Dyspeptic symptoms in middle-aged to old adults: the role of Helicobacter pylori infection, and various demographic and lifestyle factors.

OBJECTIVES: To evaluate the role of factors supposed to interfere with the gastric mucosa like Helicobacter pylori, smoking and analgesics in symptom generation in a population-based sample of middle-aged to old.
SUBJECTS: A total of 288 subjects aged 50-85 (mean 65 +/- 7.2) attending a General Science-orientated Continuing Education Programme at the University of Ulm.
METHODS: Helicobacter pylori infection was determined by the 13C-urea breath test. Demographic data, gastrointestinal symptoms and factors supposed to be involved in symptom generation were collected by a standardized questionnaire. The association between various demographic and lifestyle factors with a gastrointestinal symptom score was quantified by odds ratios (ORs) using multiple logistic regression.
RESULTS: Use of nonsteroidal anti-inflammatory drugs (OR=1.2; 95% CI=0.7-2.1) was no risk factor for abdominal symptoms, whereas female sex (OR= 1.6; 95% CI=0.9-2.9) and current smoking (OR= 3.7; 95% CI=0.9-15.4) were associated with a high symptom score. Age 70 years and over was significantly associated with a lower symptom score (OR=0.4; 95% CI=0.2-0.9). However, H. pylori infection was a risk factor for a high symptom score in that age group (OR=4.3; 95% CI=1.2-14.8), whereas no such association (and even a tendency to reduced symptom levels in infected subjects) was observed in younger age groups.
CONCLUSION: The role of H. pylori infection in symptoms may vary by age. The loss of symptoms in the elderly may delay detection of gastroduodenal pathology and appropriate treatment in older adults.