Introduction: Alzheimer’s disease (AD) is the most common form of dementia. Eradication of Helicobacter pylori (H. pylori) could affect the incidence and progression of many diseases; however, there are limited studies of the association between H. pylori eradication and AD outcome. We utilized the National Health Insurance Research Database (NHIRD) of Taiwan to determine the relationship between H. pylori eradication and AD in a diabetes mellitus (DM) population.
Methods: We collected data from the NHIRD and the Diabetes Mellitus Health Database in Taiwan of patients without a prior diagnosis of AD. We specified three cohorts: patients with (1) peptic ulcer disease (PUD) but no H. pylori treatment, without DM (PUD-HPRx in GP); (2) PUD and DM, but no H. pylori eradication therapy (PUD-HPRx in DM); (3) PUD and DM, with H. pylori eradication therapy (PUD+HPRx in DM). All cohorts were matched according to age, sex, Charlson Comorbidity Index score, and comorbidities.
Results: Data were collected from 2000 to 2010, and 157,231 patients were enrolled in total. We compared the effects of treatment for H. pylori infection on the incidence and mortality of AD. The patients with DM who received H. pylori eradication therapy had a higher incidence of AD than the general population (adjusted hazard ratio of incidence [aHR], 1.088). Subgroup analysis showed that the risk of AD was higher in the younger patients who received H. pylori eradication therapy as compared with those who did not (aHR for younger than 45 years, 1.071; aHR of age 45-54 years, 1.089; aHR of age 55-64 years, 1.079) However, a lower mortality rate was observed in the PUD+HPRx in DM group (aHR, 0.945, compared with PUD-HPRx in DM; P < 0.001).
Conclusion: In this study, we demonstrated that DM patients who underwent treatment for eradication of H. pylori had a higher incidence of AD, especially younger patients. Nevertheless, there was a lower mortality rate in patients who received H. pylori treatment. Further study is needed to clarify the interrelated roles of AD and eradication therapy for H. pylori.