Association of common infections with cognitive performance in the Baltimore Epidemiologic Catchment Area study follow-up

Introduction: Growing evidence suggests that some common infections are causally associated with cognitive impairment; however, less is known about the burden of multiple infections. Methods: We investigated the cross-sectional association of positive antibody tests for herpes simplex virus, cytomegalovirus (CMV), Epstein-Barr virus (EBV), varicella zoster virus (VZV), and Toxoplasma gondii (TOX) with Mini-Mental State Examination (MMSE) and delayed verbal recall performance in 575 adults aged 41–97 from the Baltimore Epidemiologic Catchment Area Study. Results: In multivariable-adjusted zero-inflated Poisson (ZIP) regression models, positive antibody tests for CMV (p =.011) and herpes simplex virus (p =.018) were individually associated with poorer MMSE performance (p =.011). A greater number of positive antibody tests among the five tested was associated with worse MMSE performance (p =.001). Discussion: CMV, herpes simplex virus, and the global burden of multiple common infections were independently associated with poorer cognitive performance. Additional research that investigates whether the global burden of infection predicts cognitive decline and Alzheimer's disease biomarker changes is needed to confirm these findings.