Helicobacter pylori, Vascular Risk Factors and Cognition in U.S. Older Adults

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.