A US study has found a link between long-term use of anti-reflux drugs and the risk of dementia.
Gastro-oesophageal reflux disease (GERD) is characterized by regurgitation of stomach contents. A number of factors may contribute to its development. These include Hiatal hernias, obesity, smoking, pregnancy, or a heavy evening meal. To reduce gastric acid secretion, health professionals generally prescribe proton pump inhibitors (PPIs) such as Prilosec, Prevacid, and Nexium. However, over time, their use can have an impact on patients’ cognitive function.
Esophagus. Courtesy of Olek Remesz
A link between proton pump inhibitors and dementia risk
In a study published in the American Academy of Neurology, researchers observed a link between taking Proton Pump Inhibitors for several years and the risk of dementia. “Long-term use has been associated in previous studies with a higher risk of stroke, bone fractures, and chronic kidney disease. However, some people take these drugs regularly, so we wanted to find out if they are associated with a higher risk of dementia. Although we did not find an association with short-term use, we did find a higher risk of dementia associated with long-term use of these drugs,” explains Kamakshi Lakshminarayan, lead author of the study and a vascular neurologist at the University of Minnesota School of Public Health in Minneapolis.
The Study
For the study, the researchers recruited 5,712 volunteers over the age of 45 who did not have dementia. During annual visits and interviews, the authors observed whether volunteers were taking acid reflux medication, particularly proton pump inhibitors (PPIs). They then classified them into four groups based on whether or not they were taking medication and for how long:
- Participants not taking PPIs
- Those taking them for up to 2.8 years
- Those who took them for between 2.8 and 4.4 years
- Those who took them for more than 4.4 years.
A 33% higher risk of developing dementia
Follow-up lasted 5.5 years. Nearly 10% of volunteers, or 585 people, developed dementia during this period.
After adjusting for age, gender, ethnicity, and health status, the researchers found that people who had taken anti-reflux medication for more than 4.4 years had a 33% higher risk of developing dementia than those who had never been treated. No higher risk of dementia was identified in participants who had taken these drugs for less than 4.4 years.
However, further research is needed to confirm these results. “Although there are several ways to treat acid reflux, such as taking antacids, maintaining a healthy weight, and avoiding late meals and certain foods, the different approaches may not be effective for everyone. It is important that people taking these medications consult with their doctor before making any changes to discuss the best treatment for them. Stopping these drugs abruptly can lead to worsening symptoms,” warns Kamakshi Lakshminarayan.
Read also: The Influence of Psychological Distress and Fatigue after 45 Years of Age on Dementia Risk
References
Cumulative Use of Proton Pump Inhibitors and Risk of Dementia: The Atherosclerosis Risk in Communities Study
Carin Northuis, Elizabeth Bell, Pamela Lutsey, Kristen M George, Rebecca F. Gottesman, Tom H. Mosley, Eric A Whitsel, Kamakshi Lakshminarayan
Neurology Aug 2023, 10.1212/WNL.0000000000207747; https://doi.org/10.1212/WNL.0000000000207747
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