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

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.

Baseline Infection Burden and Cognitive Function in Elders with Essential Tremor

“…The literature also shows that higher seropositivities have been associated with lower mini-mental state examination (MMSE) scores in a cohort of AD adults [ 18 ]. In 2005, Dunn et al established that diagnosis of dementia in an elderly cohort was associated with a history of two or more infections in the four years preceding the diagnosis [ 40 ]. Additional evidence spans the last two decades with multiple publications aiming to identify the role of infectious diseases in cognitive decline [ 18 39 41 ].…”

“…These three microorganisms have been extensively associated with neuropathological changes in the central nervous system that might affect higher cognitive functions [ 36 37 38 ]. Since using an index that combines numerous different infectious agents might mask the effect of certain viruses in the outcome, this analysis was deemed necessary [ 39 40 ]. The predictors were dichotomized as “0” if no history of infection was mentioned or “1” if the participant had had the disease at least once.…”

The Immunopathogenesis of Alzheimer’s Disease Is Related to the Composition of Gut Microbiota

“…Thus, reactivation of herpesviruses might initiate amyloid cascade reactions in elder vulnerable individuals, induce oxidative stress and finally neuroinflammation with the accumulation of Aβ and p-Tau [ 118 ]. Furthermore, CMV, another member of the herpes virus family, was described to promote dementia [ 119 ]. Furthermore, also an interaction between CMV and HIV-1 was described to be associated with a higher risk to develop AD [ 45 , 120 , 121 ].…”

Nanotechnology Frontiers in γ-Herpesviruses Treatments

“…Multiple sclerosis is a chronic autoimmune disease, due to demyelination of neurons resulting in panencephalitis and neuromyelitis optics. The APOE-e4 allele mutation is linked to the onset of inflammatory responses, as a consequence of herpes simplex type-1 (HSV-1) and human cytomegalovirus (hCMV) infections [77][78][79]. Increased levels of oxygen reactive species (ROS) and antioxidants have been detected in several cancer developments and progressions.…”