ArticleJournal of the American Geriatrics Society2025
Association Between Herpes Zoster and Risk of Incident Fragility Fractures in US Veterans: A Matched Cohort Study.
Article in Journal of the American Geriatrics Society, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
1 citing paper in PubMed.
- Association Between Herpes Zoster and Risk of Incident Fragility Fractures in US Veterans: A Matched Cohort Study.Journal of the American Geriatrics Society · 2025Article
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
backgroundHerpes zoster (HZ) and fragility fractures typically affect older adults and present major burdens to healthcare systems. While HZ is associated with an increased risk of neurological, ocular, skin, and visceral complications, it is unclear whether it affects long-term bone health. Therefore, we aimed to compare the risk of fragility fractures in Veterans with HZ relative to matched Veterans without HZ in the United States.
methodsWe used routinely collected data from the Veterans Aging Cohort Study (VACS-National) from 01/01/2008 to 31/12/2023. Veterans with incident HZ diagnoses aged 40+ were matched on age, sex, race, ethnicity, site of care, and calendar time with up to five Veterans without HZ. The association between HZ and subsequent fragility fractures (defined as hip/femoral, shoulder/upper arm, vertebral, and wrist/forearm fractures) overall and by site was assessed using a Cox model stratified by matched set adjusting for sociodemographic, lifestyle, and clinical confounders. Age, frailty, and receipt of antivirals (AVT) within 7 days of exposure were investigated as potential effect modifiers for the relationship.
resultsWe included 229,992 Veterans with HZ matched to 1,134,519 Veterans without HZ. Both groups were comparable in median age (67.8 vs. 67.7 years), percentage males (93.5% vs. 93.7%), and median follow-up time (5.9 vs. 5.4 years). Veterans with HZ had a 15% higher risk of incident fragility fracture (aHR = 1.15, 95% CI: 1.13, 1.18) compared to Veterans without HZ. The increased risk was observed for each fracture site. There was evidence of interaction by age, frailty, and receipt of AVT, as older, frailer, and AVT-treated Veterans had a higher risk of fragility fracture.
conclusionsVeterans with HZ were at a higher risk of fragility fractures relative to Veterans without HZ, highlighting the need for improved fracture prevention among those diagnosed with HZ. Further research in non-Veteran and female populations will improve generalizability.
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