PT  - JOURNAL ARTICLE
AU  - Katan, Mira
AU  - Moon, Yeseon Park
AU  - Paik, Myunghee Cho
AU  - Sacco, Ralph L.
AU  - Wright, Clinton B.
AU  - Elkind, Mitchell S.V.
TI  - Infectious burden and cognitive function
AID  - 10.1212/WNL.0b013e3182896e79
DP  - 2013 Mar 26
TA  - Neurology
PG  - 1209--1215
VI  - 80
IP  - 13
4099  - http://n.neurology.org/content/80/13/1209.short
4100  - http://n.neurology.org/content/80/13/1209.full
SO  - Neurology2013 Mar 26; 80
AB  - Objective: We hypothesized that infectious burden (IB), a composite serologic measure of exposure to common pathogens (i.e., Chlamydia pneumoniae, Helicobacter pylori, cytomegalovirus, and herpes simplex virus 1 and 2) associated with vascular risk in the prospective Northern Manhattan Study (NOMAS), would also be associated with cognition.Methods: Cognition was assessed using the Mini-Mental State Examination (MMSE) at enrollment and the modified Telephone Interview for Cognitive Status (TICS-m) at annual follow-up visits. Adjusted linear and logistic regressions were used to measure the association between IB index and MMSE. Generalized estimating equation models were used to evaluate associations with TICS-m and its change over time.Results: Serologies and cognitive assessments were available in 1,625 participants of the NOMAS cohort. In unadjusted analyses, higher IB index was associated with worse cognition (change per standard deviation [SD] of IB for MMSE was −0.77, p < 0.0001, and for first measurements of TICS-m was −1.89, p < 0.0001). These effects were attenuated after adjusting for risk factors (for MMSE adjusted change per SD of IB = −0.17, p = 0.06, for TICS-m adjusted change per SD IB = −0.68, p < 0.0001). IB was associated with MMSE ≤24 (compared to MMSE >24, adjusted odds ratio 1.26 per SD of IB, 95% confidence interval 1.06–1.51). IB was not associated with cognitive decline over time. The results were similar when IB was limited to viral serologies only.Conclusion: A measure of IB associated with stroke risk and atherosclerosis was independently associated with cognitive performance in this multiethnic cohort. Past infections may contribute to cognitive impairment.AD=Alzheimer disease; CI=confidence interval; CMV=cytomegalovirus; GEE=generalized estimating equation; HSV=herpes simplex virus; IB=infectious burden; IQR=interquartile range; MMSE=Mini-Mental State Examination; NOMAS=Northern Manhattan Study; OR=odds ratio; SES=socioeconomic status; TICS-m=modified Telephone Interview for Cognitive Status; VIB=viral burden index