title: Cytomegalovirus infection and risk of Alzheimer disease in older black and white individuals.
abstract: BACKGROUND
  Human cytomegalovirus (CMV) is prevalent in older adults and has been implicated in many chronic diseases of aging. This study investigated the relation between CMV and the risk of Alzheimer disease (AD).
  
  
  METHODS
  Data come from 3 cohort studies that included 849 participants (mean age [±SD], 78.6 ± 7.2 years; mean education duration [±SD], 15.4 ± 3.3 years; 25% black).
  
  
  RESULTS
  A solid-phase enzyme-linked immunosorbent assay was used for detecting type-specific immunoglobulin G antibody responses to CMV and herpes simplex virus type 1 (HSV-1) measured in archived serum samples. Of 849 participants, 73.4% had serologic evidence of exposure to CMV (89.0% black and 68.2% white; P < .001). During an average of 5.0 years of follow-up, 93 persons developed AD. CMV seropositivity was associated with an increased risk of AD (relative risk, 2.15; 95% confidence interval, 1.42-3.27) and a faster rate of decline in global cognition (estimate [±standard error], -0.02 ± 0.01; P = .03) in models that controlled for age, sex, education duration, race, vascular risk factors, vascular diseases, and apolipoprotein ε4 level. Results were similar in black and white individuals for both incident AD and change in cognitive function and were independent of HSV-1 status.
  
