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Cited by 35Cytomegalovirus and herpesvirus researchDementia and Cognitive Impairment ResearchViral-associated cancers and disorders

Association between cytomegalovirus end-organ diseases and moderate-to-severe dementia: a population-based cohort study

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Lee, Kyoung Hwa, Kwon, Da Eun, Do Han, Kyung, La, Yeonju, Han, Sang Hoon·2020·BMC Neurology
DOI 10.1186/s12883-020-01776-3PMC PMC7254693

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Abstract

Background: The association between cytomegalovirus (CMV) and dementia remains controversial. Previous studies have suggested that CMV serostatus, as assessed by serum immunoglobulin G, plays a role in neurodegeneration with cognitive impairment. We aimed to evaluate the association between CMV tissue-invasive end-organ diseases and moderate-to-severe dementia. Methods: The ICD 10th revision codes from the National Health Insurance Database covering the entire population of the Republic of Korea were used to classify patients into exposed ( n = 687, age ≥ 40 years, with CMV disease) and unexposed ( n = 3435, without CMV disease) groups, matched by age and sex at a 1:5 ratio of exposed: unexposed. All non-HIV-1-infected subjects selected during 2010–2014 with a washout period of the previous 4 years were followed up until December 2016 to identify newly diagnosed cases of moderate-to-severe dementia. Results: Multivariate regression model (M3) adjusted for age, sex, low income, body mass index, transplantation status, malignant neoplasms, end-stage renal disease on dialysis, type 2 diabetes mellitus, hypertension, and dyslipidaemia showed a significantly higher incidence of dementia (odds ratio: 1.9; 95% confidence interval: 1.2–2.8) in the exposed group than that in the unexposed group. The risk of vascular dementia (2.9, 1.1–7.5) was higher than that of Alzheimer’s disease (1.6, 1.0–2.6) in the exposed group in M3. In M3, patients aged 40–59 years with CMV diseases had a significantly higher risk of all kinds of dementia than those aged 60–79 and ≥ 80 years (11.7, 2.5–49.4 vs. 1.8, 1.1–3.2 vs. 1.3, 0.5–2.8; P = 0.025). Conclusions: CMV diseases may be associated with the risk of moderate-to-severe dementia.

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  • Dementia risk was substantially higher in a middle-aged proband (40-59y) than 60-79y or 80y+ groups.

    “Oddly, dementia risk was substantially higher in a middle-aged proband (40–59y) than 60–79y or 80y+ groups.”

    From What would it take to prove that a chronic infection is a causal agent in Alzheimer’s disease? (2025) · cites this paper as [59]

    The Abstract Results report a larger CMV-associated increase in dementia risk among patients aged 40–59 than among those aged 60–79 or ≥80 (adjusted odds ratios 11.7, 1.8, and 1.3). The claim omits the crucial CMV-disease comparison: the paper does not say that middle-aged people had a higher absolute dementia risk than older people. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

  • In a study of CMV-exposed vs. non-exposed middle-aged to aged adults, CMV-exposed adults were twice as likely to have an all-cause dementia diagnosis.

    “Of note, in a study of CMV-exposed vs. non-exposed middle-aged to aged adults, CMV-exposed adults were twice as likely to have an all-cause dementia diagnosis [59].”

    From What would it take to prove that a chronic infection is a causal agent in Alzheimer’s disease? (2025) · cites this paper as [59]

    The Results section, “Effect of CMV diseases on moderate-to-severe dementia development,” reports approximately twice the incidence rate of all types of dementia in the exposed group (14.8 versus 7.5 per 1,000 person-years). But the Discussion specifies that exposure meant diagnosed tissue-invasive CMV end-organ disease, not CMV exposure generally, and that the study counted only moderate-to-severe dementia, not every dementia diagnosis. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

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Cited by

Sorted by citations

Authors
Lee, K. H., Kwon, D. E., Do Han, K., La, Y., & Han, S. H.
Affiliations
Yonsei University (KR)
Corresponding author
Han, Sang Hoon
ORCID
Venue
BMC Neurology
Publisher
Springer Science and Business Media LLC
Published
2020-05-28
Volume
20
Issue
1
Pages
216-216
ISSN
1471-2377 (ISSN-L)
DOI
10.1186/s12883-020-01776-3
PMC
PMC7254693
OpenAlex
W3028960684
Cited by
35
References
4
Citations by year
2026: 5 · 2025: 4 · 2024: 12 · 2023: 4 · 2022: 4 · 2021: 6
FWCI
2.51
Type
journal article
Language
en
Open access
Licence
Locations
  • BMC Neurology (publishedVersion, cc-by)
  • Research Square (acceptedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • YUHSpace (Yonsei University Medical Library) (submittedVersion, cc-by-nc-nd)
Topics
  • Health Sciences › Medicine › Epidemiology › Cytomegalovirus and herpesvirus research
  • Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
  • Health Sciences › Medicine › Oncology › Viral-associated cancers and disorders
Keywords
cytomegalovirus infection, CMV end-organ disease, dementia, vascular dementia, Alzheimer's disease, neurodegeneration, age-specific risk, dementia incidence
MeSH terms
Adult, Aged, Aged, 80 and over, Cytomegalovirus Infections, Cytomegalovirus, Dementia, Female, Humans, Male, Middle Aged, Research Design, Cohort Studies, Incidence, Republic of Korea

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