No Association Found Between Midlife Seropositivity for Infection and Subsequent Cognitive Decline: The Atherosclerosis Risk in Communities Neurocognitive Study (ARIC-NCS)

Kristen M. George, Aaron R. Folsom, Faye L. Norby, Pamela L. Lutsey

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Infections of herpes simplex virus type 1 (HSV-1), cytomegalovirus (CMV), Helicobacter pylori, and Chlamydia pneumoniae may play a role in cognitive decline via systemic inflammation. We hypothesized that Atherosclerosis Risk in Communities study participants who were seropositive in midlife for antibodies to HSV-1, CMV, H pylori, or C pneumoniae would have an accelerated rate of cognitive decline over 20 years. Atherosclerosis Risk in Communities performed a case-cohort study involving a stratified random sample of participants tested for serum immunoglobulin G antibodies to the pathogens of interest. We conducted a longitudinal study using this cohort. Cognitive change was measured using Z scores from the Delayed Word Recall (DWR), Digit Symbol Substitution (DSS), and Word Fluency (WF) Tests administered at visits 2 (1990-1992), 4 (1996-1998), and 5 (2011-2013). Linear regression models with generalized estimating equations and inverse probability of attrition weights were used to evaluate associations between infection and cognitive performance. Four hundred twenty-six participants were analyzed, of which 3% were seronegative for all 4 infections, 14% seropositive for one, 33% and 34% seropositive for 2 and 3, respectively, and 16% seropositive for all infections. At baseline, test scores were significantly lower for participants seropositive for H pylori and C pneumoniae. After baseline covariate adjustment, the rate of decline in DWR, DSS, WF, and global Z scores did not differ significantly by infection status for any of the 4 infections. There was also no significant association between the number of infections for which participants were seropositive and cognitive decline. Our study provides no evidence supporting a longitudinal relationship between seropositivity and cognitive decline.

Original languageEnglish (US)
Pages (from-to)15-21
Number of pages7
JournalJournal of Geriatric Psychiatry and Neurology
Volume33
Issue number1
DOIs
StatePublished - Jan 1 2020

Bibliographical note

Funding Information:
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Ms George was supported by National Heart, Lung, and Blood Institute (NHLBI) Training Grant T32HL007779. The Atherosclerosis Risk in Communities Study is carried out as a collaborative study supported by National Heart, Lung, and Blood Institute contracts (HHSN268201100005C, HHSN268201100006C, HHSN268201100007C, HHSN26820110000 8C, HHSN268201100009C, HHSN268201100010C, HHSN26820 1100011C, and HHSN268201100012C). Neurocognitive data is collected by U01 HL096812, HL096814, HL096899, HL096902, HL0 96917 with previous brain MRI examinations funded by R01-HL70825.

Funding Information:
The authors thank the staff and participants of the ARIC study for their important contributions. The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Ms George was supported by National Heart, Lung, and Blood Institute (NHLBI) Training Grant T32HL007779. The Atherosclerosis Risk in Communities Study is carried out as a collaborative study supported by National Heart, Lung, and Blood Institute contracts (HHSN268201100005C, HHSN268201100006C, HHSN268201100007C, HHSN268201100008C, HHSN268201100009C, HHSN268201100010C, HHSN268201100011C, and HHSN268201100012C). Neurocognitive data is collected by U01 HL096812, HL096814, HL096899, HL096902, HL096917 with previous brain MRI examinations funded by R01-HL70825.

Keywords

  • cognitive decline
  • cohort study
  • infection

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