title: Persistent viral pathogens and cognitive impairment across the life course in the third national health and nutrition examination survey.
abstract: BACKGROUND
  Herpesviruses have been linked to cognitive impairment in older individuals but little is known about the association in the general US population.
  
  
  METHODS
  We determined whether cytomegalovirus (CMV) and herpes simplex virus 1 (HSV-1) seropositivity were associated with cognitive impairment among children (aged 6-16 years) and adults aged 20-59 or ≥60 years, using data from the National Health and Nutrition Examination Survey (NHANES) III. Linear and logistic regression models were used to examine the associations between pathogen seropositivity and cognitive impairment.
  
  
  RESULTS
  Among children, HSV-1 seropositivity was associated with lower reading and spatial reasoning test scores (β, -0.69; 95% confidence interval [CI], -1.18 to -.21 and β, -0.82; 95% CI, -1.29 to -.36, respectively). Among middle-aged adults, HSV-1 and CMV seropositivity were associated with impaired coding speed (odds ratio [OR], 1.54; 95% CI, 1.13-2.11, and OR, 1.41; 95% CI, 1.09-1.82, respectively). CMV seropositivity was also associated with impaired learning and recall (OR, 1.43; 95% CI, 1.14-1.80). Among older adults, HSV-1 seropositivity was associated with immediate memory impairment (OR, 3.26; 95% CI, 1.68-6.32).
  
  
  CONCLUSIONS
  Future studies examining the biological pathways by which herpesviruses influence cognitive impairment across the life course are warranted.
authors.affiliation: Department of Epidemiology, Center for Social Epidemiology & Population Health, University of Michigan School of Public Health, Ann Arbor, MI.
authors.forename: Kara D
authors.initials: KD
authors.lastname: Tarter
authors.forename: Amanda M
authors.initials: AM
authors.lastname: Simanek
authors.forename: Jennifer B
authors.initials: JB
authors.lastname: Dowd
authors.forename: Allison E
authors.initials: AE
authors.lastname: Aiello
mesh_terms: D000293:Adolescent; D000328:Adult; D000914:Antibodies, Viral / Q000097:blood; D002648:Child; D003072:Cognition Disorders / Q000453:epidemiology / Q000523:psychology* / Q000821:virology*; D003430:Cross-Sectional Studies; D003586:Cytomegalovirus Infections / Q000453:epidemiology / Q000276:immunology / Q000523:psychology* / Q000821:virology*; D005260:Female; D006561:Herpes Simplex / Q000453:epidemiology / Q000276:immunology / Q000523:psychology* / Q000821:virology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009749:Nutrition Surveys; D014481:United States / Q000453:epidemiology; D055815:Young Adult
chemical_list: D000914:Antibodies, Viral
keywords: Cognitive impairment; NHANES; cytomegalovirus; herpes simplex virus-1; lifecourse