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Chronic Cytomegalovirus Infection and Inflammation Are Associated with Prevalent Frailty in Community-Dwelling Older Women

Authors

  • Heidi N. Schmaltz MDCM,

    1. From the *Division of Geriatric Medicine, Department of Medicine, University of Calgary, Calgary, Alberta, CanadaDivision of Geriatric Medicine and Gerontology, Department of Medicine, and Department of Ophthalmology, School of Medicine, and §Center on Aging and Health, Department of Epidemiology, and Department of Health Policy, Bloomberg School of Public Health, the Johns Hopkins University, Baltimore, Maryland.
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  • Linda P. Fried MD, MPH,

    1. From the *Division of Geriatric Medicine, Department of Medicine, University of Calgary, Calgary, Alberta, CanadaDivision of Geriatric Medicine and Gerontology, Department of Medicine, and Department of Ophthalmology, School of Medicine, and §Center on Aging and Health, Department of Epidemiology, and Department of Health Policy, Bloomberg School of Public Health, the Johns Hopkins University, Baltimore, Maryland.
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  • Qian-Li Xue PhD,

    1. From the *Division of Geriatric Medicine, Department of Medicine, University of Calgary, Calgary, Alberta, CanadaDivision of Geriatric Medicine and Gerontology, Department of Medicine, and Department of Ophthalmology, School of Medicine, and §Center on Aging and Health, Department of Epidemiology, and Department of Health Policy, Bloomberg School of Public Health, the Johns Hopkins University, Baltimore, Maryland.
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  • Jeremy Walston MD,

    1. From the *Division of Geriatric Medicine, Department of Medicine, University of Calgary, Calgary, Alberta, CanadaDivision of Geriatric Medicine and Gerontology, Department of Medicine, and Department of Ophthalmology, School of Medicine, and §Center on Aging and Health, Department of Epidemiology, and Department of Health Policy, Bloomberg School of Public Health, the Johns Hopkins University, Baltimore, Maryland.
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  • Sean X. Leng MD, PhD,

    1. From the *Division of Geriatric Medicine, Department of Medicine, University of Calgary, Calgary, Alberta, CanadaDivision of Geriatric Medicine and Gerontology, Department of Medicine, and Department of Ophthalmology, School of Medicine, and §Center on Aging and Health, Department of Epidemiology, and Department of Health Policy, Bloomberg School of Public Health, the Johns Hopkins University, Baltimore, Maryland.
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  • Richard D. Semba MD, MPH

    1. From the *Division of Geriatric Medicine, Department of Medicine, University of Calgary, Calgary, Alberta, CanadaDivision of Geriatric Medicine and Gerontology, Department of Medicine, and Department of Ophthalmology, School of Medicine, and §Center on Aging and Health, Department of Epidemiology, and Department of Health Policy, Bloomberg School of Public Health, the Johns Hopkins University, Baltimore, Maryland.
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  • Funded by National Institute on Aging (NIA) Grants RO1 AG11703 and R37 AG019905; National Institutes of Health, National Center for Research Resources, Outpatient Department—General Clinical Research Center Grants RR00722, RO1 A141956; and NIA Contract NO1-AG12112.

Address correspondence to Dr. Heidi Schmaltz, Seniors' Health—Peter Lougheed Center, Sunridge Landing 3500 26 Ave NE, Calgary, AB T1Y-6J4 Canada. E-mail: heidi.schmaltz@calgaryhealthregion.ca

Abstract

Objectives: To evaluate the association between asymptomatic chronic cytomegalovirus (CMV) infection and the frailty syndrome and to assess whether inflammation modifies this association.

Design: Cross-sectional analysis.

Setting: Women's Health and Aging Study I & II, Baltimore, Maryland.

Participants: Seven hundred twenty-four community-dwelling women aged 70 to 79 with baseline measures of CMV, interleukin-6 (IL-6), and frailty status.

Measurements: CMV serology and IL-6 concentrations were measured using enzyme-linked immunosorbent assay. Frailty status was based on previously validated criteria: unintentional weight loss, weak grip strength, exhaustion, slow walking speed, and low level of activity. Frail women had three or more of the five components, prefrail women had one or two components, and women who were not frail had none of the components. Multinomial logistic regression adjusted for potential confounders.

Results: Eighty-seven percent of women were CMV seropositive, an indication of chronic infection. CMV was associated with prevalent frailty, adjusting for age, smoking history, elevated body mass index, diabetes mellitus, and congestive heart failure (CMV frail adjusted odds ratio (AOR)=3.2, P=.03; CMV prefrail AOR=1.5, P=.18). IL-6 interacted with CMV, significantly increasing the magnitude of this association (CMV positive and low IL-6 frail AOR=1.5, P=.53; CMV positive and high IL-6 frail AOR=20.3, P=.007; CMV positive and low IL-6 prefrail AOR=0.9, P=.73; CMV positive and high IL-6 prefrail AOR=5.5, P=.001).

Conclusion: Chronic CMV infection is associated with prevalent frailty, a state with increased morbidity and mortality in older adults; inflammation enhances this effect. Further prospective studies are needed to establish a causal relationship between CMV, inflammation, and frailty.

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