Can the shingles vaccine lower your risk of dementia?

You know about sleep, movement and blood sugar. Here are five less obvious things the research links to a lower risk of dementia and cognitive decline, starting with the shingles vaccine.

By Dr Lucy Burns and Dr Mary Barson, medical doctors and co-founders of Real Life Medicine. Updated September 2026.

This one started with a question in clinic. A patient asked Dr Lucy whether the shingles vaccine could help prevent dementia. She'd seen the headlines too, and rather than give a headline answer, we went and read the research properly. What we found was interesting enough to build this week's Friday 5 around it.

The short answer: five everyday things are linked to a lower risk of dementia or cognitive decline in the research.

• The shingles vaccine: linked to 20% fewer new dementia diagnoses in a Welsh natural experiment
• Knitting and other crafts: linked to a 28% lower risk of mild cognitive impairment
• Riding a bike: linked to a 19% lower risk of dementia and 22% lower risk of Alzheimer's disease
• Playing a musical instrument: linked to a 36% lower risk of dementia across three studies
• Looking after your hearing: hearing loss is the equal-largest modifiable risk factor for dementia

When we talk about dementia prevention, the usual suspects get most of the airtime: blood sugar, blood pressure, sleep and exercise. They matter enormously, and we've covered them in 5 things you can do in midlife to prevent dementia. This week is about the less expected findings, and a few of them are things you might already be doing.

One quick note before we start. Most of these studies are observational, which means they show a link rather than prove cause and effect. People who knit or ride bikes might differ from people who don't in other ways too. Where a study gets closer to showing cause and effect, we'll tell you. None of this is a guarantee, but together it paints an encouraging picture: your brain keeps responding to how you live.

1. Can the shingles vaccine lower your risk of dementia?

What the research found

The most compelling evidence comes from Wales, thanks to a quirk in how the shingles vaccine was rolled out in 2013. Eligibility was set by date of birth. People born on or after 2 September 1933 could get it. People born even a week earlier couldn't, and never became eligible. That created two groups of almost identical people separated only by an arbitrary line on the calendar, which is about as close as you can get to a randomised trial without running one.

Researchers followed 282,541 of these adults for seven years. Getting the vaccine was linked to a 20% reduction in new dementia diagnoses, and the effect was stronger in women. The study was published in Nature in 2025.

The Welsh study used an older live vaccine that's no longer used in Australia. Australia now uses Shingrix, a newer, non-live vaccine. A 2024 Oxford study of more than 200,000 people found that people who had Shingrix lived 17% longer without a dementia diagnosis than people who'd had the older vaccine. Again, the benefit was bigger in women: 22% compared with 13% in men.

Why would a shingles vaccine affect your brain? We don't know for sure. One theory is that when the virus behind shingles (the same one that causes chickenpox) reactivates, it contributes to inflammation in the brain.

How well does Shingrix prevent shingles?

Very well. In large randomised trials, Shingrix prevented around 97% of shingles cases in adults aged 50 and over and around 90% in people aged 70 and over, including the long-lasting nerve pain (post-herpetic neuralgia) that can follow. Protection stays above 80% at least seven years later. Shingles is common: around 20% to 30% of people will get it, and about half of everyone who lives to 85.

Is Shingrix safe? What are the side effects?

Most people get a sore arm, and plenty feel flat, achy or feverish for a day or two. In Australian safety monitoring, almost half of people reported some kind of reaction, usually mild and gone within a few days. There's also a very rare risk of Guillain-Barré syndrome, a nerve condition. A large US study estimated about three extra cases per million doses in people aged 65 and over, mostly after the first dose. The US regulator concluded the benefits outweigh the risks, Australia's TGA describes the risk as very rare, and it's worth knowing that shingles itself can also trigger Guillain-Barré syndrome.

Who can get Shingrix for free in Australia?

Shingrix has been free under the National Immunisation Program since 1 November 2023 for people aged 65 and over, Aboriginal and Torres Strait Islander people aged 50 and over, and some people with weakened immune systems (NCIRS). It's a two-dose course, given two to six months apart. If you're not eligible, you can buy it on prescription, but it about $600 for the 2 vaccines 

Our Thoughts

The shingles protection is solid. The dementia link is promising but not proven: the Welsh study tested the older vaccine, the Shingrix evidence is observational, and people who choose to get vaccinated may look after their health in other ways too. No randomised trial has yet tested Shingrix for dementia prevention.

So we wouldn't get Shingrix only to prevent dementia. But preventing shingles is a very good reason on its own, and a possible brain benefit is a potential bonus. 

