{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T11:55:33Z","timestamp":1788782133794,"version":"build-2803163510"},"reference-count":72,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2023,11,6]],"date-time":"2023-11-06T00:00:00Z","timestamp":1699228800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004837","name":"Spanish Ministry of Science and Innovation","doi-asserted-by":"publisher","award":["PID2020-113788RB-I00"],"award-info":[{"award-number":["PID2020-113788RB-I00"]}],"id":[{"id":"10.13039\/501100004837","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100010801","name":"Xunta de Galicia","doi-asserted-by":"publisher","award":["ED431B 2022\/16"],"award-info":[{"award-number":["ED431B 2022\/16"]}],"id":[{"id":"10.13039\/501100010801","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003329","name":"Ministry of Economy and Competitiveness","doi-asserted-by":"publisher","award":["RYC-2015-18394"],"award-info":[{"award-number":["RYC-2015-18394"]}],"id":[{"id":"10.13039\/501100003329","id-type":"DOI","asserted-by":"publisher"}]},{"name":"University of Maryland School of Medicine Center"},{"name":"Clinical Science Research & Development Service","award":["1 I01 CX001310-01"],"award-info":[{"award-number":["1 I01 CX001310-01"]}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["NIA R01 AG018859"],"award-info":[{"award-number":["NIA R01 AG018859"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,3,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Persistent inflammation related to aging (\u201cinflammaging\u201d) is exacerbated by chronic infections and contributes to frailty in older adults. We hypothesized associations between Toxoplasma gondii (T. gondii), a common parasite causing an oligosymptomatic unremitting infection, and frailty, and secondarily between T. gondii and previously reported markers of immune activation in frailty.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We analyzed available demographic, social, and clinical data in Spanish and Portuguese older adults [N = 601; age: mean (SD) 77.3 (8.0); 61% women]. Plasma T. gondii immunoglobulin G (IgG) serointensity was measured with an enzyme-linked immunosorbent assay. The Fried criteria were used to define frailty status. Validated translations of Mini-Mental State Examination, Geriatric Depression Scale, and the Charlson Comorbidity Index were used to evaluate confounders. Previously analyzed biomarkers that were significantly associated with frailty in both prior reports and the current study, and also related to T. gondii serointensity, were further accounted for in multivariable logistic models with frailty as outcome.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>In T. gondii-seropositives, there was a significant positive association between T. gondii IgG serointensity and frailty, accounting for age (p = .0002), and resisting adjustment for multiple successive confounders. Among biomarkers linked with frailty, kynurenine\/tryptophan and soluble tumor necrosis factor receptor II were positively associated with T. gondii serointensity in seropositives (p &amp;lt; .05). Associations with other biomarkers were not significant.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>This first reported association between T. gondii and frailty is limited by a cross-sectional design and warrants replication. While certain biomarkers of inflammaging were associated with both T. gondii IgG serointensity and frailty, they did not fully mediate the T. gondii\u2013frailty association.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/gerona\/glad228","type":"journal-article","created":{"date-parts":[[2023,11,8]],"date-time":"2023-11-08T23:05:18Z","timestamp":1699484718000},"source":"Crossref","is-referenced-by-count":9,"title":["<i>Toxoplasma gondii<\/i> IgG Serointensity Is Positively Associated With Frailty"],"prefix":"10.1093","volume":"79","author":[{"given":"Hira","family":"Mohyuddin","sequence":"first","affiliation":[{"name":"Department of Psychiatry, University of Maryland School of Medicine , Baltimore, Maryland , USA"},{"name":"Psychiatry Residency Training Program, George Washington University , Washington, District of Columbia , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7649-2599","authenticated-orcid":false,"given":"Blanca","family":"Laffon","sequence":"additional","affiliation":[{"name":"Universidade da Coru\u00f1a, Grupo DICOMOSA, CICA\u2014Centro Interdisciplinar de Qu\u00edmica e Biolox\u00eda, Departamento de Psicolog\u00eda, Facultad de Ciencias de la Educaci\u00f3n , Campus Elvi\u00f1a s\/n, A Coru\u00f1a , Spain"},{"name":"Instituto de Investigacio\u0301n