Abstract
Previous studies suggested that Helicobacter pylori infection could be a risk factor for stroke, dementia, and Alzheimer’s disease (AD). The authors examined data from participants, 60 years old and older in the Third National Health and Nutrition Examination Survey (NHANES-III) to assess the relation between Helicobacter pylori infection and results of the Mini-Mental State Examination (n = 1860) using logistic regression analysis controlling for age, gender, race/ethnicity, education, poverty and history of medically diagnosed diabetes. Moreover, we examined performance on the digit-symbol substitution test (DSST) of 1031 participants in the 1999–2000 NHANES according to their H. pylori infection status controlling for potential confounders using multiple linear regression analyses. In 1988–1991, older adults infected with CagA strains of H. pylori had a 50% borderline statistically significant increased level of cognitive impairment, as measured by low Mini-Mental State Examination (MMSE) scores (age–education adjusted prevalence ratio: 1.5; 95% confidence interval: 1.0, 2.0). In 1999–2000, older US adults infected with H. pylori scored 2.6 fewer points in the DSST than those uninfected (mean adjusted difference: −2.6; 95% confidence interval −5.1, −0.1). The authors concluded that H. pylori infection might be a risk factor for cognitive decline in the elderly. They also found that low cobalamin and elevated homocysteine were associated with cognitive impairment.
Highlights
Helicobacter pylori infection in 1999–2000 occurred among 28% of the United States population [1].H. pylori infection causes gastritis, peptic ulcer disease, non-cardia adenocarcinoma, and lymphoma of the stomach [2], as well as malabsorption of cobalamin due to reduced stomach acidity from H. pylori infection that blocks release of cobalamin from dietary protein; chronic inflammation with bacterial overgrowth increases consumption of cobalamin resulting in low serum levels [3,4]
The purpose of our study was to test the hypothesis that H. pylori infection increases the prevalence of mild deficits in cognitive function using a dichotomous variable in a national sample of U.S adults, using data of the first cycle (1988–1991) of the NHANES III and using measures of cognitive performance in the continuous scale, and the 1999–2000 cycle of the current NHANES
The scores of the sp-Mini-Mental State Examination (MMSE) and digit-symbol substitution test (DSST) were adjusted by age and education, the strongest correlates of both measures, and the prevalence of mild/severe cognitive impairment decreased considerably from crude comparisons by H. pylori infection status, but remained increased and was slightly stronger among those with more education and a more homogenous life experience (U.S.-born non-Hispanic whites)
Summary
Helicobacter pylori infection in 1999–2000 occurred among 28% of the United States population [1].H. pylori infection causes gastritis, peptic ulcer disease, non-cardia adenocarcinoma, and lymphoma of the stomach [2], as well as malabsorption of cobalamin (vitamin B12 ) due to reduced stomach acidity from H. pylori infection that blocks release of cobalamin from dietary protein; chronic inflammation with bacterial overgrowth increases consumption of cobalamin resulting in low serum levels [3,4]. Helicobacter pylori infection in 1999–2000 occurred among 28% of the United States population [1]. Accumulation of homocysteine (Hcy)—an independent vascular risk factor—resulting from decreases of cobalamin and folate is associated with late-onset Alzheimer’s disease (LOAD) [5]. A number of studies have previously raised the possibility that H. pylori could be a risk factor for stroke and coronary artery disease [6,7,8,9,10,11,12,13,14]. H. pylori infection in subjects with cognitive impairment, AD and dementia indicates that there is a weak. Brain Sci. 2019, 9, 370 but statistically significant association between H. pylori infection and dementia Two previous studies included in the review had conflicting results. Beydoun et al [16]
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