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Published on: July 24, 2013
Associations of common infections with frailty and mortality in two UK cohort studies
Demelza Smeeth1, Charlotte Warren-Gash2, Rebecca E Green1
1Unit for Lifelong Health and Ageing at UCL, University College London, London, United Kingdom.
Background:
Some common infections are associated with poorer age-related health outcomes; however, findings are limited to a small number of pathogens and frequently inconclusive. This study aimed to expand the range of pathogens investigated in relation to frailty and mortality in older age.
Methods:
We investigated relationships between seropositivity for 18 viruses, bacteria and protozoa with concurrent frailty and prospective mortality in middle-aged and older adults within two UK population-based cohorts: UK Biobank (N = 9427; aged 40-70 years) and Medical Research Council National Survey of Health and Development (N = 1791; aged 60-65 years). Multiplex serological assays were used to identify seropositivity for each pathogen and frailty was assessed using a frailty index measuring the accumulation of age-related health deficits. Mortality was determined from linked administrative records.
Results:
Adjusting for sex, age, income and education, previous infection with Toxoplasma gondii ((β = 0.77%; 95% CI, 0.42-1.11) and Helicobacter pylori (0.63%; 95% CI, 0.28-0.97) were associated with higher frailty equivalent to 3.8 or 3.1 years of aging, as was inflammation-weighted pathogen burden (0.41%/SD, 95% CI, 0.25-0.57; 0.42%/SD, 95% CI, 0.26-0.58). Previous infection with Chlamydia trachomatis, human herpes simplex virus 1 and cytomegalovirus were associated with increased frailty after adjustment for sex and age, although relationships were confounded by socioeconomic circumstances. No common infections were robustly associated with mortality.
Conclusions:
Our results indicate that infection with H. pylori and T. gondii, and the combined burden of infection may detrimentally impact ageing health. These pathogens may warrant targeting beyond current clinical measures to mitigate the development of frailty.
Insights
Common infections like Helicobacter pylori and Toxoplasma gondii are linked to increased frailty in older adults. Targeting these pathogens may help mitigate age-related health decline and improve healthy aging.
Area of Science:
- Gerontology
- Infectious Diseases
- Epidemiology
Background:
- Common infections are linked to adverse age-related health outcomes, but evidence is often limited and inconclusive.
- Previous research has focused on a narrow range of pathogens, necessitating a broader investigation.
Purpose of the Study:
- To investigate the association between a wide range of pathogens and frailty and mortality in middle-aged and older adults.
- To expand the understanding of how infections impact the aging process and health trajectories.
Main Methods:
- Utilized multiplex serological assays to detect seropositivity for 18 pathogens in two UK population-based cohorts (UK Biobank and MRC NSHD).
- Assessed frailty using a frailty index based on accumulated health deficits and determined mortality through linked administrative records.
- Analyzed associations adjusting for demographic and socioeconomic factors.
Main Results:
- Previous infection with *Toxoplasma gondii* and *Helicobacter pylori* was associated with significantly higher frailty, equivalent to 3.8 and 3.1 years of aging, respectively.
- A higher inflammation-weighted pathogen burden also correlated with increased frailty.
- While some infections showed associations with frailty, these were sometimes confounded by socioeconomic status; no common infections were robustly linked to mortality.
Conclusions:
- Infections with *H. pylori* and *T. gondii*, along with the cumulative burden of infections, appear to negatively affect healthy aging.
- These specific pathogens may represent targets for interventions aimed at reducing frailty development and promoting healthier aging.
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