Cytomegalovirus infection and the risk of mortality and frailty in older women: a prospective observational cohort study.
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.
Wang
George C
GC
Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland 21224, USA. gwang7@jhmi.edu
Kao
Wen Hong L
WH
Murakami
Peter
P
Xue
Qian-Li
QL
Chiou
Roger B
RB
Detrick
Barbara
B
McDyer
John F
JF
Semba
Richard D
RD
Casolaro
Vincenzo
V
Walston
Jeremy D
JD
Fried
Linda P
LP
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
D000914:Antibodies, Viral; D007074:Immunoglobulin G; D015850:Interleukin-6
J Am Geriatr Soc. 2006 Jul;54(7):1046-54
16866674
J Gerontol A Biol Sci Med Sci. 2001 Mar;56(3):M158-66
11253157
Arch Intern Med. 2000 Jul 10;160(13):2027-32
10888976
Clin Infect Dis. 2006 Nov 1;43(9):1143-51
17029132
J Infect Dis. 2000 Dec;182(6):1761-4
11069250
Circulation. 2001 Jun 19;103(24):2915-21
11413080
Transplantation. 1996 Sep 15;62(5):653-8
8830832
J Gerontol A Biol Sci Med Sci. 2006 Mar;61(3):262-6
16567375
J Biol Chem. 2001 Nov 2;276(44):40712-20
11522776
Int Immunol. 2001 Jun;13(6):785-90
11369706
J Gerontol A Biol Sci Med Sci. 2001 Mar;56(3):M146-56
11253156
Proc Natl Acad Sci U S A. 1999 Aug 17;96(17):9839-44
10449781
J Gerontol A Biol Sci Med Sci. 2000 Jan;55(1):M43-52
10719772
Proc Natl Acad Sci U S A. 2005 Mar 15;102(11):4140-5
15738399
Exp Gerontol. 2007 Jun;42(6):563-70
17337145
Am J Cardiol. 1998 Apr 1;81(7):866-8
9555776
J Am Geriatr Soc. 2005 May;53(5):747-54
15877548
JAMA. 2009 Jan 28;301(4):380-2
19176439
Med Microbiol Immunol. 2008 Jun;197(2):65-73
18087722
Annu Rev Med. 2000;51:245-70
10774463
J Nutr Health Aging. 2009 May;13(5):468-72
19390755
JAMA. 2008 Jul 23;300(4):413-22
18647984
Lancet. 1987 Aug 8;2(8554):291-3
2886763
J Infect Dis. 1998 Jan;177(1):209-12
9419190
Circulation. 2000 Nov 14;102(20):2491-6
11076822
J Gerontol A Biol Sci Med Sci. 2004 Mar;59(3):255-63
15031310
J Gerontol A Biol Sci Med Sci. 2008 Jun;63(6):610-8
18559636
J Infect Dis. 1989 Jul;160(1):1-10
2543705
J Clin Pathol. 1981 Jan;34(1):76-7
7007445
Trends Microbiol. 2002 Jul;10(7):332-9
12110212
Lancet. 2007 Apr 21;369(9570):1328-1329
17448804
Lancet. 1997 Aug 9;350(9075):430-6
9259669
J Virol. 2006 Dec;80(23):11539-55
16987970
J Am Geriatr Soc. 2005 Aug;53(8):1321-30
16078957