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

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