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Infectious burden and cognitive function: The Northern Manhattan Study
Open accessAbstract
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.
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“In a large multi-ethnic cohort, an elevated infectious burden, defined as a composite serologic measure of exposure to five specific common pathogens (e.g. cytomegalovirus, Helicobacter pylori and herpes simplex virus), was associated with cognitive impairment as assessed by the mini-mental state examination (461, 462).”
From Signalling cognition: The gut microbiota and hypothalamic-pituitary-adrenal axis (2023) · cites this paper as [461]
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Boehme, A. K., Esenwa, C., & Elkind, M. S. V. (2017) · Circulation Research · doi:10.1161/circresaha.116.308398 · Cited by 1,952
Self-citationImmunoneuropsychiatry — novel perspectives on brain disorders
Pape, K., Tamouza, R., Leboyer, M., & Zipp, F. (2019) · Nature Reviews Neurology · doi:10.1038/s41582-019-0174-4 · Cited by 461
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
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Metadata
- Authors
- Katan, M., Moon, Y. P., Paik, M. C., Sacco, R. L., Wright, C. B., & Elkind, M. S. V.
- Affiliations
- From the Department of Neurology (M.K., Y.P.M., M.S.V.E.) and Department of Epidemiology and Gertrude Sergievsky Center (M.S.V.E.), Columbia University College of Physicians and Surgeons, New York; Department of Biostatistics (M.C.P.), Mailman School of Public Health, Columbia University, New York, NY; and Departments of Neurology, Epidemiology & Public Health, and Neuroscience (R.L.S., C.B.W.), and Department of Genetics (R.L.S.), Miller School of Medicine, University of Miami, Miami, FL.
- University of Miami (US)
- Venue
- Neurology
- Published
- 2013-03-26
- Volume
- 80
- Issue
- 13
- Pages
- 1209-1215
- ISSN
- 0028-3878 (ISSN-L)
- 1526-632X
- PMC
- PMC3691781
- OpenAlex
- W2017987395
- Cited by
- 141
- References
- 44
- Citations by year
- 2026: 8 · 2025: 4 · 2024: 10 · 2023: 6 · 2022: 14 · 2021: 16 · 2020: 10 · 2019: 11 · 2018: 4 · 2017: 8 · 2016: 14 · 2015: 15 · 2014: 11 · 2013: 10
- FWCI
- 11.85
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Neurology (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Zurich Open Repository and Archive (University of Zurich) (acceptedVersion, other-oa)
- Zurich Open Repository and Archive (University of Zurich) (submittedVersion, other-oa)
- Zurich Open Repository and Archive (University of Zurich)
- Funders
- National Science Foundation
- American Heart Association
- Bristol-Myers Squibb
- GlaxoSmithKline
- Sanofi
- McKnight Foundation
- Fondation Leducq
- Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung (29993, 130982)
- National Institutes of Health (R37 NS29993)
- National Heart, Lung, and Blood Institute (R01HL108623)
- National Institute of Neurological Disorders and Stroke (R01NS048134, R37NS029993, R01NS48134, R37 NS 29993., K02NS059729)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Life Sciences › Neuroscience › Neurology › Neurological Disease Mechanisms and Treatments
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Risk Factors
- Keywords
- infectious burden, cognitive function, cognitive impairment, Chlamydia pneumoniae, Helicobacter pylori, cytomegalovirus, herpes simplex virus, vascular risk, cognitive decline, stroke risk, atherosclerosis, Northern Manhattan Study
- MeSH terms
- Aged, Cognition, Cognition Disorders, Female, Humans, Infections, Interviews as Topic, Male, Mental Status Schedule, Middle Aged, Neuropsychological Tests, Prospective Studies, Risk Factors, Cohort Studies, Stroke
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