2. Can knitting help prevent cognitive decline?

Researchers at the Mayo Clinic followed 1,929 people aged 70 and over, all with normal thinking and memory at the start, for about four years. People who did craft activities once or twice a week had a 28% lower risk of developing mild cognitive impairment (the stage that can come before dementia) than people who crafted two or three times a month or less. An earlier Mayo Clinic study of 1,321 people aged 70 to 89 found a similar pattern, with crafts like quilting and pottery linked to 34% lower odds of mild cognitive impairment.

To be upfront, nobody has studied knitting on its own. These studies grouped crafts together rather than singling out one. But knitting sits squarely in that family. Counting stitches, following a pattern, using both hands with precision and working out how to rescue a dropped stitch all give your brain a proper workout. And if you knit with other people, you get a bonus: social isolation is one of the recognised risk factors for dementia.

Dr Lucy here: I'm currently knitting a blanket. It's slow going and I'm not very good, but I'm enjoying the process, and I'd like to think my brain is too. Yes, working out what went wrong three rows back counts as brain training. We don't make the rules.

3. Does riding a bike lower your risk of dementia?

A 2025 study followed almost 480,000 people in the UK Biobank, with an average age of 56, and looked at how they usually got around: car, public transport, walking or cycling. Over about 13 years, people who cycled as part of their regular travel had a 19% lower risk of dementia and a 22% lower risk of Alzheimer's disease than people who didn't use active transport. Their brain scans showed something interesting too: cyclists had a larger hippocampus, the part of the brain that's central to memory.

This study can't tell us exactly why cycling stood out, but it asks a lot of your brain as well as your legs. It's aerobic exercise, it takes balance and coordination, and working out a route or watching traffic means paying attention and planning ahead.

No lycra required. A ride to the shops or the café counts.

4. Does playing a musical instrument protect your brain?

One of the cleverest studies here used twins. Researchers looked at 157 pairs of twins where one twin went on to develop dementia or cognitive impairment and the other didn't. Twins share their childhood and some or all of their genes, which helps rule out a lot of other explanations. The twin who played a musical instrument was 64% less likely to be the one who developed dementia or cognitive impairment, even after accounting for sex, education and physical activity.

A 2022 review that pooled three larger studies, with more than 54,000 older adults in total, found that playing an instrument was linked to a 36% lower risk of dementia.

The numbers in these studies are still small, and they didn't tell us whether it matters when you start. But playing music asks your brain to read, listen, time, coordinate and remember all at once. If there's a guitar or keyboard gathering dust in the spare room, this might be your sign. Your family may have opinions if it's the recorder.

5. How does hearing loss affect your risk of dementia?

This one surprises most people. In the 2024 Lancet Commission on dementia, a major international report on dementia risk, hearing loss was the equal-largest modifiable risk factor of the 14 identified, accounting for an estimated 7% of dementia cases.

There are a few theories about why. When your hearing drops, your brain has to work harder to make sense of sound, it gets less stimulation, and conversations get harder, so many people start to withdraw socially.

The ACHIEVE trial, published in The Lancet in 2023, randomly assigned 977 adults aged 70 to 84 with untreated hearing loss to either hearing aids and support from an audiologist, or a general health education programme. Across the whole group, there was no significant difference in thinking and memory after three years. But in the group already at higher risk of cognitive decline, the hearing support slowed cognitive decline by 48%. That's a subgroup finding, so it's promising rather than proven, but it's one of the few randomised trials we have in this space.

What this looks like in real life:

• Protect the hearing you have. Earplugs for the lawnmower, the leaf blower and live music.
• Get your hearing checked if you're asking people to repeat themselves or turning the TV up.
• Wear the hearing aids. They're not a sign you've given up. They're a sign you'd like to keep up with the gossip.

What this means for you

The common thread here is that brains like to be used, challenged, connected and protected. Asking your GP about the shingles vaccine, finishing that scarf (or blanket), pedalling to the shops, picking the guitar back up and getting your hearing checked are all realistic things you can do, at any age.

These five are the surprising extras. The foundations are still your metabolic health, your sleep, your movement and how you manage stress. That's exactly what we help you build in My Metabolic Action Plan: Strategies, Skills and Tools, one step at a time, so looking after your brain becomes part of real life rather than another thing on the to-do list.

Check out My Metabolic Action Plan here 

Frequently asked questions

Does the shingles vaccine prevent dementia?

