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Eradication of Helicobacter pylori may be beneficial in the management of Alzheimer’s disease


Kountouras, Jannis, Boziki, Marina, Gavalas, Emmanuel, Zavos, Christos, Grigoriadis, Nikolaos, Deretzi, Georgia, Tzilves, Dimitrios, Katsinelos, Panagiotis, Tsolaki, Magda, Chatzopoulos, Dimitrios, Venizelos, Ioannis


Journal Of Neurology, Volume: 256, No.: 5, Pages.: 758-767

Year of Publication



Infectious agents have been proposed as potential causes of Alzheimer’s disease (AD). Recently, we documented a high prevalence of Helicobacter pylori (Hp) infection in patients with AD. We aim to access the effect of Hp eradication on the AD cognitive (MMSE: Mini Mental State Examination and CAMCOG: Cambridge Cognitive Examination for the Elderly) and functional (FRSSD: Functional Rating Scale for Symptoms of Dementia) status parameters. In the first part of the study, a total of 50 consecutive patients with AD and 30 age-matched anaemic controls underwent an upper gastrointestinal endoscopy, and gastric mucosal biopsies were obtained to detect the presence of Hp infection by histologic analysis and rapid urease test. Serum anti-Hp-specific IgG level was analysed by enzyme-linked immunosorbent assay. In the second part, Hp-positive AD patients received a triple eradication regimen (omeprazole, clarithromycin and amoxicillin), and all patients were followed up for 2 years, while under the same treatment with cholinesterase inhibitors. Hp was detected in 88% of AD patients and in 46.7% of controls (P < 0.001). Hp eradication was successful in 84.8% of treated patients. At the 2-year clinical endpoint, cognitive and functional status parameters improved in the subgroup of patients where Hp eradication was successful (P < 0.001 and P = 0.049 for MMSE and CAMCOG, respectively; P < 0.001 for FRSSD), but not in the other patients. Hp eradication may positively influence AD manifestations, suggesting a possible common link between Hp and AD.;

Bibtex Citation

@article{Kountouras_2009, doi = {10.1007/s00415-009-5011-z}, url = {}, year = 2009, month = {feb}, publisher = {Springer Science $mathplus$ Business Media}, volume = {256}, number = {5}, pages = {758--767}, author = {Jannis Kountouras and Marina Boziki and Emmanuel Gavalas and Christos Zavos and Nikolaos Grigoriadis and Georgia Deretzi and Dimitrios Tzilves and Panagiotis Katsinelos and Magda Tsolaki and Dimitrios Chatzopoulos and Ioannis Venizelos}, title = {Eradication of Helicobacter pylori may be beneficial in the management of Alzheimer's disease}, journal = {Journal of Neurology} }


administration & dosage, aged, aged, 80 and over, alzheimer disease, amoxicillin, analysis, and, anti-bacterial agents, antiulcer agents, biopsy, blood, clarithromycin, cognition disorders, comorbidity, diagnosis, drug effects, drug therapy, endpoint determination, epidemiology, female, gastric mucosa, gastroscopy, helicobacter, helicobacter infections, helicobacter pylori, humans, infection, male, microbiology, middle aged, neuropsychological tests, omeprazole, pathology, prevalence, prevention & control, pylori, treatment outcome, urease

Countries of Study


Types of Dementia

Alzheimer’s Disease

Types of Study

Case Control Study

Type of Outcomes

ADLs/IADLs, Cognition

Type of Interventions

Pharmaceutical Interventions, Treatment/prevention of co-morbidities or additional risks

Pharmaceutical Interventions