Aging Clin Exp Res. 2015 Dec;27(6):757-65. doi: 10.1007/s40520-015-0450-0. Epub 2015 Oct 6.
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.
带状疱疹是一种常见的疼痛性传染病，其发病率和严重程度随年龄增长而增加。在老年人中，带状疱疹与功能衰退之间存在着强烈的双向联系，功能衰退是指由于衰老和残疾导致日常生活活动能力下降。然而，这种联系的确切性质仍未明确。基于多学科专家小组的意见，我们在此提出一个新模型，以解释感染、躯体/精神共病、应对技巧、多重用药和年龄之间的相互作用，这些因素可能导致老年患者与带状疱疹相关的功能衰退。该模型整合了基础疾病失代偿的风险；疼痛变为慢性（如带状疱疹后神经痛）的风险；带状疱疹非疼痛并发症的风险；带状疱疹对生活质量、功能和情绪的有害影响；多重疾病、多重用药和衰老导致的治疗困难；以及应激性生活事件在感染本身和共病抑郁症中的作用。该模型强调了早期治疗、增强应对能力和疫苗预防的重要性。