It hasn't been proven yet. A 2025 natural experiment in Wales found the shingles vaccine was linked to a 20% reduction in new dementia diagnoses over seven years, and a 2024 Oxford study linked Shingrix to 17% more time without a dementia diagnosis. No randomised trial has tested Shingrix for dementia prevention, so the main reason to have it is still to prevent shingles.

Who can get the Shingrix vaccine for free in Australia?

Since 1 November 2023, Shingrix has been free under the National Immunisation Program for people aged 65 and over, Aboriginal and Torres Strait Islander people aged 50 and over, and some people aged 18 and over with weakened immune systems. It's a two-dose course. Others can buy it on prescription.

What are the side effects of Shingrix?

Most people get a sore arm, and many feel tired, achy or feverish for a day or two. Guillain-Barré syndrome is a very rare risk, estimated at about three extra cases per million doses in people aged 65 and over.

Can knitting help prevent dementia?

Knitting hasn't been studied on its own, but craft activities as a group have been linked to a lower risk of mild cognitive impairment. A Mayo Clinic study of 1,929 people aged 70 and over found crafting once or twice a week was linked to a 28% lower risk.

Is hearing loss a risk factor for dementia?

Yes. The 2024 Lancet Commission named hearing loss as the equal-largest modifiable risk factor for dementia, accounting for an estimated 7% of cases. Protecting your hearing, getting it tested and wearing hearing aids if you need them are practical steps.

References

1. Eyting M, Xie M, Michalik F, et al. A natural experiment on the effect of herpes zoster vaccination on dementia. Nature. 2025;641(8062):438-446. Read the study
2. Taquet M, Dercon Q, Todd JA, Harrison PJ. The recombinant shingles vaccine is associated with lower risk of dementia. Nat Med. 2024;30:2777-2781. Read the study
3. Lal H, Cunningham AL, Godeaux O, et al. Efficacy of an adjuvanted herpes zoster subunit vaccine in older adults. N Engl J Med. 2015;372(22):2087-2096. Read the study
4. Cunningham AL, Lal H, Kovac M, et al. Efficacy of the herpes zoster subunit vaccine in adults 70 years of age or older. N Engl J Med. 2016;375(11):1019-1032. Read the study
5. Goud R, Lufkin B, Duffy J, et al. Risk of Guillain-Barré syndrome following recombinant zoster vaccine in Medicare beneficiaries. JAMA Intern Med. 2021;181(12):1623-1630. Read the study
6. Krell-Roesch J, Vemuri P, Pink A, et al. Association between mentally stimulating activities in late life and the outcome of incident mild cognitive impairment, with an analysis of the APOE ε4 genotype. JAMA Neurol. 2017;74(3):332-338. Read the study
7. Geda YE, Topazian HM, Roberts LA, et al. Engaging in cognitive activities, aging, and mild cognitive impairment: a population-based study. J Neuropsychiatry Clin Neurosci. 2011;23(2):149-154. Read the study
8. Hou C, Zhang Y, Zhao F, et al. Active travel mode and incident dementia and brain structure. JAMA Netw Open. 2025;8(6):e2514316. Read the study
9. Balbag MA, Pedersen NL, Gatz M. Playing a musical instrument as a protective factor against dementia and cognitive impairment: a population-based twin study. Int J Alzheimers Dis. 2014;2014:836748. Read the study
10. Arafa A, Teramoto M, Maeda S, et al. Playing a musical instrument and the risk of dementia among older adults: a systematic review and meta-analysis of prospective cohort studies. BMC Neurol. 2022;22:395. Read the study
11. Livingston G, Huntley J, Liu KY, et al. Dementia prevention, intervention, and care: 2024 report of the Lancet standing Commission. Lancet. 2024. Read the study
12. Lin FR, Pike JR, Albert MS, et al. Hearing intervention versus health education control to reduce cognitive decline in older adults with hearing loss in the USA (ACHIEVE): a multicentre, randomised controlled trial. Lancet. 2023;402(10404):786-797. Read the study
13. National Centre for Immunisation Research and Surveillance. Zoster (shingles) vaccine: frequently asked questions. Read the FAQs

This content is for general information only and isn't medical advice. Please talk with your GP before making changes to your health care.

Dr Mary Barson and Dr Lucy are the founders of Real Life Medicine. They help women who have been on every diet under the sun, optimise their health and achieve long-lasting weight loss without feeling miserable or deprived.

They do this with their 3-step framework that

• Improves metabolism
• Develops mindset skills
• Provides tools to implement it easily into busy lives

With this comes increased energy, vitality and confidence.

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