Cumulative Infectious Disease Burden's Associations with Stroke and Mood Disorders in NHANES III Open Access

Bratcher, Anna Marie (2016)

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Neuropsychiatric conditions such as stroke and mood disorders affect millions of Americans each year. The etiology of these conditions is complex, with the body of knowledge on their causes constantly growing. Given evidence of chronic infection affecting the central nervous system, we hypothesized that higher cumulative infectious disease burdens could lead to more neuropsychiatric conditions, including stroke and mood disorders. In this thesis, cumulative infectious disease burden was measured as cumulative seroprevelance to hepatitis A, hepatitis B, cytomegalovirus, Toxoplasma gondii and Toxocara spp.. Using the third national health and nutrition examination survey (NHANES III) data, logistic regressions of history of stroke, major depression, severe major depression, dysthymia, dysthymia with major depression, bipolar disorder and atypical bipolar disorder were done to assess associations with cumulative infectious disease burden. Stroke showed a significant relationship with an odds ratio of 1.37(CI: 1.09, 1.73), with evidence of interaction with age. Among 20 to 59 year olds, the odds ratio was 1.96 (CI: 1.24, 3.11). In comparison, the older age groups, 60 to 69 year olds and above 70 year olds, failed to show significant relationships (OR=1.06 CI: 0.69, 1.62; OR=1.12 CI:0.84,1.51 respectively). There were no significant relationships found between cumulative infectious disease burden and any of the mood disorder outcomes (P-Value>0.05 in all cases). These findings suggest that cumulative infectious disease burden my lead to a higher risk of stroke, particularly in younger ages, but not mood disorders.

Table of Contents

Introduction 1

Background 4

Research Objective 17

Methods 18

Analysis 22

Results 30

Discussion 36

References 43

Tables and Figures 46

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