Journal
NEUROLOGY
Volume 80, Issue 13, Pages 1209-1215Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1212/WNL.0b013e3182896e79
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Funding
- NIH/NINDS [R37 NS 29993, R01 NS 48134]
- Swiss National Science Foundation [PBZHP3-130982]
- Fondation Leducq
- BRAHMS/Thermo Fisher Scientific
- NINDS for the Northern Manhattan Study [R37 NS 29993]
- Evelyn McKnight Brain Institute
- NIH [K02 NS 059729, R01 HL 108623]
- American Heart Association [SDG 0735387N]
- UpToDate
- dia-Dexus, Inc.
- Bristol-Myers Squibb/Sanofi Pharmaceuticals Partnership
- NIH/NINDS
- American Academy of Neurology
- Swiss National Science Foundation (SNF) [PBZHP3-130982] Funding Source: Swiss National Science Foundation (SNF)
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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 toMMSE >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. Neurology (R) 2013;80:1209-1215
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