Infections of herpes simplex virus type 1 (HSV-1), cytomegalovirus (CMV), Helicobacter pylori, and Chlamydia pneumoniae may play a role in cognitive decline via systemic inflammation. We hypothesized that Atherosclerosis Risk in Communities study participants who were seropositive in midlife for antibodies to HSV-1, CMV, H pylori, or C pneumoniae would have an accelerated rate of cognitive decline over 20 years. Atherosclerosis Risk in Communities performed a case-cohort study involving a stratified random sample of participants tested for serum immunoglobulin G antibodies to the pathogens of interest. We conducted a longitudinal study using this cohort. Cognitive change was measured using Z scores from the Delayed Word Recall (DWR), Digit Symbol Substitution (DSS), and Word Fluency (WF) Tests administered at visits 2 (1990-1992), 4 (1996-1998), and 5 (2011-2013). Linear regression models with generalized estimating equations and inverse probability of attrition weights were used to evaluate associations between infection and cognitive performance. Four hundred twenty-six participants were analyzed, of which 3% were seronegative for all 4 infections, 14% seropositive for one, 33% and 34% seropositive for 2 and 3, respectively, and 16% seropositive for all infections. At baseline, test scores were significantly lower for participants seropositive for H pylori and C pneumoniae. After baseline covariate adjustment, the rate of decline in DWR, DSS, WF, and global Z scores did not differ significantly by infection status for any of the 4 infections. There was also no significant association between the number of infections for which participants were seropositive and cognitive decline. Our study provides no evidence supporting a longitudinal relationship between seropositivity and cognitive decline.

中文翻译：

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未发现中年感染血清阳性与随后的认知衰退之间存在关联：社区神经认知研究 (ARIC-NCS) 中的动脉粥样硬化风险。

单纯疱疹病毒 1 型 (HSV-1)、巨细胞病毒 (CMV)、幽门螺杆菌和肺炎衣原体感染可能通过全身性炎症导致认知能力下降。我们假设社区动脉粥样硬化风险研究的参与者在中年时对 HSV-1、CMV、幽门螺杆菌或肺炎衣原体抗体呈血清反应阳性，其认知能力在 20 年内会加速下降。社区中的动脉粥样硬化风险进行了一项病例队列研究，涉及参与者的分层随机样本，测试了针对感兴趣的病原体的血清免疫球蛋白 G 抗体。我们使用这个队列进行了纵向研究。使用在访问 2 (1990-1992)、4 (1996-1998)、和 5 (2011-2013)。使用具有广义估计方程和逆损耗概率权重的线性回归模型来评估感染与认知表现之间的关联。对 426 名参与者进行了分析，其中 3% 的所有 4 种感染均为血清反应阴性，14% 的血清反应为 1 次，33% 和 34% 的血清反应为 2 次和 3 次，所有感染的血清反应均为 16%。在基线时，幽门螺杆菌和肺炎衣原体血清反应阳性的参与者的测试分数明显较低。基线协变量调整后，DWR、DSS、WF 和全局 Z 评分的下降率在 4 种感染中的任何一种感染状态下均无显着差异。参与者血清阳性的感染数量与认知能力下降之间也没有显着关联。