Helicobacter pylori infection in asymptomatic elderly subjects living at home or in a nursing home: Effects on gastric function and nutritional status

Abstract

Age and close living conditions are known to be risk factors for the acquisition of Helicobacter pylori (HP) infection. It is unknown whether institutionalization of asymptomatic, elderly subjects is an additional risk factor and whether gastric function and nutritional status are affected by the HP infection. The study sample comprised 102 subjects over 65 years of age: 52 living in a nursing home and 50 at home. No subject had symptoms or previous pathology related to the upper digestive tract. In all subjects, serum levels of specific anti-HP antibodies were determined. Gastric function was evaluated by levels of pepsinogen A (PGA), pepsinogen C (PGC) and gastrin. The nutritional status of the subject was evaluated by measuring: albumin, haemoglobin, iron, ferritin, transferrin, vitamin B12, and folic acid in blood, and body mass index and mid-arm muscle area. The prevalence of anti-HP antibodies was 86.5% in institutionalized subjects (men: 100%; women: 76.6%, p < 0.05) and 82.0% in subjects living at home (men: 86.3%; women: 76.3%). No differences between the two groups were observed in levels of serum anti-HP antibodies, PGA, PGC or gastrin. In institutionalized subjects, a significant correlation between anti-HP antibodies and PGC was identified. In neither group were differences observed between serum positive (HP + ve) and negative (HP - ve) subjects with respect to the biohumoral and anthropometric indices of nutritional status. We conclude: (1) the seroprevalence of the HP infection was high (82-86%) in asymptomatic elderly patients living either at home or in an institution; (2) the presence of specific IgG anti-HP antibodies in asymptomatic elderly individuals, at home or in a nursing home, was not associated with changes in PGA, PGC or gastrin; however, there was a correlation between anti-HP antibody titre and PGC levels in institutionalized subjects; (3) nutritional indices were not influenced by the presence of anti-HP antibodies.