title: Cytomegalovirus infection and the risk of mortality and frailty in older women: a prospective observational cohort study.
abstract: Cytomegalovirus (CMV), a prevalent pathogen, causes severe disease in immunocompromised humans. However, present understanding is limited regarding the long-term clinical effect of persistent CMV infection in immunocompetent adults. The authors conducted a prospective observational cohort study (1992-2002) of 635 community-dwelling women in Baltimore, Maryland, aged 70-79 years in the Women's Health and Aging Studies to examine the effect of CMV infection on the risk of frailty, a common geriatric syndrome, and mortality in older women. The effect of baseline serum CMV antibody (immunoglobulin G) concentration on the risk of 3-year incident frailty, defined by using a 5-component measure, and 5-year mortality was examined with Cox proportional hazards models. Compared with those who were CMV seronegative, women in the highest quartile of CMV antibody concentration had a greater incidence of frailty (hazard ratio = 3.46, 95% confidence interval: 1.45, 8.27) and mortality (hazard ratio = 3.81, 95% confidence interval: 1.64, 8.83). After adjustment for potential confounders, CMV antibody concentration in the highest quartile independently increased the risk of 5-year mortality (hazard ratio = 2.79, 95% confidence interval: 1.22, 6.40). Better understanding of the long-term clinical consequences of CMV infection in immunocompetent humans is needed to guide public health efforts for this widely prevalent infection.
authors.affiliation: Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland 21224, USA. gwang7@jhmi.edu
authors.forename: George C
authors.initials: GC
authors.lastname: Wang
authors.forename: Wen Hong L
authors.initials: WH
authors.lastname: Kao
authors.forename: Peter
authors.initials: P
authors.lastname: Murakami
authors.forename: Qian-Li
authors.initials: QL
authors.lastname: Xue
authors.forename: Roger B
authors.initials: RB
authors.lastname: Chiou
authors.forename: Barbara
authors.initials: B
authors.lastname: Detrick
authors.forename: John F
authors.initials: JF
authors.lastname: McDyer
authors.forename: Richard D
authors.initials: RD
authors.lastname: Semba
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Casolaro
authors.forename: Jeremy D
authors.initials: JD
authors.lastname: Walston
authors.forename: Linda P
authors.initials: LP
authors.lastname: Fried
mesh_terms: D000367:Age Factors; D000368:Aged; D000914:Antibodies, Viral / Q000097:blood; D015142:Baltimore / Q000453:epidemiology; D015331:Cohort Studies; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D003587:Cytomegalovirus / Q000276:immunology; D003586:Cytomegalovirus Infections / Q000453:epidemiology / Q000276:immunology / Q000401:mortality*; D005260:Female; D016330:Frail Elderly / Q000706:statistics & numerical data*; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D015994:Incidence; D007249:Inflammation / Q000276:immunology / Q000503:physiopathology; D015850:Interleukin-6 / Q000097:blood; D016015:Logistic Models; D015999:Multivariate Analysis; D016017:Odds Ratio; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors
chemical_list: D000914:Antibodies, Viral; D007074:Immunoglobulin G; D015850:Interleukin-6
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