Wang Jian, Yu Neng-Wei, Wang Duo-Zi, Guo Lei, Yang Shu, Zheng Bo, Guo Fu-Qiang, Wang Jian-Hong
Department of Neurology, Ya'an People's Hospital, Ya'an, Sichuan, China.
Department of Neurology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Sichuan Provincial People's Hospital, Chengdu, Sichuan, China.
J Alzheimers Dis. 2023;91(4):1351-1358. doi: 10.3233/JAD-221112.
Previous cross-sectional studies have identified a possible link between Helicobacter pylori (H. pylori) infection and dementia. However, the association of H. pylori infection with longitudinal cognitive decline has rarely been investigated.
This cohort study aims to demonstrate the effects of H. pylori infection on longitudinal cognitive decline.
This cohort study recruited 268 subjects with memory complaints. Among these subjects, 72 had a history of H. pylori infection, and the rest 196 subjects had no H. pylori infection. These subjects were followed up for 24 months and received cognitive assessment in fixed intervals of 12 months.
At baseline, H. pylori infected, and uninfected participants had no difference in MMSE scores. At 2 years of follow-up, H. pylori infected participants had lower MMSE scores than uninfected participants. H. pylori infection was associated with an increased risk of longitudinal cognitive decline, as defined by a decrease of MMSE of 3 points or more during follow-up, adjusting for age, sex, education, APOEɛ4 genotype, hypertension, diabetes, hyperlipidemia, and smoking history (HR: 2.701; 95% CI: 1.392 to 5.242). H. pylori infection was associated with larger cognitive decline during follow-up, adjusting for the above covariates (standardized coefficient: 0.282, p < 0.001). Furthermore, H. pylori infected subjects had significantly higher speed of cognitive decline than uninfected subjects during follow-up, adjusting for the above covariates.
H. pylori infection increases the risk of longitudinal cognitive decline in older subjects with memory complaints. This study is helpful for further understanding the association between infection and dementia.
既往横断面研究已确定幽门螺杆菌(H. pylori)感染与痴呆之间可能存在联系。然而,H. pylori感染与纵向认知衰退之间的关联很少被研究。
本队列研究旨在证明H. pylori感染对纵向认知衰退的影响。
本队列研究招募了268名有记忆问题的受试者。在这些受试者中,72名有H. pylori感染史,其余196名受试者无H. pylori感染。对这些受试者进行了24个月的随访,并每隔12个月进行一次认知评估。
在基线时,H. pylori感染组和未感染组的简易精神状态检查表(MMSE)评分无差异。在随访2年时,H. pylori感染组的MMSE评分低于未感染组。在对年龄、性别、教育程度、APOEɛ4基因型、高血压、糖尿病、高脂血症和吸烟史进行校正后,H. pylori感染与纵向认知衰退风险增加相关,纵向认知衰退定义为随访期间MMSE降低3分或更多(风险比:2.701;95%置信区间:1.392至5.242)。在对上述协变量进行校正后,H. pylori感染与随访期间更大的认知衰退相关(标准化系数:0.282,p<0.001)。此外,在对上述协变量进行校正后,H. pylori感染受试者在随访期间的认知衰退速度明显高于未感染受试者。
H. pylori感染增加了有记忆问题的老年受试者纵向认知衰退的风险。本研究有助于进一步了解感染与痴呆之间的关联。