Association Between Immune Response to Cytomegalovirus and Cognition in the Health and Retirement Study
Abstract Chronic infections and the subsequent immune response have recently been shown to be risk factors for cognitive decline and Alzheimer disease and related dementias (ADRD). While some studies have shown an association between cytomegalovirus (CMV), a chronic and highly prevalent infection, a...
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| Veröffentlicht in: | American journal of epidemiology 2021-05, Vol.190 (5), p.786-797 |
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| creator | Stebbins, Rebecca C Noppert, Grace A Yang, Yang Claire Dowd, Jennifer B Simanek, Amanda Aiello, Allison E |
| description | Abstract
Chronic infections and the subsequent immune response have recently been shown to be risk factors for cognitive decline and Alzheimer disease and related dementias (ADRD). While some studies have shown an association between cytomegalovirus (CMV), a chronic and highly prevalent infection, and cognition and/or ADRD, these studies have been limited by nonrepresentative and small samples. Using 2016 data on 5,617 adults aged 65 years or more from the Health and Retirement Study, we investigated the cross-sectional associations of both CMV serostatus and immunoglobulin G (IgG) antibody response with cognitive function using linear regression models adjusting for age, sex, race/ethnicity, and educational attainment. We further investigated potential effect-measure modification by educational attainment. Overall, both CMV seropositivity and higher IgG antibody response were associated with lower cognitive function, though the relationship was not statistically significant in adjusted models. Among participants with less than a high school diploma, CMV seropositivity and being in the first tertile of IgG response, relative to seronegative persons, were associated with lower scores on the Telephone Interview for Cognitive Status (−0.56 points (95% confidence interval: −1.63, 0.52) and −0.89 points (95% confidence interval: −2.07, 0.29), respectively), and the relationship was attenuated among those with higher education. Our results suggest that CMV may be a risk factor for cognitive impairment, particularly among persons with fewer educational resources. |
| doi_str_mv | 10.1093/aje/kwaa238 |
| format | Article |
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Chronic infections and the subsequent immune response have recently been shown to be risk factors for cognitive decline and Alzheimer disease and related dementias (ADRD). While some studies have shown an association between cytomegalovirus (CMV), a chronic and highly prevalent infection, and cognition and/or ADRD, these studies have been limited by nonrepresentative and small samples. Using 2016 data on 5,617 adults aged 65 years or more from the Health and Retirement Study, we investigated the cross-sectional associations of both CMV serostatus and immunoglobulin G (IgG) antibody response with cognitive function using linear regression models adjusting for age, sex, race/ethnicity, and educational attainment. We further investigated potential effect-measure modification by educational attainment. Overall, both CMV seropositivity and higher IgG antibody response were associated with lower cognitive function, though the relationship was not statistically significant in adjusted models. Among participants with less than a high school diploma, CMV seropositivity and being in the first tertile of IgG response, relative to seronegative persons, were associated with lower scores on the Telephone Interview for Cognitive Status (−0.56 points (95% confidence interval: −1.63, 0.52) and −0.89 points (95% confidence interval: −2.07, 0.29), respectively), and the relationship was attenuated among those with higher education. Our results suggest that CMV may be a risk factor for cognitive impairment, particularly among persons with fewer educational resources.</description><identifier>ISSN: 0002-9262</identifier><identifier>EISSN: 1476-6256</identifier><identifier>DOI: 10.1093/aje/kwaa238</identifier><identifier>PMID: 33094810</identifier><language>eng</language><publisher>United States: Oxford University Press</publisher><subject>Aged ; Aged, 80 and over ; Alzheimer's disease ; Antibody response ; Chronic Disease ; Chronic infection ; Cognition ; Cognition & reasoning ; Cognitive ability ; Cognitive Dysfunction - virology ; Confidence intervals ; Cross-Sectional Studies ; Cytomegalovirus ; Cytomegalovirus - immunology ; Cytomegalovirus Infections - immunology ; Education ; Educational attainment ; Educational Status ; Female ; Humans ; IgG antibody ; Immune response ; Immune system ; Immunoglobulin G ; Immunoglobulin G - immunology ; Male ; Neurodegenerative diseases ; Original Contribution ; Prevalence ; Regression analysis ; Regression models ; Retirement ; Risk Factors ; Statistical analysis ; United States - epidemiology</subject><ispartof>American journal of epidemiology, 2021-05, Vol.190 (5), p.786-797</ispartof><rights>The Author(s) 2020. