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Helicobacter Pylori Infection, Peptic Ulcer, Gastritis and Risk of Parkinson´s Disease: a Nationwide Matched Cohort Study

S. Licaj, A. Ploner, A. Szwajda, S. Hägg, F. Fang, J. Ludvigsson, K. Wirdefeldt (Solna, Sweden)

Meeting: 2025 International Congress

Keywords: Gastrointestinal problemsm(also see autonomic dysfunction), Parkinson’s

Category: Parkinson's Disease: Epidemiology, Phenomenology, Clinical Assessment, Rating Scales

Objective: To examine the potential link between H. pylori infection, gastritis, peptic ulcer and Parkinson’s Disease (PD) risk.

Background: Gastrointestinal disorders are frequent among PD patients and may start decades before the diagnosis, suggesting a potential role in disease pathogenesis. PD patients consistently showed higher H. pylori infection rates compared to the general population, but the infection role in disease development has been little explored. Epidemiological evidence on gastritis and peptic ulcer in PD risk is limited or contradictory.

Method: A prospective cohort study was conducted using the nationwide ESPRESSO cohort. Exposed individuals diagnosed with H. pylori infection, peptic ulcer or gastritis between 1987 (or 1990) and 2017 were compared to up to five unexposed referents in three distinct cohorts. Referents were randomly selected from the general population and matched to the exposed individuals on age, sex, calendar year and county of residence. Hazard ratios (HR) with 95% confidence intervals (CI) were estimated using stratified Cox models adjusted for country of birth, education, chronic obstructive pulmonary disease – as a proxy for heavy smoking- and number of healthcare visits. Incident PD cases were retrieved by diagnoses in the National Patient Register.

Results: The H. pylori cohort included 48,258 exposed individuals and 231,805 unexposed referents; the peptic ulcer cohort included 52,761 exposed individuals and 274,313 referents, while the gastritis cohort included 242,325 exposed individuals and 1,053,688 referents. Incident PD rates per 1000 person years were 1.0 in the H. pylori exposed cohort (0.9 for referents), 1.3 in the peptic ulcer exposed cohort (1.2 for referents) and 1.1 for individuals exposed to gastritis (0.9 for referents). H. pylori infection (HR: 1.14,95% CI: 1.02-1.28), gastritis (HR: 1.14, 95% CI 1.09-1.19) and peptic ulcer (HR: 1.08, 95% CI: 0.98-1.19) were associated with a marginally increased risk of PD, with no statistically significant association for peptic ulcer. The PD risk increase for gastritis was most pronounced within the first two years after diagnosis (HR: 1.27; 95% CI: 1.16-1.41) and up to ten years.

Conclusion: H. pylori infection, peptic ulcer, and gastritis are unlikely major contributors to PD risk.

To cite this abstract in AMA style:

S. Licaj, A. Ploner, A. Szwajda, S. Hägg, F. Fang, J. Ludvigsson, K. Wirdefeldt. Helicobacter Pylori Infection, Peptic Ulcer, Gastritis and Risk of Parkinson´s Disease: a Nationwide Matched Cohort Study [abstract]. Mov Disord. 2025; 40 (suppl 1). https://www.mdsabstracts.org/abstract/helicobacter-pylori-infection-peptic-ulcer-gastritis-and-risk-of-parkinsons-disease-a-nationwide-matched-cohort-study/. Accessed October 5, 2025.
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