%0 Journal Article %J American Journal of Epidemiology %D 2021 %T Association Between Immune Response to Cytomegalovirus and Cognition in the Health and Retirement Study. %A Rebecca C Stebbins %A Grace A Noppert %A Yang Claire Yang %A Jennifer B Dowd %A Simanek, Amanda %A Allison E Aiello %K Alzheimer's disease %K Cognitive decline %K Cytomegalovirus %K Dementia %K Educational attainment %K immune function %X

Chronic infections and the subsequent immune response have recently been shown to be risk factors for cognitive decline and Alzheimer disease and related dementias (ADRD). While some studies have shown an association between cytomegalovirus (CMV), a chronic and highly prevalent infection, and cognition and/or ADRD, these studies have been limited by nonrepresentative and small samples. Using 2016 data on 5,617 adults aged 65 years or more from the Health and Retirement Study, we investigated the cross-sectional associations of both CMV serostatus and immunoglobulin G (IgG) antibody response with cognitive function using linear regression models adjusting 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 antibody response were associated with lower cognitive function, though the relationship was not statistically significant in adjusted models. Among participants with less than a high school diploma, CMV seropositivity and being in the first tertile of IgG response, relative to seronegative persons, were associated with lower scores on the Telephone Interview for Cognitive Status (-0.56 points (95% confidence interval: -1.63, 0.52) and -0.89 points (95% confidence interval: -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 persons with fewer educational resources.

%B American Journal of Epidemiology %V 190 %P 786-797 %G eng %N 5 %R 10.1093/aje/kwaa238 %0 Journal Article %J The Journals of Gerontology: Series B %D 2021 %T Life Course Socioeconomic Disadvantage and the Aging Immune System: Findings from the Health and Retirement Study %A Grace A Noppert %A Rebecca C Stebbins %A Jennifer B Dowd %A Robert A Hummer %A Allison E Aiello %K immune aging %K life course studies %K persistent infections %K socioeconomic disadvantage %X Previous research has documented a consistent association between current socioeconomic status (SES) and cytomegalovirus (CMV). Early life is likely a critical period for CMV exposure and immune development, but less is known about early life socioeconomic factors and CMV, particularly in older age populations. Using data from the Health and Retirement Study, we investigated the association between life course socioeconomic disadvantage and immune response to CMV among older adults.Using ordered logit models, we estimated associations between several measures of socioeconomic disadvantage and the odds of being in a higher CMV Immunoglobulin G (IgG) response category in a sample of 8,168 respondents aged 50+ years.We found a significant association between educational attainment and CMV IgG response. Those with less than a high school education had 2.00 (95% CI: 1.67, 2.40) times the odds of being in a higher CMV category compared to those with a college degree or greater. In addition, we also observed a significant association with parental education and CMV response. Individuals with parents having 8 years or less of schooling had 2.32 (95% CI: 2.00, 2.70) times the odds of higher CMV response compared to those whose parents had greater than a high school education.CMV IgG levels in older adults are associated with both early life and adult SES. Life course socioeconomic disadvantage may contribute to disparities in immunological aging. %B The Journals of Gerontology: Series B %V 76 %P 1195-1205 %@ 1079-5014 %G eng %N 6 %R https://doi.org/10.1093/geronb/gbaa144 %0 Journal Article %J Immun Ageing %D 2011 %T Cytomegalovirus antibodies in dried blood spots: a minimally invasive method for assessing stress, immune function, and aging. %A Jennifer B Dowd %A Allison E Aiello %A Laura Chyu %A Yuan-Yen Huang %A Thomas W McDade %X

BACKGROUND: Cytomegalovirus (CMV) is a prevalent herpesvirus with links to both stress and aging. This paper describes and validates a minimally invasive method for assessing antibodies against CMV in finger stick whole blood spot samples for use as an indirect marker of an aspect of cell-mediated immunity.

RESULTS: Analysis of CMV in dried blood spot samples (DBS) was based on modifications of a commercially available protocol for quantifying CMV antibodies in serum or plasma. The method was evaluated through analysis of precision, reliability, linearity, and correlation between matched serum and DBS samples collected from 75 volunteers. Correlation between DBS and plasma values was linear and high (Pearson correlation R = .96), and precision, reliability, and linearity of the DBS assay were within acceptable ranges.

CONCLUSIONS: The validity of a DBS assay for CMV antibodies will enable its inclusion in population-based surveys and other studies collecting DBS samples in non-clinical settings, increasing scientific understanding of the interaction of social and biological stress and immune function.

%B Immun Ageing %I 8 %V 8 %P 3 %8 2011 Jan 13 %G eng %N 1 %1 http://www.ncbi.nlm.nih.gov/pubmed/21232134?dopt=Abstract %2 PMC3031243 %4 Biomarker data %$ 62800 %R 10.1186/1742-4933-8-3 %0 Journal Article %J Epidemiology %D 2009 %T Socioeconomic differentials in immune response. %A Jennifer B Dowd %A Allison E Aiello %K Adult %K Aged %K Cytomegalovirus %K Cytomegalovirus Infections %K Female %K Health Status Disparities %K Humans %K Male %K Middle Aged %K Nutrition Surveys %K Regression Analysis %K Social Class %K United States %X

BACKGROUND: Lower socioeconomic status (SES) is strongly linked to health outcomes, though the mechanisms are poorly understood. Little is known about the role of the immune system in creating and sustaining health disparities. Here we test whether SES is related to cell-mediated immunity, as measured by the host's ability to keep persistent cytomegalovirus (CMV) antibody levels in a quiescent state.

METHODS: Censored regression models were used to test the cross-sectional relationship of education, income, and race/ethnicity with antibody response to CMV, using a nationally representative sample of 9721 respondents aged 25 years and older in the Third National Health and Nutrition Examination Survey (NHANES III, 1988-1994).

RESULTS: Among CMV-seropositive respondents, those with less education, lower income, and nonwhite race/ethnicity had higher levels of CMV antibodies at all ages. On average, each additional year of age was associated with CMV antibody levels that were 0.03 units higher (95% confidence interval = 0.03 to 0.04), whereas each additional year of education was associated with antibody levels that were 0.05 units lower (0.02 to 0.09). A doubling of family income was associated with antibody levels that were 0.25 units lower (0.11 to 0.39), the equivalent of 8 fewer years of age-related CMV antibody response. These relationships remained strong after controlling for baseline health conditions, smoking status, and BMI.

CONCLUSIONS: SES is associated with an indirect marker of cell-mediated immunity in a nationally representative sample. SES differences in immune control over CMV may have fundamental implications for health disparities over the life course.

%B Epidemiology %I 20 %V 20 %P 902-8 %8 2009 Nov %G eng %N 6 %1 http://www.ncbi.nlm.nih.gov/pubmed/19797966?dopt=Abstract %2 PMC2765221 %4 Socioeconomic Differences/immune response %$ 62790 %R 10.1097/EDE.0b013e3181bb5302