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com. 2020</rights><rights>The Author(s) 2020. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c440t-9c4496f2af6ce62615d2e10c7b5731ace1b0041376db50d8891847ada9a8413a3</citedby><cites>FETCH-LOGICAL-c440t-9c4496f2af6ce62615d2e10c7b5731ace1b0041376db50d8891847ada9a8413a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,1584,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33094810$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Stebbins, Rebecca C</creatorcontrib><creatorcontrib>Noppert, Grace A</creatorcontrib><creatorcontrib>Yang, Yang Claire</creatorcontrib><creatorcontrib>Dowd, Jennifer B</creatorcontrib><creatorcontrib>Simanek, Amanda</creatorcontrib><creatorcontrib>Aiello, Allison E</creatorcontrib><title>Association Between Immune Response to Cytomegalovirus and Cognition in the Health and Retirement Study</title><title>American journal of epidemiology</title><addtitle>Am J Epidemiol</addtitle><description>Abstract
Chronic infections and the subsequent immune response have recently been shown to be risk factors for cognitive decline and Alzheimer disease and related dementias (ADRD). While some studies have shown an association between cytomegalovirus (CMV), a chronic and highly prevalent infection, and cognition and/or ADRD, these studies have been limited by nonrepresentative and small samples. Using 2016 data on 5,617 adults aged 65 years or more from the Health and Retirement Study, we investigated the cross-sectional associations of both CMV serostatus and immunoglobulin G (IgG) antibody response with cognitive function using linear regression models adjusting for age, sex, race/ethnicity, and educational attainment. We further investigated potential effect-measure modification by educational attainment. Overall, both CMV seropositivity and higher IgG antibody response were associated with lower cognitive function, though the relationship was not statistically significant in adjusted models. Among participants with less than a high school diploma, CMV seropositivity and being in the first tertile of IgG response, relative to seronegative persons, were associated with lower scores on the Telephone Interview for Cognitive Status (−0.56 points (95% confidence interval: −1.63, 0.52) and −0.89 points (95% confidence interval: −2.07, 0.29), respectively), and the relationship was attenuated among those with higher education. Our results suggest that CMV may be a risk factor for cognitive impairment, particularly among persons with fewer educational resources.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Alzheimer's disease</subject><subject>Antibody response</subject><subject>Chronic Disease</subject><subject>Chronic infection</subject><subject>Cognition</subject><subject>Cognition & reasoning</subject><subject>Cognitive ability</subject><subject>Cognitive Dysfunction - virology</subject><subject>Confidence intervals</subject><subject>Cross-Sectional Studies</subject><subject>Cytomegalovirus</subject><subject>Cytomegalovirus - immunology</subject><subject>Cytomegalovirus Infections - immunology</subject><subject>Education</subject><subject>Educational attainment</subject><subject>Educational Status</subject><subject>Female</subject><subject>Humans</subject><subject>IgG antibody</subject><subject>Immune response</subject><subject>Immune system</subject><subject>Immunoglobulin G</subject><subject>Immunoglobulin G - immunology</subject><subject>Male</subject><subject>Neurodegenerative diseases</subject><subject>Original Contribution</subject><subject>Prevalence</subject><subject>Regression analysis</subject><subject>Regression models</subject><subject>Retirement</subject><subject>Risk Factors</subject><subject>Statistical analysis</subject><subject>United States - epidemiology</subject><issn>0002-9262</issn><issn>1476-6256</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kcFrFDEUh4Modq2evEtAEKGMTTKZTHIR6qJtoSBUPYe3M293s84ka5Jp2f_e2F2L9dDTg7wvP37JR8hrzj5wZupT2ODpz1sAUesnZMZlqyolGvWUzBhjojJCiSPyIqUNY5ybhj0nR3XNjNSczcjqLKXQOcguePoJ8y2ip5fjOHmk15i2wSekOdD5LocRVzCEGxenRMH3dB5W3t1ddJ7mNdILhCGv73bXmF3EEX2m3_LU716SZ0sYEr46zGPy48vn7_OL6urr-eX87KrqpGS5MmUYtRSwVB0qoXjTC-SsaxdNW3PokC8Yk7xuVb9oWK-14Vq20IMBXY6hPiYf97nbaTFi35UCEQa7jW6EuLMBnH248W5tV-HGamaU1G0JeH8IiOHXhCnb0aUOhwE8hilZIRtZvl1pWdC3_6GbMEVfnmeFlkWBFloX6mRPdTGkFHF5X4Yz-0egLQLtQWCh3_zb_579a6wA7_ZAmLaPJv0GOvml5A</recordid><startdate>20210504</startdate><enddate>20210504</enddate><creator>Stebbins, Rebecca C</creator><creator>Noppert, Grace A</creator><creator>Yang, Yang Claire</creator><creator>Dowd, Jennifer B</creator><creator>Simanek, Amanda</creator><creator>Aiello, Allison E</creator><general>Oxford University Press</general><general>Oxford Publishing Limited (England)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>7T2</scope><scope>7TK</scope><scope>7U7</scope><scope>7U9</scope><scope>C1K</scope><scope>H94</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20210504</creationdate><title>Association Between Immune Response to Cytomegalovirus and Cognition in the Health and Retirement Study</title><author>Stebbins, Rebecca C ; Noppert, Grace A ; Yang, Yang Claire ; Dowd, Jennifer B ; Simanek, Amanda ; Aiello, Allison E</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c440t-9c4496f2af6ce62615d2e10c7b5731ace1b0041376db50d8891847ada9a8413a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Alzheimer's disease</topic><topic>Antibody response</topic><topic>Chronic Disease</topic><topic>Chronic infection</topic><topic>Cognition</topic><topic>Cognition & reasoning</topic><topic>Cognitive ability</topic><topic>Cognitive Dysfunction - virology</topic><topic>Confidence intervals</topic><topic>Cross-Sectional Studies</topic><topic>Cytomegalovirus</topic><topic>Cytomegalovirus - immunology</topic><topic>Cytomegalovirus Infections - immunology</topic><topic>Education</topic><topic>Educational attainment</topic><topic>Educational Status</topic><topic>Female</topic><topic>Humans</topic><topic>IgG antibody</topic><topic>Immune response</topic><topic>Immune system</topic><topic>Immunoglobulin G</topic><topic>Immunoglobulin G - immunology</topic><topic>Male</topic><topic>Neurodegenerative diseases</topic><topic>Original Contribution</topic><topic>Prevalence</topic><topic>Regression analysis</topic><topic>Regression models</topic><topic>Retirement</topic><topic>Risk Factors</topic><topic>Statistical analysis</topic><topic>United States - epidemiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Stebbins, Rebecca C</creatorcontrib><creatorcontrib>Noppert, Grace A</creatorcontrib><creatorcontrib>Yang, Yang Claire</creatorcontrib><creatorcontrib>Dowd, Jennifer B</creatorcontrib><creatorcontrib>Simanek, Amanda</creatorcontrib><creatorcontrib>Aiello, Allison E</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Health and Safety Science Abstracts (Full archive)</collection><collection>Neurosciences Abstracts</collection><collection>Toxicology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>American journal of epidemiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Stebbins, Rebecca C</au><au>Noppert, Grace A</au><au>Yang, Yang Claire</au><au>Dowd, Jennifer B</au><au>Simanek, Amanda</au><au>Aiello, Allison E</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Association Between Immune Response to Cytomegalovirus and Cognition in the Health and Retirement Study</atitle><jtitle>American journal of epidemiology</jtitle><addtitle>Am J Epidemiol</addtitle><date>2021-05-04</date><risdate>2021</risdate><volume>190</volume><issue>5</issue><spage>786</spage><epage>797</epage><pages>786-797</pages><issn>0002-9262</issn><eissn>1476-6256</eissn><abstract>Abstract
Chronic infections and the subsequent immune response have recently been shown to be risk factors for cognitive decline and Alzheimer disease and related dementias (ADRD). While some studies have shown an association between cytomegalovirus (CMV), a chronic and highly prevalent infection, and cognition and/or ADRD, these studies have been limited by nonrepresentative and small samples. Using 2016 data on 5,617 adults aged 65 years or more from the Health and Retirement Study, we investigated the cross-sectional associations of both CMV serostatus and immunoglobulin G (IgG) antibody response with cognitive function using linear regression models adjusting for age, sex, race/ethnicity, and educational attainment. We further investigated potential effect-measure modification by educational attainment. Overall, both CMV seropositivity and higher IgG antibody response were associated with lower cognitive function, though the relationship was not statistically significant in adjusted models. Among participants with less than a high school diploma, CMV seropositivity and being in the first tertile of IgG response, relative to seronegative persons, were associated with lower scores on the Telephone Interview for Cognitive Status (−0.56 points (95% confidence interval: −1.63, 0.52) and −0.89 points (95% confidence interval: −2.07, 0.29), respectively), and the relationship was attenuated among those with higher education. Our results suggest that CMV may be a risk factor for cognitive impairment, particularly among persons with fewer educational resources.</abstract><cop>United States</cop><pub>Oxford University Press</pub><pmid>33094810</pmid><doi>10.1093/aje/kwaa238</doi><tpages>12</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Aged Aged, 80 and over Alzheimer's disease Antibody response Chronic Disease Chronic infection Cognition Cognition & reasoning Cognitive ability Cognitive Dysfunction - virology Confidence intervals Cross-Sectional Studies Cytomegalovirus Cytomegalovirus - immunology Cytomegalovirus Infections - immunology Education Educational attainment Educational Status Female Humans IgG antibody Immune response Immune system Immunoglobulin G Immunoglobulin G - immunology Male Neurodegenerative diseases Original Contribution Prevalence Regression analysis Regression models Retirement Risk Factors Statistical analysis United States - epidemiology |
| title | Association Between Immune Response to Cytomegalovirus and Cognition in the Health and Retirement Study |
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