Granted, this is not really about “nutrition”, but a lot of people are wondering if their Prilosec, Nexium, Prevacid or Protonix is increasing their risk of dementia? These are the most frequently prescribed PPI’s or protein pump inhibitors – medications that effectively reduce the production of stomach acid.
For a great many people with GERD (gastrointestinal reflux disease), hiatal hernia, ulcer issues or just plain old heart burn, PPIs have proven to be very effective. But a recent article in the Journal of the AMA Neurology from the German Center for Neurodegenerative Diseases supports previous concerns regarding their effect on cognitive function, such as memory. Researchers found that people 75 years or older who took PPIs regularly had a 44% increased risk of dementia compared to those who did not. Many doctors also feel PPIs are often used inappropriately i.e. when not really necessary or when simpler symptomatic measures may do the job.
It’s important to note that this (PPIs and dementia) is a statistical association; it does not prove that PPIs actually cause dementia. Nonetheless, if you’re taking these medications, either over the counter or by prescription, talk to your physician and make sure you’re taking them appropriately. Caution is certainly warranted, especially if one already has an increase in risk due to e.g. diabetes and/or a strong family history of dementia.
Gomm, W., K. von Holt, et al. (2016). “Association of Proton Pump Inhibitors With Risk of Dementia: A Pharmacoepidemiological Claims Data Analysis.” JAMA Neurol.
Importance: Medications that influence the risk of dementia in the elderly can be relevant for dementia prevention. Proton pump inhibitors (PPIs) are widely used for the treatment of gastrointestinal diseases but have also been shown to be potentially involved in cognitive decline. Objective: To examine the association between the use of PPIs and the risk of incident dementia in the elderly. Design, Setting, and Participants: We conducted a prospective cohort study using observational data from 2004 to 2011, derived from the largest German statutory health insurer, Allgemeine Ortskrankenkassen (AOK). Data on inpatient and outpatient diagnoses (coded by the German modification of the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision) and drug prescriptions (categorized according to the Anatomical Therapeutic Chemical Classification System) were available on a quarterly basis. Data analysis was performed from August to November 2015. Exposures: Prescription of omeprazole, pantoprazole, lansoprazole, esomeprazole, or rabeprazole. Main Outcomes and Measures: The main outcome was a diagnosis of incident dementia coded by the German modification of the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision. The association between PPI use and dementia was analyzed using time-dependent Cox regression. The model was adjusted for potential confounding factors, including age, sex, comorbidities, and polypharmacy. Results: A total of 73679 participants 75 years of age or older and free of dementia at baseline were analyzed. The patients receiving regular PPI medication (n = 2950; mean [SD] age, 83.8 [5.4] years; 77.9% female) had a significantly increased risk of incident dementia compared with the patients not receiving PPI medication (n = 70729; mean [SD] age, 83.0 [5.6] years; 73.6% female) (hazard ratio, 1.44 [95% CI, 1.36-1.52]; P < .001). Conclusions and Relevance: The avoidance of PPI medication may prevent the development of dementia. This finding is supported by recent pharmacoepidemiological analyses on primary data and is in line with mouse models in which the use of PPIs increased the levels of beta-amyloid in the brains of mice. Randomized, prospective clinical trials are needed to examine this connection in more detail.
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