Investigating pathogen burden in relation to a cumulative deficits index in a representative sample of US adults
Open accessAbstract
Pathogen burden is a construct developed to assess the cumulative effects of multiple, persistent pathogens on morbidity and mortality. Despite the likely biological wear and tear on multiple body systems caused by persistent infections, few studies have examined the impact of total pathogen burden on such outcomes and specifically on preclinical markers of dysfunction. Using data from two waves of the National Health and Nutrition Examination Survey, we compared three alternative methods for measuring pathogen burden, composed of mainly persistent viral infections, using a cumulative deficits index (CDI) as an outcome: single pathogen associations, a pathogen burden summary score and latent class analyses. We found significant heterogeneity in the distribution of the CDI by age, sex, race/ethnicity and education. There was an association between pathogen burden and the CDI by all three metrics. The latent class classification of pathogen burden showed particularly strong associations with the CDI; these associations remained after controlling for age, sex, body mass index, smoking, race/ethnicity and education. Our results suggest that pathogen burden may influence early clinical indicators of poor health as measured by the CDI. Our results are salient since we were able to detect these associations in a relatively young population. These findings suggest that reducing pathogen burden and the specific pathogens that drive the CDI may provide a target for preventing the early development of age-related physiological changes.
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The cumulative effect of exposure to multiple infectious pathogens, both bacterial and viral, over several years is associated with changes in cognition, as well as multi-system biological dysfunction before clinical disease is apparent.
“Evidence suggests that the cumulative effect of exposure to multiple infectious pathogens, both bacterial and viral, over several years is associated with changes in cognition, as well as multi-system biological dysfunction before clinical disease is apparent (459, 460).”
From Signalling cognition: The gut microbiota and hypothalamic-pituitary-adrenal axis (2023) · cites this paper as [460]
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Research works printed but not linked: 3
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- [35]Zajacova A Dowd J Aiello A Socioeconomic and race/ethnic patterns in persistent infection burden among US adults The Journals of Gerontology Series A: Biomedical Sciences and Medical Sciences 2009 64 272 279 PMC2655034 19196638
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Signalling cognition: The gut microbiota and hypothalamic-pituitary-adrenal axis
Rusch, J. A., Layden, B. T., & Dugas, L. R. (2023) · Frontiers in Endocrinology · doi:10.3389/fendo.2023.1130689 · Cited by 415 · see citing works
- Authors
- Noppert, G. A., Aiello, A. E., O'Rand, A. M., & Cohen, H. J.
- Affiliations
- University of North Carolina at Chapel Hill (US)
- Duke University (US)
- Corresponding author
- Noppert, G. A.
- Venue
- Epidemiology and Infection
- Publisher
- Cambridge University Press (CUP)
- Published
- 2018-06-14
- Volume
- 146
- Issue
- 15
- Pages
- 1968-1976
- ISSN
- 0950-2688 (ISSN-L)
- 1469-4409
- PMC
- PMC6175667
- OpenAlex
- W2808484613
- Cited by
- 11
- References
- 38
- Citations by year
- 2026: 4 · 2023: 1 · 2022: 2 · 2021: 1 · 2020: 2 · 2019: 1
- FWCI
- 0.78
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Epidemiology and Infection (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Carolina Digital Repository (University of North Carolina at Chapel Hill) (submittedVersion)
- UNC Libraries
- Funders
- National Institutes of Health (#HD050924, DK087864, AG040115, AG028716)
- National Institute on Aging (AG000029, R01AG040115, AG000029-41, AG028716, R00AG062749, T32AG000029, P30AG028716)
- National Institute of Diabetes and Digestive and Kidney Diseases (R01DK087864)
- National Institute of Child Health and Human Development (T32-AG000029)
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (P2CHD050924, T32HD091058)
- Topics
- Health Sciences › Medicine › Epidemiology › Chronic Disease Management Strategies
- Social Sciences › Health › Health disparities and outcomes
- Health Sciences › Medicine › Emergency Medicine › HIV-related health complications and treatments
- Keywords
- pathogen burden, viral persistence, latent class analysis, age-related physiological decline, chronic infection, health disparities, NHANES
- MeSH terms
- Adult, Bacteria, Bacterial Infections, Chronic Disease, Female, Humans, Male, Middle Aged, United States, Virus Diseases, Viruses, Prevalence, Young Adult
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