title: Eradication of Helicobacter pylori Is Associated with the Progression of Dementia: A Population-Based Study.
abstract: Objective. To evaluate the effect of eradication of Helicobacter pylori (H. pylori) on the progression of dementia in Alzheimer's disease (AD) patients with peptic ulcer. Methods. Participants with the diagnosis of AD and peptic ulcer were recruited between 2001 and 2008. We examined the association between eradication of H. pylori and the progression of AD using the multiple regression models. Medication shift from Donepezil, Rivastgmine, and Galantamine to Mematine is defined as progression of dementia according to the insurance of National Health Insurance (NHI) under expert review. Results. Among the 30142 AD patients with peptic ulcers, the ratio of medication shift in AD patients with peptic ulcers is 79.95%. There were significant lower incidence comorbidities (diabetes mellitus, hypertension, cerebrovascular disease, coronary artery disease, congestive heart failure and hyperlipidemia) in patients with H. pylori eradication as compared with no H. pylori eradication. Eradication of H. pylori was associated with a decreased risk of AD progression (odds ratio [OR] 0.35 [0.23-0.52]) as compared with no H. pylori eradication, which was not modified by comorbidities. Conclusions. Eradication of H. pylori was associated with a decreased progression of dementia as compared to no eradication of H. pylori in AD patients with peptic ulcers.
authors.affiliation: Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan.
authors.forename: Yang-Pei
authors.initials: YP
authors.lastname: Chang
authors.affiliation: Department of Information, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung 801, Taiwan.
authors.forename: Guei-Fen
authors.initials: GF
authors.lastname: Chiu
authors.affiliation: School of Medicine, College of Medicine, I-Shou University and E-Da Hospital, Kaohsiung 824, Taiwan ; Graduate Institute of Public Health, Kaohsiung Medical University, Kaohsiung 807, Taiwan.
authors.forename: Fu-Chen
authors.initials: FC
authors.lastname: Kuo
authors.affiliation: Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan.
authors.forename: Chiou-Lian
authors.initials: CL
authors.lastname: Lai
authors.affiliation: Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan.
authors.forename: Yuan-Han
authors.initials: YH
authors.lastname: Yang
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan ; Department of Medicine, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan.
authors.forename: Huang-Ming
authors.initials: HM
authors.lastname: Hu
authors.affiliation: Administration Center, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan.
authors.forename: Pi-Yu
authors.initials: PY
authors.lastname: Chang
authors.affiliation: Department of Radiology, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan ; Cancer Center, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan.
authors.forename: Chiao-Yun
authors.initials: CY
authors.lastname: Chen
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan ; Cancer Center, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan ; Department of Internal Medicine, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung 812, Taiwan.
authors.forename: Deng-Chyang
authors.initials: DC
authors.lastname: Wu
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan ; Department of Medicine, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan.
authors.forename: Fang-Jung
authors.initials: FJ
authors.lastname: Yu