Proton Pump Inhibitor Use and Dementia Risk: Prospective Population-Based Study
Shelly L Gray1, Rod L Walker2, Sascha Dublin2,3
1School of Pharmacy, University of Washington, Seattle, Washington.
Journal of the American Geriatrics Society
|November 15, 2017
Summary
Higher proton pump inhibitor (PPI) use was not linked to increased dementia risk in a 7.5-year study. This finding suggests that concerns about PPIs causing dementia may be unfounded, even with long-term exposure.
Area of Science:
- Gerontology
- Pharmacology
- Neurology
Background:
- Proton pump inhibitors (PPIs) are widely used for acid-related gastrointestinal disorders.
- Long-term PPI use has raised concerns regarding potential adverse effects, including cognitive decline.
- The association between cumulative PPI exposure and dementia risk remains unclear.
Purpose of the Study:
- To investigate the relationship between cumulative proton pump inhibitor (PPI) exposure and the risk of developing dementia.
- To assess whether prolonged or high-dose PPI use is associated with an increased incidence of dementia or Alzheimer's disease (AD).
Main Methods:
- A prospective, population-based cohort study involving 3,484 individuals aged 65 and older without dementia at baseline.
- Time-varying PPI exposure was quantified using total standardized daily doses (TSDDs) over 10 years and duration of use.
- Multivariable Cox regression models were employed to analyze the association between PPI exposure and dementia/AD diagnosis over a mean follow-up of 7.5 years.
Main Results:
- No significant association was found between PPI exposure and the risk of dementia (P = .66) or Alzheimer's disease (AD) (P = .77).
- Cumulative PPI exposure, including high levels equivalent to 5 years of daily use, did not increase dementia risk.
- The duration of PPI use also showed no association with dementia or AD outcomes.
Conclusions:
- Proton pump inhibitor use, even at high cumulative doses, is not associated with an elevated risk of dementia.
- The study findings do not support avoiding PPIs due to concerns about dementia risk.
- While other safety considerations for long-term PPI use exist, dementia risk is not a supported concern based on this research.
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