A Systematic Review and Meta-Analysis of the Association between Helicobacterpylori Infection and Dementia.

BACKGROUND

A positive association between Helicobacter pylori infection and dementia has been reported, yet findings are inconsistent.

OBJECTIVE

To examine the association between H. pylori infection and dementia.

METHODS

A literature search was performed using the databases OVID-Medline, Institute of Scientific Information Web of Science, and EMBASE. The meta-analysis was conducted using the random effects model. The primary analysis included studies in which the exposure variable was presence of H. pylori infection (yes versus no) and the outcome was incident dementia (yes versus no), which was pre-selected as the end-result of gradual cognitive decline overtime. Publication bias was explored using funnel plot and the Egger regression intercept.

RESULTS

A total of 260 records were identified; 13 addressed cognition and/or dementia in relation to H. pylori infection, of which only seven were included in the meta-analysis. The primary analysis showed a significant positive association between H. pylori infection and dementia; pooled odds ratio 1.71 (95% CI 1.17-2.49) (pv = 0.01). No significant evidence of publication bias was found.

CONCLUSIONS

H. pylori may play a role in the etiology of dementia. Identification of the biological mechanisms of such association is needed, as well as assessment of the impact of H. pylori therapy on the risk and progression of dementia.