Does Helicobacter pylori Infection Increase Incidence of Dementia? The Personnes Agees QUID Study

作者：Baudron Claire Roubaud; Letenneur Luc; Langlais Anthony; Buissonniere Alice; Megraud Francis; Dartigues Jean Francois; Salles Nathalie

来源：Journal of the American Geriatrics Society, 2013, 61(1): 74-78.

DOI：10.1111/jgs.12065

<jats:sec><jats:title>Objectives</jats:title><jats:p>To determine whether <jats:italic><jats:styled-content style="fixed-case">H</jats:styled-content>elicobacter pylori</jats:italic> infection was associated with dementia and risk of developing dementia in a longitudinal population‐based cohort of elderly adults living in the community.</jats:p></jats:sec><jats:sec><jats:title>Design</jats:title><jats:p>Prospective community‐based cohort study.</jats:p></jats:sec><jats:sec><jats:title>Setting</jats:title><jats:p>The population‐based <jats:styled-content style="fixed-case">P</jats:styled-content>ersonnes <jats:styled-content style="fixed-case">A</jats:styled-content>gées <jats:styled-content style="fixed-case">QUID</jats:styled-content> (<jats:styled-content style="fixed-case">PAQUID</jats:styled-content>) <jats:styled-content style="fixed-case">S</jats:styled-content>tudy.</jats:p></jats:sec><jats:sec><jats:title>Participants</jats:title><jats:p>Six hundred three noninstitutionalized individuals aged 65 and older living in the southwest <jats:styled-content style="fixed-case">of F</jats:styled-content>rance followed from 1989 to 2008.</jats:p></jats:sec><jats:sec><jats:title>Measurements</jats:title><jats:p>A descriptive and comparative analysis including dementia prevalence, according to <jats:italic><jats:styled-content style="fixed-case">H</jats:styled-content>. pylori</jats:italic> status (serology), was made at baseline. Cox proportional hazard models were used to study the risk of developing dementia according to <jats:italic><jats:styled-content style="fixed-case">H</jats:styled-content>. pylori</jats:italic> status assessed on sera samples from elderly adults initially free of dementia and followed for 20 years. A neurologist diagnosed dementia according to <jats:italic><jats:styled-content style="fixed-case">D</jats:styled-content>iagnostic and <jats:styled-content style="fixed-case">S</jats:styled-content>tatistical <jats:styled-content style="fixed-case">M</jats:styled-content>anual of <jats:styled-content style="fixed-case">M</jats:styled-content>ental <jats:styled-content style="fixed-case">D</jats:styled-content>isorders <jats:styled-content style="fixed-case">T</jats:styled-content>hird <jats:styled-content style="fixed-case">E</jats:styled-content>dition</jats:italic> criteria.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>At baseline, 391 (64.8%) subjects (348 women, mean age 73.9 ± 6.5) were seropositive for <jats:italic><jats:styled-content style="fixed-case">H</jats:styled-content>. pylori</jats:italic>. Dementia prevalence was higher in the infected group (5.4% vs 1.4%, <jats:italic>P </jats:italic>=<jats:italic> </jats:italic>.02). After 20 years of follow‐up, 148 incident cases of dementia were diagnosed. After controlling for age, sex, educational level, apolipoprotein <jats:styled-content style="fixed-case">E</jats:styled-content>4 status, cardiovascular risk factors, and <jats:styled-content style="fixed-case">M</jats:styled-content>ini‐<jats:styled-content style="fixed-case">M</jats:styled-content>ental <jats:styled-content style="fixed-case">S</jats:styled-content>tate <jats:styled-content style="fixed-case">E</jats:styled-content>xamination score, <jats:italic><jats:styled-content style="fixed-case">H</jats:styled-content>. pylori</jats:italic> infection was determined to be a risk factor for developing dementia (hazard ratio = 1.46, <jats:italic>P </jats:italic>=<jats:italic> </jats:italic>.04).</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>This longitudinal population‐based study provides additional epidemiological support to the hypothesis of an association between dementia and <jats:italic><jats:styled-content style="fixed-case">H</jats:styled-content>. pylori</jats:italic> infection, which may enhance neurodegeneration.</jats:p></jats:sec>

• 出版日期2013-1