The new research is published in the journal neurology have found that people taking proton pump inhibitors (a type of acid reflux drug) for more than 4.4 years may have a 33% higher risk of developing dementia compared to nonusers.
Prolonged use of a proton pump inhibitor, similar sour reflux medication, may be linked to an increased risk of dementia, suggests a study recently published in neurology, medical journal of the American Academy of Neurology. Importantly, this study does not prove that these drugs directly cause dementia but only shows a correlation.
Acid reflux occurs when stomach acid flows into the esophagus, usually after eating or while lying down. This condition can cause symptoms such as heartburn and ulcers. If acid reflux occurs frequently, it can develop into gastroesophageal reflux disease (GERD), which has the potential to cause esophageal cancer.
Proton pump inhibitors (PPIs) are a class of drugs that reduce stomach acid production. Commonly prescribed for conditions such as gastroesophageal reflux disease (GERD) and peptic ulcer disease, they work by inhibiting the proton pump in the lining of the stomach.
Proton pump inhibitors reduce stomach acid by targeting the enzymes in the stomach lining that produce that acid.
“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, 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 whether these drugs were associated with a higher risk of dementia. While we found no association with short-term use, we did find a higher risk of dementia associated with long-term use of this drug.”
The study included 5,712 people, aged 45 and over, who did not have dementia at study entry. They have an average age of 75 years.
Researchers determined whether participants were taking acid reflux medications by reviewing their medications during study visits and during annual phone calls. Of the participants, 1,490 people, or 26%, had used the drug. Participants were then divided into four groups based on whether they had been taking the drug and for how long, as follows: people who had not taken the drug; those who used the drug up to 2.8 years; those who took it for 2.8 to 4.4 years; and people who took it for more than 4.4 years.
Participants were then followed for an average duration of 5.5 years. During this time, 585 people, or 10%, developed dementia.
Of the 4,222 people who did not use the drug, 415 people developed dementia, or 19 cases per 1,000 person-years. The person-years represent the number of people in the study and the amount of time each person spent in the research. Of 497 people who took the drug for more than 4.4 years, 58 people developed dementia, or 24 cases per 1,000 person-years.
After adjusting for factors such as age, gender, and race, as well as health-related factors such as high blood pressure and diabetes, the researchers found that people who had taken acid reflux drugs for more than 4.4 years had a 33 risk % higher exposed to gastric acid. develop dementia than people who have never taken medication.
The researchers found no higher risk of dementia in people who took the drug for less than 4.4 years.
“Further studies are needed to confirm our findings and explore reasons for the possible association between long-term use of proton pump inhibitors and a higher risk of dementia,” said Lakshminarayan. “While there are different ways to treat acid reflux, such as taking antacids, maintaining a healthy weight, and avoiding late night meals and certain foods, different approaches may not work for everyone. It is important for people taking this medication to talk to their doctor before making any changes, to discuss the best treatment for them, and because stopping this drug suddenly could result in worse symptoms.
References: “Cumulative Use of Proton Pump Inhibitors and Risk of Dementia: Risk of Atherosclerosis in a Community Study” by Carin Northuis, Elizabeth Bell, Pamela Lutsey, Kristen M George, Rebecca F. Gottesman, Tom H. Mosley, Eric A Whitsel and Kamakshi Lakshminarayan, 9 August 2023, neurology.
DOI: 10.1212/WNL.0000000000207747
A limitation of the study was that participants were asked once a year about drug use, so we estimated usage between annual check-ins. If participants stop and restart acid reflux medication between check-ins, estimates of their use may be inaccurate. The authors also were unable to assess whether participants were taking over-the-counter acid reflux medications.
This study is supported by National Institute of Healthincluding the National Heart, Lung, and Blood Institute.
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