Chronic Cytomegalovirus Infection and Inflammation Are Associated with Prevalent Frailty in Community‐Dwelling Older Women

Abstract

See editorial comments by Dr. Kevin P. High on pp 906-908) OBJECTIVES: To evaluate the association between asymptomatic chronic cytomegalovirus (CMV) infection and the frailty syndrome and to assess whether inflammation modifies this association. DESIGN: Cross-sectional analysis. SETTING: Women's Health and Aging Study I & II, Baltimore, Maryland. PARTICIPANTS: Seven hundred twenty-four communitydwelling women aged 70 to 79 with baseline measures of CMV, interleukin-6 (IL-6), and frailty status. MEASUREMENTS: CMV serology and IL-6 concentrations were measured using enzyme-linked immunosorbent assay. Frailty status was based on previously validated criteria: unintentional weight loss, weak grip strength, exhaustion, slow walking speed, and low level of activity. Frail women had three or more of the five components, prefrail women had one or two components, and women who were not frail had none of the components. Multinomial logistic regression adjusted for potential confounders. RESULTS: Eighty-seven percent of women were CMV seropositive, an indication of chronic infection. CMV was associated with prevalent frailty, adjusting for age, smoking history, elevated body mass index, diabetes mellitus, and congestive heart failure (CMV frail adjusted odds ratio (AOR) 5 3.2, P 5.03; CMV prefrail AOR 5 1.5, P 5.18). IL-6 interacted with CMV, significantly increasing the magnitude of this association (CMV positive and low IL-6 frail AOR 5 1.5, P 5.53; CMV positive and high IL-6 frail AOR 5 20.3, P 5.007; CMV positive and low IL-6 prefrail AOR 5 0.9, P 5.73; CMV positive and high IL-6 prefrail AOR 5 5.5, P 5.001). CONCLUSION: Chronic CMV infection is associated with prevalent frailty, a state with increased morbidity and mortality in older adults; inflammation enhances this effect. Further prospective studies are needed to establish a causal relationship between CMV, inflammation, and frailty. J Am Geriatr Soc 53: 747-754, 2005.

Seroprevalence of cytomegalovirus among some voluntary blood donors at the 37 military Hospital, Accra, Ghana

“…Additionally, recent studies have associated chronic CMV infection with prevalent frailty, a state with increased morbidity and mortality in older adults 24,25 . Ghana must introduce the provision of CMV seronegative blood product support to the above stated vulnerable individuals as soon as possible, since this has been the standard of care since the late 1980s in most developed countries after studies showed this strategy significantly reduced the rate of TT-CMV [26][27][28] .…”

Massive Load of Functional Effector CD4+ and CD8+ T Cells against Cytomegalovirus in Very Old Subjects

“…CMV is a candidate causative agent for this activation as it chronically infects people lifelong, from newborns to centenarians. Chronic CMV infection is also associated with prevalent frailty, a state with increased morbidity and mortality in older adults (25). Accordingly, we have evaluated functional T cell responses to peptides spanning two CMV immunogenic proteins, pp65 and IE-1, in 65 chronically infected subjects aged 25-100 years.…”

Fatigue in older adults: an early indicator of the aging process?

“…An evolving definition of inflammation in gerontology is low-grade activation of the innate immune system, leading to chronic production of inflammatory mediators. Inflammatory processes in general have been implicated as predictors of or contributors to chronic diseases and conditions of aging (117), such as cardiovascular disease (118), low cognitive performance (119), osteoarthritis and dementia (120), frailty (121,122), muscle wasting (123), physical performance (123,124), disability (125,126) and mortality (127)(128)(129). These associations have been…”