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Helicobacter pylori Seropositivity and Cognitive Performance Among US Adults: Evidence From a Large National Survey

Beydoun, May A. PhD; Beydoun, Hind A. PhD, MPH; Shroff, Monal R. PhD; Kitner-Triolo, Melissa H. PhD; Zonderman, Alan B. PhD

doi: 10.1097/PSY.0b013e31829108c3
Original Articles

Background: Helicobacter pylori seropositivity is a potential risk for poor cognition among US adults.

Methods: Cross-sectional data from the National Health and Nutrition Examination Survey III, Phase 1 (1988–1991), were used. Measures included age group-specific neuropsychological test batteries and two measures of H. pylori seropositivity (immunoglobulin G [IgG] and IgG CagA) (20–59 years old: n = 2090–2,248; 60–90 years old: n = 2123–2388). We explored sex- and race-specific associations.

Results: Using multiple ordinary least square and zero-inflated Poisson regression models, we detected a poorer performance among those 60–90 years old with H. pylori IgG+ versus IgG− on a verbal memory test (story recall, correct items), overall (β = −0.04 [0.01], p = .010). Non-Hispanic (NH) blacks and women (20–59 years old) performed worse on the serial digits learning total errors (SDL-TE) when H. pylori IgG+ (versus IgG−), another verbal memory test (β = +0.94 [0.40; p = .029] and β = +1.19 [0.44; p = .012], respectively; p<.10 for interaction by sex and race). More trials to completion on this test (SDL-TTC) were also required among H. pylori IgG+ overall (20–59 years old; β = +0.30 [0.13], p = .033). Other race-specific associations without significant interaction by race were detected in the same direction of worse performance with seropositivity in all three major race groups and for both age categories, covering several domains of cognition.

Conclusions: H. pylori seropositivity markers were associated with poor cognition among US adults. Longitudinal research is needed to extrapolote those findings to cognitive decline, incident dementia, and Alzheimer's disease.

Supplemental digital content is available in the article.

From the National Institute on Aging (M.A.B., M.H.K.-T, A.B.Z.), NIA/NIH/IRP, Baltimore, Maryland; Graduate Program in Public Health (H.A.B.), Eastern Virginia Medical School, Norfolk, Virginia; and Michigan Public Health Institute (M.R.S.), Okemos, Michigan.

Address correspondence and reprint requests to May A. Beydoun, PhD, NIH Biomedical Research Center, National Institute on Aging, IRP, 251 Bayview Blvd, Suite 100, Room 04B118, Baltimore, MD 21224. E-mail:

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s Web site (

Received for publication August 3, 2012; revision received February 6, 2013.

May A. Beydoun had full access to the data used in this manuscript and completed all the statistical analyses.

Melissa H. Kitner-Triolo and Alan B. Zonderman are cosenior authors.

Copyright © 2013 by American Psychosomatic Society
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