The association between infections and general cognitive ability in young men – a nationwide study
Open accessAbstract
BACKGROUND: Infections and activated immune responses can affect the brain through several pathways that might also affect cognition. However, no large-scale study has previously investigated the effect of infections on the general cognitive ability in the general population. METHODS: Danish nationwide registers were linked to establish a cohort of all 161,696 male conscripts during the years 2006-2012 who were tested for cognitive ability, which was based on logical, verbal, numerical and spatial reasoning at a mean age of 19.4 years. Test scores were converted to a mean of 100.00 and with a standard deviation (SD) of 15. Data were analyzed as a cohort study with severe infections requiring hospitalization as exposure using linear regression. RESULTS: Adjusted effect sizes were calculated with non-exposure to severe infections as reference, ranging from 0.12 SD to 0.63 SD on general cognitive ability. A prior infection was associated with significantly lower cognitive ability by a mean of 1.76 (95%CI: -1.92 to -1.61; corresponding to 0.12 SD). The cognitive ability was affected the most by the temporal proximity of the last infection (P<0.001) and by the severity of infection measured by days of admission (P<0.001). The number of infections were associated with decreased cognitive ability in a dose-response relationship, and highest mean differences were found for ≥10 hospital contacts for infections (Mean: -5.54; 95%CI: -7.20 to -3.89; corresponding to 0.37 SD), and for ≥5 different types of infections (Mean: -9.44; 95%CI: -13.2 to -5.69; corresponding to 0.63 SD). Hospital contacts with infections had occurred in 35% of the individuals prior to conscription. CONCLUSIONS: Independent of a wide range of possible confounders, significant associations between infections and cognitive ability were observed. Infections or related immune responses might directly affect the cognitive ability; however, associated heritable and environmental factors might also account for the lowered cognitive ability.
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Both bacterial and viral infections have been associated with cognitive impairment and functional decline in humans.
“Unsurprisingly, both bacterial and viral infections have been associated with cognitive impairment and functional decline in humans (451–453).”
From Signalling cognition: The gut microbiota and hypothalamic-pituitary-adrenal axis (2023) · cites this paper as [451]
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Mohammed, A. I., Mohammed, A. I., & Reynolds, E. C. (2025) · Journal of Oral Pathology and Medicine · doi:10.1111/jop.70111 · Cited by 2 · see citing works
Gao, Y., Mika Kivimaki, B., Frank, P., Scholes, S., Zaninotto, P., & Steptoe, A. (2026) · Brain Behavior & Immunity - Health · doi:10.1016/j.bbih.2026.101371 · Cited by 1 · see citing works
Malva, J. O., Moreira, R., Martins, B., Novo, J. P., Pereira, F. C., Raposo, R. D. S., Oriá, R. B., & Ribeiro, C. (2021) · Elsevier eBooks · doi:10.1016/b978-0-12-818000-6.00013-5 · Cited by 1 · see citing works
Nicholas, P. (2020) · Queensland University of Technology · doi:10.5204/thesis.eprints.203098
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- Authors
- Benros, M. E., Sørensen, H. J., Nielsen, P. R., Nordentoft, M., Mortensen, P. B., & Petersen, L.
- Affiliations
- University of Copenhagen (DK)
- Aarhus University (DK)
- Corresponding author
- Benros, Michael Eriksen
- ORCID
- Venue
- PLoS ONE
- Publisher
- Public Library of Science (PLoS)
- Published
- 2015-05-13
- Volume
- 10
- Issue
- 5
- Pages
- e0124005
- ISSN
- 1932-6203 (ISSN-L)
- PMC
- PMC4429968
- OpenAlex
- W1488030804
- Cited by
- 50
- References
- 47
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 2 · 2023: 5 · 2022: 1 · 2021: 4 · 2020: 10 · 2019: 12 · 2018: 6 · 2017: 5 · 2016: 2 · 2015: 1
- FWCI
- 1.57
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- PLoS ONE (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Research at the University of Copenhagen (University of Copenhagen) (publishedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Stanley Medical Research Institute
- Lundbeckfonden (R155-2014-1724)
- H. Lundbeck A/S
- FP7 Ideas: European Research Council (294838)
- Topics
- Life Sciences › Neuroscience › Biological Psychiatry › Tryptophan and brain disorders
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Cognitive Abilities and Testing
- Life Sciences › Immunology and Microbiology › Microbiology › Bacterial Infections and Vaccines
- Keywords
- infection, general intelligence, serious infections, hospitalization, immune response, young men, conscripts, cognitive performance, infection severity, dose-response relationship, heritability of intelligence
- MeSH terms
- Adolescent, Bacterial Infections, Brain, Cognition, Cognition Disorders, Denmark, Humans, Intelligence Tests, Male, Military Personnel, Mycoses, Registries, Research Design, Virus Diseases, Cohort Studies, Linear Models, Young Adult
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