Hernández-Ruiz Virgilio, Roubaud-Baudron Claire, Von Campe Hugo, Retuerto Noelia, Mégraud Francis, Helmer Catherine, Amieva Hélène, Pérès Karine
INSERM, Bordeaux Population Health Research Center, UMR 1219, University of Bordeaux, Bordeaux, France.
Pôle de Gérontologie Clinique, CHU Bordeaux, Bordeaux, France.
J Am Geriatr Soc. 2024 Apr;72(4):1191-1198. doi: 10.1111/jgs.18748. Epub 2024 Jan 23.
Chronic infectious diseases are increasingly being considered as potential contributors to dementia risk. Among those infections, Helicobacter pylori, the main cause of chronic gastritis worldwide, has been suggested. As the prevalence of H. pylori infection has decreased, the main objective of this work was to reconsider the association between H. pylori infection and the risk of incident dementia, including Alzheimer's disease.
Prospective cohort of 689 older (≥65 years) agricultural workers from Southwest France. Descriptive and comparative analyses were performed according to H. pylori status determined by serology at baseline. The risk of incident dementia according to H. pylori status over a 7-year follow-up was explored by survival analyses: Kaplan-Meier curve and Cox proportional hazards models.
Two-hundred (29.0%) participants were H. pylori-positive at baseline. Compared to H. pylori-negative participants, they showed worse cognitive performances at baseline. Eighty-five incident dementia cases were diagnosed during the follow-up period. After adjustment for age, sex, education, apolipoprotein ε4, and several cardiovascular risk factors, H. pylori remained associated with an increased risk of dementia (HR 1.70, 95% CI, 1.05-2.74). The risk was stronger for Alzheimer's disease (HR 2.85, 95% CI, 1.58-5.12).
Despite an observed decrease in H. pylori infection prevalence, this study provides evidence for the association between H. pylori infection and dementia. These results should encourage further research on the mechanisms underlying the contribution of infectious diseases to pathological brain aging, especially the influence of gut inflammation on the brain.
慢性传染病越来越被认为是痴呆风险的潜在因素。在这些感染中，有人提出了幽门螺杆菌，它是全球慢性胃炎的主要病因。随着幽门螺杆菌感染率的下降，这项研究的主要目的是重新审视幽门螺杆菌感染与包括阿尔茨海默病在内的新发痴呆风险之间的关联。
对法国西南部689名年龄≥65岁的老年农业工人进行前瞻性队列研究。根据基线时血清学检测确定的幽门螺杆菌感染状况进行描述性和比较性分析。通过生存分析（Kaplan-Meier曲线和Cox比例风险模型）探讨了在7年随访期间根据幽门螺杆菌感染状况发生痴呆的风险。
200名（29.0%）参与者在基线时幽门螺杆菌呈阳性。与幽门螺杆菌阴性的参与者相比，他们在基线时的认知表现更差。在随访期间诊断出85例新发痴呆病例。在对年龄、性别、教育程度、载脂蛋白ε4和几种心血管危险因素进行调整后，幽门螺杆菌感染仍与痴呆风险增加相关（风险比1.70，95%置信区间，1.05 - 2.74）。阿尔茨海默病的风险更强（风险比2.85，95%置信区间，1.58 - 5.12）。
尽管观察到幽门螺杆菌感染率有所下降，但本研究为幽门螺杆菌感染与痴呆之间的关联提供了证据。这些结果应鼓励进一步研究传染病导致病理性脑老化的潜在机制，尤其是肠道炎症对大脑的影响。