Biome\u0301dica de A Corun\u0303a (INIBIC) , Oza, A Corun\u0303a , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jo\u00e3o P","family":"Teixeira","sequence":"additional","affiliation":[{"name":"Environment Health Department, National Institute of Health Dr Ricardo Jorge , Porto , Portugal"},{"name":"EPIUnit - Instituto de Sa\u00fade P\u00fablica da Universidade do Porto , Porto , Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Solange","family":"Costa","sequence":"additional","affiliation":[{"name":"Environment Health Department, National Institute of Health Dr Ricardo Jorge , Porto , Portugal"},{"name":"EPIUnit - Instituto de Sa\u00fade P\u00fablica da Universidade do Porto , Porto , Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Armanda","family":"Teixeira-Gomes","sequence":"additional","affiliation":[{"name":"EPIUnit - Instituto de Sa\u00fade P\u00fablica da Universidade do Porto , Porto , Portugal"},{"name":"School of Medicine and Biomedical Sciences (ICBAS), University of Porto , Porto , Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eduardo","family":"P\u00e1saro","sequence":"additional","affiliation":[{"name":"Universidade da Coru\u00f1a, Grupo DICOMOSA, CICA\u2014Centro Interdisciplinar de Qu\u00edmica e Biolox\u00eda, Departamento de Psicolog\u00eda, Facultad de Ciencias de la Educaci\u00f3n , Campus Elvi\u00f1a s\/n, A Coru\u00f1a , Spain"},{"name":"Instituto de Investigacio\u0301n Biome\u0301dica de A Corun\u0303a (INIBIC) , Oza, A Corun\u0303a , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niel","family":"Constantine","sequence":"additional","affiliation":[{"name":"Institute of Human Virology and Department of Pathology, University of Maryland School of Medicine , Baltimore, Maryland , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aline","family":"Dagdag","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, University of Maryland School of Medicine , Baltimore, Maryland , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heidi K","family":"Ortmeyer","sequence":"additional","affiliation":[{"name":"Baltimore VA Medical Center , Baltimore, Maryland , USA"},{"name":"Department of Medicine, University of Maryland School of Medicine , Baltimore, Maryland , 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USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher A","family":"Lowry","sequence":"additional","affiliation":[{"name":"Department of Integrative Physiology, Department of Psychology and Neuroscience, Center for Neuroscience, and Center for Microbial Exploration, University of Colorado Boulder , Boulder, Colorado , USA"},{"name":"VA Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC) , Aurora, Colorado , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew J","family":"Hoisington","sequence":"additional","affiliation":[{"name":"VA Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC) , Aurora, Colorado , USA"},{"name":"Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus , Aurora, Colorado , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jill A","family":"RachBeisel","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, University of Maryland School of Medicine , Baltimore, Maryland , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5572-1089","authenticated-orcid":false,"given":"Vanessa","family":"Valdiglesias","sequence":"additional","affiliation":[{"name":"Instituto de Investigacio\u0301n Biome\u0301dica de A Corun\u0303a (INIBIC) , Oza, A Corun\u0303a , Spain"},{"name":"Universidade da Coru\u00f1a, Grupo NanoToxGen, CICA\u2014Centro Interdisciplinar de Qu\u00edmica e Biolox\u00eda, Departamento de Biolog\u00eda, Facultad de Ciencias , Campus A Zapateira s\/n, A Coru\u00f1a , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlota","family":"Lema-Arranz","sequence":"additional","affiliation":[{"name":"Universidade da Coru\u00f1a, Grupo DICOMOSA, CICA\u2014Centro Interdisciplinar de Qu\u00edmica e Biolox\u00eda, Departamento de Psicolog\u00eda, Facultad de Ciencias de la Educaci\u00f3n , Campus Elvi\u00f1a s\/n, A Coru\u00f1a , Spain"},{"name":"Instituto de Investigacio\u0301n Biome\u0301dica de A Corun\u0303a (INIBIC) , Oza, A Corun\u0303a , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalia","family":"Fern\u00e1ndez-Bert\u00f3lez","sequence":"additional","affiliation":[{"name":"Instituto de Investigacio\u0301n Biome\u0301dica de A Corun\u0303a (INIBIC) , Oza, A Corun\u0303a , Spain"},{"name":"Universidade da Coru\u00f1a, Grupo NanoToxGen, CICA\u2014Centro Interdisciplinar de Qu\u00edmica e Biolox\u00eda, Departamento de Biolog\u00eda, Facultad de Ciencias , Campus A Zapateira s\/n, A Coru\u00f1a , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6693-539X","authenticated-orcid":false,"given":"Ana","family":"Maseda","sequence":"additional","affiliation":[{"name":"Universidade da Coru\u00f1a, Gerontology and Geriatrics Research Group, Instituto de Investigaci\u00f3n Biom\u00e9dica de A Coru\u00f1a (INIBIC), Complexo Hospitalario Universitario de A Coru\u00f1a (CHUAC), Servizo Galego de Sa\u00fade (SERGAS) , A Coru\u00f1a , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 C","family":"Mill\u00e1n-Calenti","sequence":"additional","affiliation":[{"name":"Universidade da Coru\u00f1a, Gerontology and Geriatrics Research Group, Instituto de Investigaci\u00f3n Biom\u00e9dica de A Coru\u00f1a (INIBIC), Complexo Hospitalario Universitario de A Coru\u00f1a (CHUAC), Servizo Galego de Sa\u00fade (SERGAS) , A Coru\u00f1a , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth J","family":"Kovacs","sequence":"additional","affiliation":[{"name":"VA Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC) , Aurora, Colorado , USA"},{"name":"Department of Surgery, Division of GI, Trauma and Endocrine Surgery, Alcohol Research Program, Burn Research Program, University of Colorado Denver, Anschutz Medical Campus , Aurora, Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johanna M","family":"Gostner","sequence":"additional","affiliation":[{"name":"Institute of Medical Biochemistry, Biocenter, Innsbruck Medical University , Innsbruck , Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1627-9563","authenticated-orcid":false,"given":"Dietmar","family":"Fuchs","sequence":"additional","affiliation":[{"name":"Institute of Biological Chemistry, Biocenter, Innsbruck Medical University , Innsbruck , Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa A","family":"Brenner","sequence":"additional","affiliation":[{"name":"VA Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC) , Aurora, Colorado , USA"},{"name":"Departments of Psychiatry, Physical Medicine and Rehabilitation, and Neurology, University of Colorado Anschutz Medical Campus , Aurora, Colorado , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4870-6515","authenticated-orcid":false,"given":"Laura","family":"Lorenzo-L\u00f3pez","sequence":"additional","affiliation":[{"name":"Universidade da Coru\u00f1a, Gerontology and Geriatrics Research Group, Instituto de Investigaci\u00f3n Biom\u00e9dica de A Coru\u00f1a (INIBIC), Complexo Hospitalario Universitario de A Coru\u00f1a (CHUAC), Servizo Galego de Sa\u00fade (SERGAS) , A Coru\u00f1a , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teodor T","family":"Postolache","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, University of Maryland School of Medicine , Baltimore, Maryland , USA"},{"name":"VA Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC) , Aurora, Colorado , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,11,6]]},"reference":[{"key":"2024020818523715500_CIT0001","first-page":"752","article-title":"Frailty in elderly people","volume-title":"Lancet","author":"Clegg","year":"2013"},{"key":"2024020818523715500_CIT0002","first-page":"1","article-title":"Inflammation and frailty in the elderly: a systematic review and meta-analysis","volume-title":"Ageing Res Rev.","author":"Soysal","year":"2016"},{"key":"2024020818523715500_CIT0003","first-page":"1451","article-title":"Association of inflammatory mediators with frailty status in older adults: results from a systematic review and meta-analysis","volume-title":"Geroscience","author":"Marcos-Perez","year":"2020"},{"key":"2024020818523715500_CIT0004","first-page":"244","article-title":"Inflamm-aging. An evolutionary perspective on immunosenescence","volume-title":"Ann N Y Acad Sci.","author":"Franceschi","year":"2000"},{"key":"2024020818523715500_CIT0005","first-page":"725","article-title":"Does vascular endothelial dysfunction play a role in physical frailty and sarcopenia? A systematic review","volume-title":"Age Ageing.","author":"Amarasekera","year":"2021"},{"key":"2024020818523715500_CIT0006","first-page":"716","article-title":"Association between frailty and quality of life among community-dwelling older people: a systematic review and meta-analysis","volume-title":"J Epidemiol Community Health.","author":"Kojima","year":"2016"},{"key":"2024020818523715500_CIT0007","first-page":"388","article-title":"Frailty predicts mortality in all emergency surgical admissions regardless of age. An observational study","volume-title":"Age Ageing.","author":"Hewitt","year":"2019"},{"key":"2024020818523715500_CIT0008","first-page":"429","article-title":"Frailty and the geriatrician","volume-title":"Age