The association between H. pylori infection and cognitive deterioration: a systematic review and meta-analysis.

IF 3.4 3区医学 Q2 MEDICINE, RESEARCH & EXPERIMENTAL

European Journal of Medical Research Pub Date : 2025-09-16 DOI:10.1186/s40001-025-03160-8

Mahmoud M Elhady, Abdelrahman Zidan, Eslam Mohammed Rabea, Heidi Sherif Farouk, Moustafa Z Elattar, Manar Adel, Mariam Abdulkhaliq Khalil, Amira A Aboali, Marwa Abdel Aziz Zeid, Mohamed A Shaltout, Alzahraa M Abdel-Daim, Asmaa Gomaa Alwarraqi, Hazem AbuEl-Enien, Mohamed Sayed Zaazouee

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Abstract

Background: The association between cognitive decline and Helicobacter pylori (H. pylori) infection remains controversial, with some evidence suggesting that H. pylori eradication may slow the progression of the disease. This meta-analysis aims to investigate the bidirectional relationship between H. pylori and cognitive decline.

Methods: We searched PubMed, Web of Science, the Cochrane Library, and Scopus for double-arm studies that reported either the prevalence of cognitive decline in individuals with H. pylori-positive status or the prevalence of H. pylori infection in patients with cognitive decline. A random-effects meta-analysis was conducted using Comprehensive Meta-Analysis software to pool the odds ratios from the included studies. Study quality was assessed using the Newcastle-Ottawa Scale.

Results: Our search identified 1,240 records, with 16 studies meeting the inclusion criteria. Meta-analysis showed that patients with H. pylori had a significantly higher risk of cognitive decline (OR = 1.338, 95% CI 1.046-1.713), with the strongest association seen in studies grouping cognitive dysfunction and dementia (OR: 3.190, 95% CI 1.853-5.490). However, the risk of Alzheimer's disease was insignificant. Cognitive decline cohorts showed a significantly higher prevalence of H. pylori (OR = 1.5, 95% CI 1.131-1.989), with a significant association with Alzheimer's disease (OR: 1.630, 95% CI 1.064-2.497), but not with dementia or cognitive dysfunction. The association varied across study designs, with cross-sectional studies showing no association in both analyses. Heterogeneity was substantial (I² > 70% in most analyses), highlighting variability in the findings.

Conclusion: This meta-analysis indicates a bidirectional association between H. pylori and cognitive decline. While H. pylori infection increased the overall risk of cognitive decline, no significant link was found with Alzheimer's disease. Conversely, Alzheimer's disease patients had a higher prevalence of H. pylori infection. High heterogeneity underscores the need for further well-designed studies to clarify this relationship.

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幽门螺杆菌感染与认知能力下降之间的关系：一项系统综述和荟萃分析。

背景：认知能力下降与幽门螺杆菌感染之间的关系仍然存在争议，一些证据表明根除幽门螺杆菌可能会减缓疾病的进展。本荟萃分析旨在探讨幽门螺旋杆菌与认知能力下降之间的双向关系。方法：我们检索了PubMed、Web of Science、Cochrane Library和Scopus，检索了报道幽门螺杆菌阳性个体认知能力下降患病率或认知能力下降患者幽门螺杆菌感染患病率的双臂研究。采用综合荟萃分析软件进行随机效应荟萃分析，汇总纳入研究的优势比。使用纽卡斯尔-渥太华量表评估研究质量。结果：我们的检索确定了1,240条记录，其中16项研究符合纳入标准。荟萃分析显示，幽门螺杆菌患者认知能力下降的风险明显更高（OR = 1.338, 95% CI 1.046-1.713），其中认知功能障碍和痴呆的相关性最强（OR: 3.190, 95% CI 1.853-5.490）。然而，患阿尔茨海默病的风险微不足道。认知能力下降的队列显示幽门螺杆菌的患病率明显更高（OR = 1.5, 95% CI 1.131-1.989），与阿尔茨海默病（OR: 1.630, 95% CI 1.064-2.497）有显著关联，但与痴呆或认知功能障碍无关。这种关联因研究设计而异，横断面研究显示两种分析均无关联。异质性是显著的（在大多数分析中为60% ~ 70%），突出了研究结果的可变性。结论：这项荟萃分析表明幽门螺旋杆菌与认知能力下降之间存在双向关联。虽然幽门螺旋杆菌感染增加了认知能力下降的总体风险，但与阿尔茨海默病没有明显的联系。相反，阿尔茨海默病患者的幽门螺杆菌感染率更高。高异质性强调需要进一步精心设计的研究来澄清这种关系。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Journal of Medical Research 医学-医学：研究与实验

CiteScore

3.20

自引率

0.00%

发文量

247

审稿时长

>12 weeks

期刊介绍： European Journal of Medical Research publishes translational and clinical research of international interest across all medical disciplines, enabling clinicians and other researchers to learn about developments and innovations within these disciplines and across the boundaries between disciplines. The journal publishes high quality research and reviews and aims to ensure that the results of all well-conducted research are published, regardless of their outcome.