AIM: To investigate seroepidemiology of cagA(+) and vacA(+) strains of Helicobacter pylori (H. pylori) in an elderly population in Beijing and to determine risk factors for seropositivity. METHODS: A total of 2006 elderly persons (>60 years) were selected using a random cluster sampling method in different parts of the Beijing area (urban, suburban and mountainous districts). Structured questionnaires were completed during home visits, including history of H. pylori infection, history of gastrointestinal diseases, diet types, hygiene habits, occupation and economic status. Blood samples (2 mL) were collected from each participant, and serum IgG antibodies to cagA, vacA and H. pylori urease antigens were measured by immunodetection. RESULTS: The prevalence of H. pylori infection in elderly subjects was 83.4% and the type. H. pylori strain infection rate was 56%. The seroprevalence for type. H. pylori strain infection in urban and suburban districts was higher than that in the mountainous areas (P < 0.001). Elderly subjects who had previously performed manual labor or were in the young-old age group (age < 75 years) had a higher seroprevalence of H. pylori infection than those who had previously performed mental labor or were in the oldest-old age group (age >= 75 year) (P < 0.05). The type. H. pylori strain infection rate in the elderly with vegetarian diets was higher than in those eating high-protein foods (P < 0.001). There was no significant difference in the prevalence of H. pylori strains between male and female elderly participants (P > 0.05). CONCLUSION: Type. H. pylori seroprevalence is higher in elderly people. The distribution of strains of H. pylori is significantly affected by age, area and dietary habits. (C) 2014 Baishideng Publishing Group Co., Limited. All rights reserved.