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Functional decline and herpes zoster in older people: an interplay of multiple factors

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Abstract

Herpes zoster is a frequent painful infectious disease whose incidence and severity increase with age. In older people, there is a strong bidirectional link between herpes zoster and functional decline, which refers to a decrement in ability to perform activities of daily living due to ageing and disabilities. However, the exact nature of such link remains poorly established. Based on the opinion from a multidisciplinary group of experts, we here propose a new model to account for the interplay between infection, somatic/psychiatric comorbidity, coping skills, polypharmacy, and age, which may account for the functional decline related to herpes zoster in older patients. This model integrates the risk of decompensation of underlying disease; the risk of pain becoming chronic (e.g. postherpetic neuralgia); the risk of herpes zoster non-pain complications; the detrimental impact of herpes zoster on quality of life, functioning, and mood; the therapeutic difficulties due to multimorbidity, polypharmacy, and ageing; and the role of stressful life events in the infection itself and comorbid depression. This model underlines the importance of early treatment, strengthening coping, and vaccine prevention.

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Acknowledgments

The authors are extremely grateful to Karine Bloch, Charles Baptiste, and Isabelle Bertrand (Sanofi Pasteur MSD) for their assistance in preparing the meeting. They also thank Fabienne Péretz (Abelia Science) for her assistance (supported by Sanofi Pasteur MSD) in preparing the manuscript.

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    Herpes Zoster and Functional Decline Consortium

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    The authors declared that they have received within the past 5 years the following: NA: Reimbursement and fees for advisory boards or speakers from Pfizer, Lilly, Sanofi Pasteur, Sanofi Pasteur MSD, Grunenthal, Adir, Astra Zeneca, Astellas. CD: Reimbursement and fees for advisory board from Sanofi Pasteur MSD. GG: Reimbursement and fees for advisory board from bioMérieux, ECDC, OMS, Pfizer, ViforPharma; lecture, training courses: Pfizer, Sanofi Pasteur, Sanofi Pasteur MSD, ViforPharma; invitations to attend national and international conferences: Sanofi Pasteur MSD, bioMérieux, Pfizer, Janssens, Novartis; Grant support from Sanofi Pasteur MSD, bioMérieux, Pfizer studies. PG: Reimbursement and fees for advisory board from AstraZeneca, Bristol-Myers-Squibb, Janssen, Lilly, Lundbeck, Naurex, Otsuka, Roche, Sanofi Pasteur MSD, Servier and Shire. ML: Reimbursement and fees for advisory boards or speakers bureau from Alcon, Allergan, Bausch & Lomb, Sanofi Pasteur MSD, Santen, Thea. FL: Reimbursement and fees for advisory board from Sanofi Pasteur MSD. GP: Sanofi Pasteur MSD, Grünenthal. KS: Grant support from Merck for zoster vaccine study.

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    The Herpes Zoster and Functional Decline Consortium list of authors is shown in the Appendix.

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    Appendix

    Appendix

    The Herpes Zoster and Functional Decline Consortium list of authors is as follows:

    Nadine ATTAL (INSERM U 987 and CETD, Hôpital Ambroise Paré, APHP, 9 Avenue Charles de Gaulle, Boulogne Billancourt, 92100, France; Université Versailles- Saint Quentin en Yvelines, Versailles, France); Claire DEBACK (Service de Virologie, Hôpital Paul Brousse, APHP, Université Paris Sud, Villejuif, 94804, France; INSERM U996, Clamart, 92140, France); Gaétan Gavazzi (Université Grenoble-Alpes, GREPI AGIM, and Clinique Universitaire de Médecine Gériatrique, CHU de Grenoble, Nord Michallon, Boulevard De La Chantourne, La Tronche, 38700, France); Philip Gorwood (CMME, Centre Hospitalier Sainte-Anne, Université Paris Descartes, Paris, France; INSERM U894, 100 Rue de la Santé, Paris Cedex 14, 75158, France), Marc Labetoulle (Service d’Ophtalmologie, CHU Bicêtre, APHP, Université Paris Sud, Kremlin-Bicêtre, 94275, France; Laboratoire de virologie moléculaire et structurale, UPR 3296, CNRS, Gif-Sur-Yvette, 91198, France); François Liard (72 Grand Rue, Saint-Epain, 37800, France); Gisèle Pickering (CHU Clermont-Ferrand, Centre de Pharmacologie Clinique, Clermont-Ferrand, 63003, France; INSERM, CIC 1405, INSERM Neurodol 1107, Clermont-Ferrand, 63003, France; Pharmacologie, Faculté de médecine, Clermont Université, Clermont- Ferrand, 63001, France); Kenneth E Schmader (Durham VA medical Center GRECC and Duke University Medical Centers, Durham, NC, USA).

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    Herpes Zoster and Functional Decline Consortium. Functional decline and herpes zoster in older people: an interplay of multiple factors. Aging Clin Exp Res 27, 757–765 (2015). https://doi.org/10.1007/s40520-015-0450-0

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