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.

Keywords: Cognitive impairment; NHANES; cytomegalovirus; herpes simplex virus-1; lifecourse.

Figure 1.

Derivation of study sample from the National Health and Nutrition Examination Survey (NHANES) III, 1988–1994. Abbreviations: CMV, cytomegalovirus; HSV-1, herpes simplex virus-1; NES, Neurobehavioral Evaluation System; sp-MMSE, short portable Mini-Mental State Examination WISC-R, Wechsler Intelligence Scale for Children–Revised; WRAT-R, Wide Range Achievement Test–Revised.