title: Herpesvirus Infections and Risk of Frailty and Mortality in Older Women: Women's Health and Aging Studies.
abstract: To examine the relationship between herpesvirus infections and mortality and incident frailty risks in community-dwelling older women.
  
  
  
  Nested prospective cohort study.
  
  
  
  Women's Health and Aging Studies I and II.
  
  
  
  Community-dwelling older women aged 70 to 79 (n = 633).
  
  
  
  Baseline serum antibody (immunoglobulin G) levels against four herpesviruses (herpes simplex virus types 1 (HSV-1) and 2 (HSV-2), varicella-zoster virus (VZV), 7 Epstein-Barr virus (EBV)), 3-year incident frailty rates, and 5-year mortality.
  
  
  
  Women seropositive for HSV-1 and HSV-2, but not VZV and EBV, had higher risk of 3-year incident frailty (HSV-1: hazard ratio (HR) = 1.90, 95% confidence interval (CI) = 0.96-3.74; HSV-2: HR = 2.10, 95% CI = 1.05-4.37) and 5-year mortality (HR = 1.73, 95% CI = 0.93-3.20; HR = 1.80, 95% CI = 0.94-3.44, respectively) than seronegative women. Incremental increases in serum HSV-1 and HSV-2 antibody levels were associated with incrementally higher risks of incident frailty and mortality. After adjustment for potential confounders, only higher serum HSV-2 antibody level was independently predictive of higher risk of mortality in older women (for each unit increase in antibody index, HR = 1.47, 95% CI = 1.05-2.07).
  
  
  
  HSV-1 and HSV-2 antibody levels are not independently associated with risk of incident frailty in older women. Only HSV-2 antibody level is independently predictive of 5-year mortality risk, with each incremental increase in the antibody level adding further risk.
authors.affiliation: Division of Geriatric Medicine and Gerontology, Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland.
authors.forename: George C
authors.initials: GC
authors.lastname: Wang
authors.affiliation: Division of Geriatric Medicine and Gerontology, Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland.
authors.forename: Christina
authors.initials: C
authors.lastname: Han
authors.affiliation: Department of Pathology, School of Medicine, Johns Hopkins University, Baltimore, Maryland.
authors.forename: Barbara
authors.initials: B
authors.lastname: Detrick
authors.affiliation: Department of Medicine and Surgery, University of Salerno, Baronissi, Salerno, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Casolaro
authors.affiliation: Division of General Internal Medicine, Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland.
authors.forename: David M
authors.initials: DM
authors.lastname: Levine
authors.affiliation: Department of Epidemiology, Mailman School of Public Health, Columbia University, New York City, New York.
authors.forename: Linda P
authors.initials: LP
authors.lastname: Fried
authors.affiliation: Division of Geriatric Medicine and Gerontology, Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland.
authors.forename: Jeremy D
authors.initials: JD
authors.lastname: Walston
mesh_terms: D000368:Aged; D015142:Baltimore / Q000453:epidemiology; D015415:Biomarkers / Q000097:blood; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D016330:Frail Elderly; D006566:Herpesviridae Infections / Q000097:blood / Q000401:mortality*; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D015994:Incidence; D057187:Independent Living; D015850:Interleukin-6 / Q000097:blood; D011446:Prospective Studies; D012307:Risk Factors
chemical_list: D015415:Biomarkers; D007074:Immunoglobulin G; D015850:Interleukin-6
keywords: cytomegalovirus; frailty; herpes simplex virus; herpesvirus; mortality