The association of common infectious exposures with cognitive performance in community-dwelling older adults.

INTRODUCTION: The Northern Manhattan Study (NOMAS) previously identified that a combined infectious disease exposure index correlates with impaired cognitive performance in older adults. METHODS: We extended these findings by examining the association of serological titers of five common infectious diseases (herpes simplex virus [HSV] 1 and 2, cytomegalovirus [CMV], Chlamydia pneumoniae, and Helicobacter Pylori) with domain-specific cognitive performance and incident cognitive impairment and dementia in 593 community-dwelling older adults. We performed confounder-adjusted mixed linear regression between infectious serologies and longitudinal cognitive performance. RESULTS: CMV and HSV-2 serologies were associated with impaired executive function, whereas C. pneumoniae serology was associated with impaired performance on language testing. In univariate Cox proportional hazard models, CMV serologies were associated with incident cognitive impairment and dementia. DISCUSSION: CMV seropositivity may accelerate domain-specific cognitive worsening and could confer increased risk for cognitive impairment and dementia, warranting further evaluation in observational and experimental datasets. HIGHLIGHTS: Infectious exposures may contribute to neurodegeneration and risk of cognitive impairment. Cytomegalovirus (CMV) and herpes simplex virus 2 exposure were associated with impaired executive function. Chlamydia pneumoniae was associated with decreased performance on language testing. CMV may be associated with incident cognitive impairment and dementia.