Skokowski Jaroslaw, Vashist Yogesh, Girnyi Sergii, Cwalinski Tomasz, Mocarski Piotr, Antropoli Carmine, Brillantino Antonio, Boccardi Virginia, Goyal Aman, Ciarleglio Francesco A, Almohaimeed Muhannad Abdullah, De Luca Raffaele, Abou-Mrad Adel, Marano Luigi, Oviedo Rodolfo J, Januszko-Giergielewicz Beata
Department of Medicine, Academy of Applied Medical and Social Sciences-AMiSNS: Akademia Medycznych I Spolecznych Nauk Stosowanych, 82-330 Elbląg, Poland.
Department of General Surgery and Surgical Oncology, "Saint Wojciech" Hospital, "Nicolaus Copernicus" Health Center, 80-000 Gdańsk, Poland.
Int J Mol Sci. 2024 Nov 28;25(23):12826. doi: 10.3390/ijms252312826.
Aging is a multifactorial biological process characterized by a decline in physiological function and increasing susceptibility to various diseases, including malignancies and gastrointestinal disorders. Helicobacter pylori () infection is highly prevalent among older adults, particularly those in institutionalized settings, contributing to conditions such as atrophic gastritis, peptic ulcer disease, and gastric carcinoma. This review examines the intricate interplay between aging, gastrointestinal changes, and pathogenesis. The age-associated decline in immune function, known as immunosenescence, exacerbates the challenges of managing infection. Comorbidities and polypharmacy further increase the risk of adverse outcomes in older adults. Current clinical guidelines inadequately address the specific needs of the geriatric population, who are disproportionately affected by antibiotic resistance, heightened side effects, and diagnostic complexities. This review focuses on recent advancements in understanding infection among older adults, including epidemiology, diagnostics, therapeutic strategies, and age-related gastric changes. Diagnostic approaches must consider the physiological changes that accompany aging, and treatment regimens need to be carefully tailored to balance efficacy and tolerability. Emerging strategies, such as novel eradication regimens and adjunctive probiotic therapies, show promise for improving treatment outcomes. However, significant knowledge gaps persist regarding the impact of aging on pathogenesis and treatment efficacy. A multidisciplinary approach involving gastroenterologists, geriatricians, and other specialists is crucial to providing comprehensive care for this vulnerable population. Future research should focus on refining diagnostic and therapeutic protocols to bridge these gaps, ultimately enhancing clinical outcomes and reducing the burden of -associated diseases in the aging population.
衰老 是一个多因素的生物学过程，其特征是生理功能下降，对包括恶性肿瘤和胃肠道疾病在内的各种疾病的易感性增加。幽门螺杆菌（）感染在老年人中高度流行，尤其是在机构化环境中的老年人，它会导致萎缩性胃炎、消化性溃疡病和胃癌等疾病。本综述探讨了衰老、胃肠道变化和发病机制之间的复杂相互作用。与年龄相关的免疫功能下降，即免疫衰老，加剧了控制感染的挑战。合并症和多种药物治疗进一步增加了老年人出现不良后果的风险。当前的临床指南未能充分满足老年人群的特殊需求，他们受到抗生素耐药性、副作用增加和诊断复杂性的影响尤为严重。本综述重点关注老年人幽门螺杆菌感染的最新研究进展，包括流行病学、诊断、治疗策略以及与年龄相关的胃部变化。诊断方法必须考虑到衰老伴随的生理变化，治疗方案需要精心制定以平衡疗效和耐受性。新出现的策略，如新型根除方案和辅助益生菌疗法，有望改善治疗效果。然而，关于衰老对幽门螺杆菌发病机制和治疗效果的影响仍存在重大知识空白。涉及胃肠病学家、老年病学家和其他专家的多学科方法对于为这一脆弱人群提供全面护理至关重要。未来的研究应专注于完善诊断和治疗方案以弥合这些差距，最终改善临床结果并减轻老年人群中幽门螺杆菌相关疾病的负担。
