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Association between cytomegalovirus end-organ diseases and moderate-to-severe dementia: a population-based cohort

Kyoung Hwa Lee1, Da Eun Kwon1, Kyung Do Han2

  • 1Division of Infectious Disease, Department of Internal Medicine, Yonsei University College of Medicine, 211 Eonju-ro, Gangnam-gu, Seoul, 06273, Republic of Korea.

BMC Neurology
|May 30, 2020
PubMed
Abstract

Insights

Cytomegalovirus (CMV) tissue-invasive diseases are linked to an increased risk of moderate-to-severe dementia. This association was particularly strong in younger adults aged 40-59, highlighting a potential link between CMV infection and cognitive decline.

Area of Science:

  • Neuroscience
  • Infectious Diseases
  • Gerontology

Background:

  • The relationship between cytomegalovirus (CMV) and dementia is debated, with prior research focusing on CMV serostatus.
  • Existing studies suggest a potential role for CMV immunoglobulin G in neurodegeneration and cognitive impairment.
  • This study investigates the link between CMV end-organ diseases and the incidence of moderate-to-severe dementia.

Purpose of the Study:

  • To evaluate the association between cytomegalovirus (CMV) tissue-invasive diseases and the risk of developing moderate-to-severe dementia.
  • To explore the specific types of dementia (vascular dementia and Alzheimer's disease) associated with CMV disease.
  • To examine age-related differences in dementia risk among individuals with CMV diseases.

Main Methods:

  • Utilized the National Health Insurance Database of the Republic of Korea, including ICD 10th revision codes.
  • Classified 687 patients (age ≥ 40) with CMV disease (exposed group) and 3435 without (unexposed group), matched by age and sex (1:5 ratio).
  • Followed non-HIV-1-infected subjects from 2010-2014 until December 2016 to identify new cases of moderate-to-severe dementia.

Main Results:

  • A significantly higher incidence of dementia was observed in the CMV-exposed group (OR: 1.9; 95% CI: 1.2-2.8) after adjusting for multiple covariates.
  • The risk of vascular dementia (OR: 2.9; 95% CI: 1.1-7.5) was notably higher than Alzheimer's disease (OR: 1.6; 95% CI: 1.0-2.6) in the exposed group.
  • Younger adults (40-59 years) with CMV diseases showed a significantly higher risk of all dementia types compared to older age groups (P=0.025).

Conclusions:

  • Cytomegalovirus (CMV) diseases may be associated with an increased risk of moderate-to-severe dementia.
  • The findings suggest a potential causal link between CMV end-organ disease and dementia development.
  • Age appears to be a significant factor, with younger individuals with CMV disease exhibiting a greater dementia risk.
Keywords:
Alzheimer’s diseaseClaims data analysisCytomegalovirusDementiaEnd-organ diseasesSouth KoreaVascular dementia

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