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10 August 2023
There is an emerging research suggests that prolonged use of proton pump inhibitors (PPIs) might entail a heightened risk of dementia.
According to a study featured in the journal Neurology, individuals aged 45 and above who took PPIs for more than four years displayed a 33% higher susceptibility to developing dementia compared to those who never used these medications.
PPIs are widely available over-the-counter and are frequently employed to address mild heartburn sensations accompanying acid reflux.
Dr. Kamakshi Lakshminarayan, a neurologist from the University of Minnesota School of Public Health in Minneapolis and a member of the American Academy of Neurology, who authored the study, underscored that the findings do not establish a definitive causal link between acid reflux drugs and dementia. Instead, they highlight an association.
Lakshminarayan and her team conducted a study to investigate the link between proton pump inhibitors (PPIs) and dementia, from a population-based study of 5,712 individuals aged 45 to 64 who did not have dementia at the start of the study.
They found that people who used PPIs for at least 4.5 years had a 32% higher risk of developing dementia than those who did not use PPIs. However, there was no increased risk for people who used PPIs for less than 4.4 years.
The researchers identified two potential mechanisms by which PPIs could increase the risk of dementia:
- B12 deficiency: PPIs can interfere with the absorption of vitamin B12, which is essential for cognitive function. Low levels of vitamin B12 have been linked to an increased risk of dementia.
- Amyloid metabolism: PPIs can alter the way the brain breaks down amyloid, a protein that is involved in Alzheimer’s disease. This could lead to an accumulation of amyloid in the brain, which is a hallmark of Alzheimer’s disease.
The study did have some limitations. For example, participants were only asked about their medication use once a year, so it is possible that some people stopped or started using PPIs between assessments. Additionally, the study only looked at prescription PPIs, not over-the-counter PPIs.
Overall, the study suggests that long-term use of PPIs may increase the risk of dementia. However, more research is needed to confirm these findings and to identify the specific mechanisms by which PPIs increase the risk of dementia.
So, how about those who are currently on PPIs?
People who have been taking proton pump inhibitors (PPIs) for more than 4 years should talk to their doctor about alternative treatments, because suddenly stopping PPIs can worsen symptoms.
There are other medications that can be used to treat acid reflux and heartburn, such as antacids and H2 blockers. Antacids work by neutralizing stomach acid, while H2 blockers work by reducing the amount of acid produced by the stomach.
Some people may be taking PPIs unnecessarily, or for symptoms that are not severe enough. They should talk to their doctor about whether they really need to be taking PPIs, and whether there are other, less risky treatments that could be used.
In addition to medication, there are also lifestyle changes that can help to reduce acid reflux and heartburn. These include avoiding foods that trigger symptoms, eating smaller meals more often, and losing weight if you are overweight or obese.
Link to the full News (CNN Health):
https://edition.cnn.com/2023/08/09/health/acid-reflux-medication-dementia/index.html
