Journal
AGING CLINICAL AND EXPERIMENTAL RESEARCH
Volume 27, Issue 6, Pages 757-765Publisher
SPRINGER
DOI: 10.1007/s40520-015-0450-0
Keywords
Coping style; Functional decline; Herpes zoster; Polypharmacy; Postherpetic neuralgia
Categories
Funding
- Sanofi Pasteur MSD
- bioMerieux
- Pfizer studies
- Merck
- Pfizer
- Lilly
- Sanofi Pasteur
- Grunenthal
- Adir
- Astra Zeneca
- Astellas
- ECDC
- OMS
- ViforPharma
- Bristol-Myers-Squibb
- Janssen
- Lundbeck
- Naurex
- Otsuka
- Roche
- Servier
- Shire
- Alcon
- Allergan
- Bausch Lomb
- Santen
- Thea
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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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