A Population-Based Study of the Association between Trypanosoma cruzi Infection and Cognitive Impairment in Old Age (The Bambuí Study)Lima-Costa M.F.a, b · Castro-Costa E.a–c · Uchôa E.a, b · Firmo J.a, b · Ribeiro A.L.P.b · Ferri C.P.c · Prince M.c
aPublic Health and Ageing Research Group, Oswaldo Cruz Foundation René Rachou Institute, and bFederal University of Minas Gerais Medical School, Belo Horizonte, Brazil; cHealth Service and Population Research Department, Institute of Psychiatry, King’s College London, London, UK
Laboratório de Epidemiologia e Antropologia Médica, Centro de Pesquisas René Rachou da Fundação Oswaldo Cruz, Av. Augusto de Lima, 1715
CEP: 30190-002, Belo Horizonte, MG (Brazil)
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Background: Limited clinical data suggest that chronic Trypanosoma cruzi infection, which causes Chagas’ disease (ChD), is associated with cognitive impairment. This study investigated this association in a large population-based sample of older adults. Methods: Participants in this cross-sectional study comprised 1,449 persons aged ≥60 years from a Brazilian endemic area (Bambuí). Cognitive functioning was ascertained by the Mini-Mental State Examination (MMSE), considering its score in percentiles [≤14 (<5th percentile), 15–22 (5th to <25th) and ≥23]. Hypothesized risk factors were T. cruzi infection, ChD-related electrocardiographic (ECG) abnormalities and use of digoxin medication. Potential confounders included depressive symptoms, smoking, stroke, hemoglobin, HDL cholesterol, blood glucose, systolic blood pressure, and use of psychoactive medication. Results: The prevalence of T. cruzi infection was 37.6%. There was a graded and independent association between infection and the MMSE score (adjusted odds ratios estimated by ordinal logistic regression = 1.99; 95% CI 1.43–2.76). No significant associations between the MMSE score and ECG abnormalities or digoxin medication use were found. Conclusions: This study provides for the first time epidemiological evidence of an association between T. cruzi infection and cognitive impairment which was not mediated by either ChD-related ECG abnormalities or digoxin medication use.
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