{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T14:12:39Z","timestamp":1790172759372,"version":"4.1.0"},"reference-count":31,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"9","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[2003,9]]},"abstract":"<jats:p>\n            <jats:bold>\n              <jats:italic>Background and Purpose\u2014<\/jats:italic>\n            <\/jats:bold>\n            Inflammation and infectious etiology have been implicated in the pathogenesis of dementia. We sought to investigate whether the seropositivity of common infections was associated with cognitive function.\n          <\/jats:p>\n          <jats:p>\n            <jats:bold>\n              <jats:italic>Methods\u2014<\/jats:italic>\n            <\/jats:bold>\n            Viral burden (seropositivity for herpes simplex virus type 1 [HSV-1], herpes simplex virus type 2 [HSV-2], or cytomegalovirus [CMV]) and bacterial burden (\n            <jats:italic>Chlamydia pneumoniae<\/jats:italic>\n            and\n            <jats:italic>Mycoplasma pneumoniae<\/jats:italic>\n            ) were related to cognitive status and its impairment among 383 home-dwelling elderly with cardiovascular diseases (mean age, 80 years). The Mini-Mental State Examination (MMSE) and its changes and the Clinical Dementia Rating (CDR) were used to define cognitive impairment.\n          <\/jats:p>\n          <jats:p>\n            <jats:bold>\n              <jats:italic>Results\u2014<\/jats:italic>\n            <\/jats:bold>\n            At baseline, 0 to 1, 2, and 3 positive titers toward viruses were found in 48 (12.5%), 229 (59.8%), and 106 individuals (27.7%), respectively. MMSE points decreased with increasing viral burden (\n            <jats:italic>P<\/jats:italic>\n            =0.03). At baseline, 58 individuals (15.1%) had cognitive impairment, which after adjustments was significantly associated with seropositivity for 3 viruses (hazard ratio, 2.5; 95% CI, 1.3 to 4.7). MMSE score decreased in 150 (43% of 348) during 12-month follow-up. After adjustment for MMSE score at baseline and with 0 to 1 seropositivities as reference (1.0), the hazard ratios were 1.8 (95% CI, 0.9 to 3.6) and 2.3 (95% CI, 1.1 to 5.0) for 2 and 3 seropositivities, respectively. The prevalence of possible or definite dementia according to CDR also increased with viral burden. No significant associations were observed between bacterial burden and cognition.\n          <\/jats:p>\n          <jats:p>\n            <jats:bold>\n              <jats:italic>Conclusions\u2014<\/jats:italic>\n            <\/jats:bold>\n            Viral pathogen burden of HSV and CMV was associated with cognitive impairment in home-dwelling elderly persons with cardiovascular diseases. The results need to be tested in larger databases, but they may offer a preventable cause of cognitive decline.\n          <\/jats:p>","DOI":"10.1161\/01.str.0000086754.32238.da","type":"journal-article","created":{"date-parts":[[2003,8,19]],"date-time":"2003-08-19T00:46:02Z","timestamp":1061253962000},"page":"2126-2131","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":115,"title":["Impact of Viral and Bacterial Burden on Cognitive Impairment in Elderly Persons With Cardiovascular Diseases"],"prefix":"10.1161","volume":"34","author":[{"given":"Timo E.","family":"Strandberg","sequence":"first","affiliation":[{"name":"From the Department of Medicine, Geriatric Clinic, and Department of Virology, University of Helsinki, Helsinki, Finland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaisu H.","family":"Pitkala","sequence":"additional","affiliation":[{"name":"From the Department of Medicine, Geriatric Clinic, and Department of Virology, University of Helsinki, Helsinki, Finland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kimmo H.","family":"Linnavuori","sequence":"additional","affiliation":[{"name":"From the Department of Medicine, Geriatric Clinic, and Department of Virology, University of Helsinki, Helsinki, Finland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reijo S.","family":"Tilvis","sequence":"additional","affiliation":[{"name":"From the Department of Medicine, Geriatric Clinic, and Department of Virology, University of Helsinki, Helsinki, Finland."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_1_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(02)11667-9"},{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1002\/glia.440070113"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/atvb.20.4.1057"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1038\/nature01325"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.59.6.880"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1002\/jmv.1890330403"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(96)10149-5"},{"key":"e_1_3_2_8_2","first-page":"173","volume":"1","year":"1998","unstructured":"Lin WR, Graham J, MacGowan SM, Wilcock GK, Itzhaki RF. 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