I could wait 7 or 8 years until I qualify via insurance, but is that really worth the risk for what is an easily absorbed cost to me? Especially when I have a friend in her late 30s who just went through a very rough bout of…

If you have any developing countries nearby (holiday, etc.), you can usually get it cheaper at a clinic. I get my vaccines (when on holiday) in Thailand here: https://www.thaitravelclinic.com/vaccine-price-list/

Re: The shingles vaccine may reduce the risk of dementia

#224

Post by throwaway2037 »

dr_kiszonka wrote: post #102
copperx wrote: post #17

Earlier quoted context omitted.

Shingles terrifies me because it can cause hearing loss. I spoke to my GP and he wouldn't give me a script for it even though I'm 3 years away from qualifying. He mentioned side effects.

"An increased risk of Guillain-Barré syndrome (severe muscle weakness) was observed after vaccination with SHINGRIX" https://www.shingrix.com/side-effects/

For the record, annual flu vaccines also have this risk, but it doesn't stop 450 million people from getting them.

Re: The shingles vaccine may reduce the risk of dementia

#225

Post by runeks »

modeless wrote: post #95
what_hn wrote: post #72

Is it also possible they're finding healthier people that are proactive in their treatment, maybe even exercise more, work longer, etc...

Good guess. The actual mechanism is that people who don't get the vaccination are more likely to need to visit the hospital to treat their shingles, and because they visit the hospital more they have more chances to get a diagnosis of dementia in a hospital. See this presentation: https://youtu.be/qlTnnQytOJ0 The lesson is to be extremely suspicious of findings of causation based on observational studies.

> Good guess. The actual mechanism [...]

Why couldn't both these factors contribute to the result of the study?

Re: The shingles vaccine may reduce the risk of dementia

#226

Post by sarchertech »

hereme888 wrote: post #222
sarchertech wrote: post #221

Earlier quoted context omitted.

I was wrong calling it a survey study, because I didn’t realize Taiwan had such detailed information on every citizen. But looking at the specific data the naive ratio for pediatricians is lower than several other specialities. It was only higher when they adjusted for confounding factors. But the list of confounders was limited by the data available. In addition they found that for some reason working at a large hos…

Let me try to paint a picture: Academic and ongoing challenging education results in greater number of connections between nerves. In normal population, as plaque accumulates, it causes loss of transmission and deterioration of nerve connections. In physicians, because they have more "density" and more pathways in which nerves are connected than the general population, dementias like Alzheimer's show no symptoms unti…

That’s possible (although the plaque hypothesis as the sole cause is looking less plausible).

But that’s not what the study is saying. It’s literally just saying that older doctors are more likely than younger doctors to have dementia.

Also that study only looks at dementia and Alzheimer’s only accounts for ~2/3 of cases.

Re: The shingles vaccine may reduce the risk of dementia

#227

Post by hereme888 »

sarchertech wrote: post #226
hereme888 wrote: post #222

Earlier quoted context omitted.

Let me try to paint a picture: Academic and ongoing challenging education results in greater number of connections between nerves. In normal population, as plaque accumulates, it causes loss of transmission and deterioration of nerve connections. In physicians, because they have more "density" and more pathways in which nerves are connected than the general population, dementias like Alzheimer's show no symptoms unti…

That’s possible (although the plaque hypothesis as the sole cause is looking less plausible). But that’s not what the study is saying. It’s literally just saying that older doctors are more likely than younger doctors to have dementia. Also that study only looks at dementia and Alzheimer’s only accounts for ~2/3 of cases.

Plaque is the end-cause. What's debatable is why it accumulates and what pharmaceuticals and interventions we doctors should prescribe for our patients, not whether it's present or not.

Re: The shingles vaccine may reduce the risk of dementia

#228

Post by chasil »

realxrobau wrote: post #212
chasil wrote: post #199

Earlier quoted context omitted.

Not to the union, it's not. 'The plaintiffs alleged that the vaccines do not prevent someone from becoming infected with COVID-19 and characterized it as a treatment rather than a “traditional vaccine.”' https://calmatters.org/education/2024/06/covid-vaccine-manda...

You're aware that the article you posted is full of sovcit antivaxers? The reason the case was dismissed was because the requirement was removed. The case was reopened on appeal due to the rules being temporarily re-established. Anything else is nonsense. This is spelled out in the article but wrapped with a bunch of whatifs and maybes and possiblies. If your hypothesis was correct, then NOTHING is a vaccine.

Do I care?

Re: The shingles vaccine may reduce the risk of dementia

#229

Post by realxrobau »

chasil wrote: post #228
realxrobau wrote: post #212

Earlier quoted context omitted.

You're aware that the article you posted is full of sovcit antivaxers? The reason the case was dismissed was because the requirement was removed. The case was reopened on appeal due to the rules being temporarily re-established. Anything else is nonsense. This is spelled out in the article but wrapped with a bunch of whatifs and maybes and possiblies. If your hypothesis was correct, then NOTHING is a vaccine.

Do I care?

Well you're the one making the claim that a vaccine needs to block infections permanently, so I guess you do?

Re: The shingles vaccine may reduce the risk of dementia

#230

Post by sarchertech »

hereme888 wrote: post #227
sarchertech wrote: post #226

Earlier quoted context omitted.

That’s possible (although the plaque hypothesis as the sole cause is looking less plausible). But that’s not what the study is saying. It’s literally just saying that older doctors are more likely than younger doctors to have dementia. Also that study only looks at dementia and Alzheimer’s only accounts for ~2/3 of cases.

Plaque is the end-cause. What's debatable is why it accumulates and what pharmaceuticals and interventions we doctors should prescribe for our patients, not whether it's present or not.

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