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Long-term Use of Proton Pump Inhibitors Linked With Higher Dementia Risk

Jolynn Tumolo

Use of prescription proton pump inhibitors that stretched 4.5 years or longer was associated with an increased risk of dementia, according to study findings published in Neurology.

“Proton pump inhibitors are a useful tool to help control acid reflux, however long-term use has been linked in previous studies to a higher risk of stroke, bone fractures, and chronic kidney disease,” said study author Kamakshi Lakshminarayan, MBBS, PhD, of the University of Minnesota School of Public Health in Minneapolis, and a member of the American Academy of Neurology. “Still, some people take these drugs regularly, so we examined if they are linked to a higher risk of dementia. While we did not find a link with short-term use, we did find a higher risk of dementia associated with long-term use of these drugs.”

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The study included 5712 adults aged 45 and older; the average age was 75. No participants had dementia at the study start.
 
During clinic visits and annual phone calls, 26% of participants indicated they had taken proton pump inhibitors. Researchers grouped participants based on their cumulative use: no use; people who took proton pump inhibitors for up to 2.8 years; those who took proton pump inhibitors for 2.8 to 4.4 years; and those who took the drugs for longer than 4.4 years.

Over a median 5.5 years of follow-up, 10% of people in the study developed dementia. Among people with no use of proton pump inhibitors, the incidence of dementia was 19 per 1000 person-years, according to the study. Among people with 4.5 or more years of use, dementia incidence was 24 per 1000 person-years.

After adjustment age, sex, race, and health-related factors, such as high blood pressure and diabetes, people with 4.5 or more years of use had a 33% higher risk of developing dementia compared with people who never took the drugs, the study found. Less than 4.4 years of use was not associated with increased dementia risk.

“More research is needed to confirm our findings and explore reasons for the possible link between long-term proton pump inhibitor use and a higher risk of dementia,” said Dr Lakshminarayan. “While there are various ways to treat acid reflux, such as taking antacids, maintaining a healthy weight, and avoiding late meals and certain foods, different approaches may not work for everyone. It is important that people taking these medications speak with their doctor before making any changes to discuss the best treatment for them, and because stopping these drugs abruptly may result in worse symptoms.”

 

References

Northuis C, Bell E, Lutsey P, et al. Cumulative use of proton pump inhibitors and risk of dementia: the Atherosclerosis Risk in Communities Study. Neurology. Published online August 9, 2023. doi:10.1212/WNL.0000000000207747

Long-term use of certain acid reflux drugs linked to higher risk of dementia. News release. American Academy of Neurology; August 3, 2023. Accessed August 31, 2023.

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