Association of common infections with cognitive performance in the Baltimore Epidemiologic Catchment Area study follow‐up

Abstract

IntroductionGrowing evidence suggests that some common infections are causally associated with cognitive impairment; however, less is known about the burden of multiple infections.MethodsWe investigated the cross‐sectional association of positive antibody tests for herpes simplex virus, cytomegalovirus (CMV), Epstein‐Barr virus (EBV), varicella zoster virus (VZV), and Toxoplasma gondii (TOX) with Mini‐Mental State Examination (MMSE) and delayed verbal recall performance in 575 adults aged 41–97 from the Baltimore Epidemiologic Catchment Area Study.ResultsIn multivariable‐adjusted zero‐inflated Poisson (ZIP) regression models, positive antibody tests for CMV (p = .011) and herpes simplex virus (p = .018) were individually associated with poorer MMSE performance (p = .011). A greater number of positive antibody tests among the five tested was associated with worse MMSE performance (p = .001).DiscussionCMV, herpes simplex virus, and the global burden of multiple common infections were independently associated with poorer cognitive performance. Additional research that investigates whether the global burden of infection predicts cognitive decline and Alzheimer's disease biomarker changes is needed to confirm these findings.

Viral Infections, Are They a Trigger and Risk Factor of Alzheimer’s Disease?

“…Surveying these historical perspectives reveals the gradual evolution of thoughts that led to recent considerations and investigations of this viral hypothesis in AD. During the mid-20th century, there were records by clinicians and researchers reporting peculiar associations between infectious events and cognitive decline generally [ 16 , 17 , 18 , 19 , 20 , 21 ]. Specifically, the persuasive work by Oskar Fischer in 1907 established AD pathology, and it was not until decades later, specifically during the 1980s, that infectious agents came under scrutiny for their potential influence on neurodegeneration.…”

Viral Infections, a Trigger and Risk Factor of Alzheimer’s Disease?

“…During the mid-20th century, there were records by clinicians and researchers reporting peculiar associations between infectious events and cognitive decline generally [16][17][18][19][20][21]. Specifically, the persuasive work by Oskar Fischer in 1907 established AD pathology, and it was not until decades later, specifically during the 1980s, that infectious agents came under scrutiny for their potential influence on neurodegeneration.…”

Human Cytomegalovirus Infection and Neurocognitive and Neuropsychiatric Health

“…In addition, there appears to be less research in young and middle-aged adult populations compared to older ones, but most research on HCMV and cognition has been carried out in children [7]. It is significant that an increasing number of studies appear to be considering the impact of multiple infections on cognition [45]. Given that HCMV has been associated with increased risk for medical conditions that may independently affect cognition, including heart disease and stroke [38], it seems necessary that future studies control for and consider these conditions.…”

“…However, most studies consider either associations between HCMV and mood or HCMV and cognition, but not both. Furthermore, most studies investigating associations between cognitive function in adults are cross-sectional, and additional longitudinal studies are sorely needed to confirm these associations as well as to elucidate mechanisms of action [45]. In addition, identification of risk factors for the occurrence of deficits in cognitive function in adults and older adults with HCMV infection is needed.…”