  
  CONCLUSIONS
  These results suggest that CMV infection is associated with an increased risk of AD and a faster rate of cognitive decline in older diverse populations.
authors.affiliation: Rush Alzheimer's Disease Center Department of Neurological Sciences Department of Behavioral Sciences, Rush University Medical Center, Chicago, Illinois.
authors.forename: Lisa L
authors.initials: LL
authors.lastname: Barnes
authors.affiliation: Rush Alzheimer's Disease Center Department of Neurological Sciences.
authors.forename: Ana W
authors.initials: AW
authors.lastname: Capuano
authors.affiliation: Department of Epidemiology, University of Michigan, Ann Arbor.
authors.forename: Alison E
authors.initials: AE
authors.lastname: Aiello
authors.affiliation: Rush Alzheimer's Disease Center.
authors.forename: Arlener D
authors.initials: AD
authors.lastname: Turner
authors.affiliation: The Stanley Medical Research Institute, Chevy Chase, Maryland.
authors.forename: Robert H
authors.initials: RH
authors.lastname: Yolken
authors.affiliation: The Stanley Medical Research Institute, Chevy Chase, Maryland.
authors.forename: E Fuller
authors.initials: EF
authors.lastname: Torrey
authors.affiliation: Rush Alzheimer's Disease Center Department of Neurological Sciences.
authors.forename: David A
authors.initials: DA
authors.lastname: Bennett
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000453:epidemiology*; D044383:Black People; D015331:Cohort Studies; D003586:Cytomegalovirus Infections / Q000150:complications*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D015995:Prevalence; D018570:Risk Assessment; D013997:Time Factors; D044465:White People
keywords: Alzheimer's disease; CMV; epidemiology; race
references.citation: J Am Geriatr Soc. 2006 Jul;54(7):1046-54
references.pmid: 16866674
references.citation: J Infect Dis. 2014 Mar;209(6):837-44
references.pmid: 24253286
references.citation: Lancet. 1997 Jan 25;349(9047):241-4
references.pmid: 9014911
references.citation: Ann N Y Acad Sci. 2004 Jun;1019:15-8
references.pmid: 15246985
references.citation: BMC Infect Dis. 2007 Jul 02;7:71
references.pmid: 17605813
references.citation: Clin Infect Dis. 2010 Jun 1;50(11):1439-47
references.pmid: 20426575
references.citation: J Infect Dis. 2013 Aug 15;208(4):564-72
references.pmid: 23661800
references.citation: Herpes. 2005 Oct;12(2):42-5
references.pmid: 16209860
references.citation: Arch Gen Psychiatry. 2003 May;60(5):466-72
references.pmid: 12742867
references.citation: Neurology. 2001 Jan 9;56(1):49-56
references.pmid: 11148235
references.citation: PLoS One. 2014 May 20;9(5):e95510
references.pmid: 24846058
references.citation: J Virol. 2005 Mar;79(6):3675-83
references.pmid: 15731261
references.citation: J Am Geriatr Soc. 2005 May;53(5):747-54
references.pmid: 15877548
references.citation: J Psychiatr Res. 1975 Nov;12(3):189-98
references.pmid: 1202204
references.citation: J Int Neuropsychol Soc. 2005 Jul;11(4):400-7
references.pmid: 16209420
references.citation: Alzheimers Dement. 2009 Jul;5(4):348-60
references.pmid: 19560105
references.citation: Am J Epidemiol. 2010 Aug 15;172(4):363-71
references.pmid: 20660122
references.citation: Neuroepidemiology. 2013;40(3):211-9
references.pmid: 23364031
references.citation: Mech Ageing Dev. 2006 Jun;127(6):538-43
references.pmid: 16513159
references.citation: Am J Transplant. 2009 Nov;9(11):2453-8
references.pmid: 19843027
references.citation: Curr Alzheimer Res. 2012 Jul;9(6):628-45
references.pmid: 22471860
references.citation: PLoS One. 2011 Feb 17;6(2):e16103
references.pmid: 21379581
references.citation: J Am Geriatr Soc. 2011 Dec;59(12):2201-8
references.pmid: 22092044
references.citation: Curr Alzheimer Res. 2012 Jul;9(6):734-45
references.pmid: 22471868
references.citation: Lancet. 2001 Feb 17;357(9255):513-8
references.pmid: 11229670
references.citation: Arch Gen Psychiatry. 2001 Nov;58(11):1032-7
references.pmid: 11695949
references.citation: Neurology. 2005 Dec 27;65(12):1901-6
references.pmid: 16380610
references.citation: Clin Infect Dis. 2006 Nov 1;43(9):1143-51
references.pmid: 17029132
references.citation: Curr Alzheimer Res. 2012 Jul;9(6):646-63
references.pmid: 22471867
references.citation: Biometrics. 1982 Dec;38(4):963-74
references.pmid: 7168798
references.citation: J Int Neuropsychol Soc. 2011 Jul;17(4):587-92
references.pmid: 23131599
references.citation: Neurobiol Aging. 2013 Jul;34(7):1846-52
references.pmid: 23434472
references.citation: Schizophr Res. 2008 Dec;106(2-3):268-74
references.pmid: 18801645
references.citation: Stroke. 2003 Sep;34(9):2126-31
references.pmid: 12920256
references.citation: Intervirology. 1990;31(2-4):223-9
references.pmid: 2165047
references.citation: J Gerontol A Biol Sci Med Sci. 2009 Feb;64(2):272-9
references.pmid: 19196638
references.citation: Neurology. 1984 Jul;34(7):939-44
references.pmid: 6610841
references.citation: J Infect Dis. 2008 Jan 1;197(1):34-41
references.pmid: 18171282
references.citation: Epidemiology. 2009 Nov;20(6):902-8
references.pmid: 19797966
references.citation: Intervirology. 1999;42(5-6):314-21
references.pmid: 10702712
references.citation: Brain Behav Immun. 2008 Oct;22(7):1103-1107
references.pmid: 18571372
references.citation: Curr Opin Immunol. 2012 Aug;24(4):507-11
references.pmid: 22541724
references.citation: Exp Gerontol. 2007 Jun;42(6):563-70
references.pmid: 17337145
references.citation: Epidemiol Infect. 2009 Jan;137(1):58-65
references.pmid: 18413004
references.citation: Am J Cardiol. 1998 Apr 1;81(7):866-8
references.pmid: 9555776
references.citation: Arch Neurol. 2003 Feb;60(2):185-9
references.pmid: 12580702
references.citation: Neurobiol Dis. 2002 Feb;9(1):82-7
references.pmid: 11848687