Research published on Tuesday is the latest to suggest that the viral disease shingles can be harmful to our long-term brain health. Scientists have shown that people who have had shingles were about 20% more likely to experience cognitive decline afterwards. The findings appear to bolster the growing idea that the shingles vaccine can be protective against dementia.

Shingles is caused by the varicella zoster virus (VSV), the same germ that causes chickenpox in children and younger adults. After someone recovers from chickenpox, the virus will often manage to survive and hide dormant inside our nervous system. Years, usually decades later, about one-third of chickenpox cases will experience a resurgent infection of the virus, known as shingles.

Shingles is no picnic, often causing excruciating pain, rashes, and other symptoms for up to five weeks. Some people will also develop lingering nerve pain that can last for years. Some research has suggested that VSV and other germs hiding in the brain can cause subtle neurological harm, particularly an increased risk of Alzheimer’s disease and dementia.

But this remains contentious and some studies have failed to support such a connection. Scientists at Brigham and Women’s Hospital led this newest study, hoping to better untangle any potential relationship between shingles and worsening brain health. The researchers analyzed data from three earlier large-scale studies that have proactively tracked the long-term health of nursing .