Ageing.","author":"Rockwood","year":"2004"},{"key":"2024020818523715500_CIT0009","first-page":"188","article-title":"Frailty: an emerging public health priority","volume-title":"J Am Med Dir Assoc.","author":"Cesari","year":"2016"},{"key":"2024020818523715500_CIT0010","first-page":"M146","article-title":"Frailty in older adults: evidence for a phenotype","volume-title":"J Gerontol A Biol Sci Med Sci.","author":"Fried","year":"2001"},{"key":"2024020818523715500_CIT0011","first-page":"421","article-title":"Environmental risk factors for Toxoplasma gondii infections and the impact of latent infections on allostatic load in residents of central North Carolina","volume-title":"BMC Infect Dis.","author":"Egorov","year":"2018"},{"key":"2024020818523715500_CIT0012","first-page":"1525","article-title":"Allostatic load and frailty in older adults","volume-title":"J Am Geriatr Soc.","author":"Gruenewald","year":"2009"},{"key":"2024020818523715500_CIT0013","first-page":"519","article-title":"Brains and brawn: Toxoplasma infections of the central nervous system and skeletal muscle","volume-title":"Trends Parasitol.","author":"Wohlfert","year":"2017"},{"key":"2024020818523715500_CIT0014","first-page":"352","article-title":"Regulatory T cells promote myositis and muscle damage in Toxoplasma gondii infection","volume-title":"J Immunol.","author":"Jin","year":"2017"},{"key":"2024020818523715500_CIT0015","first-page":"1019","article-title":"Advances in the life cycle of Toxoplasma gondii","volume-title":"Int J Parasitol.","author":"Dubey","year":"1998"},{"key":"2024020818523715500_CIT0016","first-page":"878","article-title":"Risk factors for Toxoplasma gondii infection in the United States","volume-title":"Clin Infect Dis.","author":"Jones","year":"2009"},{"key":"2024020818523715500_CIT0017","first-page":"108","article-title":"The gut mucosal immune response to Toxoplasma gondii","volume-title":"Parasite Immunol.","author":"Cohen","year":"2015"},{"key":"2024020818523715500_CIT0018","first-page":"1611","article-title":"Induction of dendritic cell migration upon Toxoplasma gondii infection potentiates parasite dissemination","volume-title":"Cell Microbiol.","author":"Lambert","year":"2006"},{"key":"2024020818523715500_CIT0019","first-page":"369","article-title":"Pathophysiological mechanisms of cognitive impairment and neurodegeneration by Toxoplasma gondii infection","volume-title":"Brain Sci.","author":"Ortiz-Guerrero","year":"2020"},{"key":"2024020818523715500_CIT0020","first-page":"3370","article-title":"The molecular biology and immune control of chronic Toxoplasma gondii infection","volume-title":"J Clin 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(Lausanne)","author":"Franceschi","year":"2018"},{"key":"2024020818523715500_CIT0029","first-page":"51","article-title":"CXCL9 and CXCL10 display an age-dependent profile in Chagas patients: a cohort study of aging in Bambui, Brazil","volume-title":"Infect Dis Poverty.","author":"de Araujo","year":"2020"},{"key":"2024020818523715500_CIT0030","first-page":"22139","article-title":"Pathogenic load and frailty in older adults: Singapore longitudinal ageing study","volume-title":"Aging (Albany NY).","author":"Ng","year":"2020"},{"key":"2024020818523715500_CIT0031","first-page":"104024","article-title":"Aging, sex, inflammation, frailty, and CMV and HIV infections","volume-title":"Cell Immunol.","author":"Leng","year":"2020"},{"key":"2024020818523715500_CIT0032","first-page":"747","article-title":"Chronic cytomegalovirus infection and inflammation are associated with prevalent frailty in community-dwelling older women","volume-title":"J Am Geriatr 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.","author":"Xu","year":"2017"},{"key":"2024020818523715500_CIT0037","first-page":"55","article-title":"Effectiveness of influenza vaccine in aging and older adults: comprehensive analysis of the evidence","volume-title":"Clin Interv Aging.","author":"Lang","year":"2012"},{"key":"2024020818523715500_CIT0038","first-page":"1364","article-title":"The effect of ageing of the immune system on vaccination responses","volume-title":"Hum Vaccin Immunother","author":"Lord","year":"2013"},{"key":"2024020818523715500_CIT0039","first-page":"e10576","article-title":"Toxoplasma gondii infection and peripheral-blood gene expression profiling of older people reveals dysregulation of cytokines and identifies hub genes as potential therapeutic targets","volume-title":"Heliyon","author":"Naranjo-Galvis","year":"2022"},{"key":"2024020818523715500_CIT0040","first-page":"1906","article-title":"Role of NF-\u03baB in ageing and age-related diseases: lessons from genetically modified mouse 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