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Immune Response to Cytomegalovirus and Cognition in the Health and Retirement Study


Stebbins, Rebecca C.; Noppert, Grace A.; Yang, Yang Claire; Dowd, Jennifer Beam; Simanek, Amanda M.; & Aiello, Allison E. (2021). Immune Response to Cytomegalovirus and Cognition in the Health and Retirement Study. American Journal of Epidemiology, 190(5), 786-797. PMCID: PMC8096487


Chronic infections and the subsequent immune response have recently been shown to be risk factors for cognitive decline and Alzheimer's Disease and related disorders (ADRD). While some studies have shown an association between cytomegalovirus (CMV), a chronic and highly prevalent infection, and cognition and/or ADRD, these are limited by non-representative and small samples. Using data from 5,617 adults aged 65 years and older from the 2016 Health and Retirement Study, we investigated the cross-sectional association between both CMV serostatus and IgG antibody response and cognitive function using linear regression models adjusted for age, sex, race/ethnicity, and educational attainment. We further investigated potential effect measure modification by educational attainment. Overall, both CMV seropositivity and higher IgG were associated with lower cognitive function, though the relationship was not statistically significant in adjusted models. Among those with less than a high school diploma, CMV seropositivity and being in the first tertile of IgG response relative to seronegatives were associated with lower TICS score (-0.56 (95%CI: -1.63, 0.52) and -0.89 (95%CI: -2.07, 0.29), respectively), and the relationship was attenuated among those with higher education. Our results suggest that CMV may be a risk factor for cognitive impairment, particularly among those with low educational resources.


Reference Type

Journal Article

Article Type


Year Published


Journal Title

American Journal of Epidemiology


Stebbins, Rebecca C.
Noppert, Grace A.
Yang, Yang Claire
Dowd, Jennifer Beam
Simanek, Amanda M.
Aiello, Allison E.



Data Set/Study

Health and Retirement Study (HRS)


United States of America