| Summary: | 博士 === 國立臺灣大學 === 流行病學與預防醫學研究所 === 107 === Background/purpose: Helicobacter pylori (H. pylori) infection has been positively associated with cognitive impairment. However, previous studies have shown inconsistent findings. In 2016, one meta-analysis including 7 studies found a significant association between H. pylori infection and dementia with a pooled odds ratio of 1.71 but a recent large cohort study did not confirm these findings.
Material & Methods: This cross-sectional study included 587 elderly participants (age ≥ 65) from the annual elderly health checkup program at National Taiwan University Hospital from 2011 to 2013. H. pylori infection was assessed by a serology test of IgG using a commercial enzyme immunoassay (EIA). Both global and domain-specific cognition were assessed using various neuropsychological tests. Factor analysis, multivariable linear regression and logistic regression models were utilized to assess the association between the serum H. pylori IgG level and cognitive impairment.
Results: Compared with the lowest quartile of H. pylori IgG (Q1), the highest quartile (Q4) was associated with lower performance on verbal fluency-vegetables [(β=-0.24, 95% confidence interval (CI)= -0.45, -0.03; odds ratio (OR) =1.53, 95% confidence interval (CI)= 0.88, 2.66)], attention domain [digit span-forward: β=-0.19, 95% confidence interval (CI) = -0.42, -0.04; odds ratio (OR) =1.83, 95% confidence interval (CI) = 1.03, 3.24], and attention factor (β=-0.20, 95% confidence interval (CI) = -0.37, -0.02; OR= 2.67, 95% CI = 1.51, 4.73). No significant association was observed for global cognition. Stratified analyses revealed that, among men, the highest quartile (Q4) of serum H. pylori IgG was associated with poor performance on verbal fluency-vegetables (β= -0.38, 95% CI=-0.66, -0.09; OR=3.01, 95% CI=1.42, 6.38).
Conclusion: Our findings disclosed a positive association between serum H. pylori level and cognitive impairment of verbal fluency and attention function.
Public health implication
Our study provides important information for the primary prevention of cognitive impairment through the eradication of H. pylori. To assess H. pylori infection, we performed a serology test that is relatively non-invasive, inexpensive and suitable for mass screening and early detection of the high-risk group in the community dwelling elderly.
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