Prolonged antacid use linked to higher dementia risk: Study

Aditi Tandon

New Delhi, October 11

Prolonged use of antacid medicines meant to treat gastroesophageal reflux disease (GERD) and peptic ulcers is associated with a higher risk of dementia, according to a new study published in “Neurology”.

PPI consumption

11.6% (58 out of 497) proton pump inhibitors (PPI) users got dementia

9.8% (415 out of 4,222) PPI non-users got dementia

(Courtesy: A study in “Neurology”)

The study led by Kamakshi Laxminarayan, professor of neurology at the University of Minnesota School of Public Health, studied data from over 5,700 people with the average age of 75 and found that those who consumed proton pump inhibitors (PPIs) for more than four and a half years were at 33% higher risk of developing dementia than those who did not use the medications.

No social network & exercise risk factors

The main risk factors for dementia are unhealthy lifestyle choices like smoking, alcohol use and lack of exercise, and conditions like diabetes, hypertension, deafness, social isolation, low literacy, and some inherited genetic abnormalities, say experts.

Chronic PPI use has been linked to stroke, cardiovascular disease and chronic kidney disease but previous studies on the link between the PPI use and dementia have reported mixed results.

The most commonly prescribed PPIs are Prevacid, Nexium, Psilosec and Protonix. The study, however, does not name the PPIs the participants used.

It evaluated associations between the current and cumulative PPI use and the risk of incident dementia in the Atherosclerosis Risk in Communities (ARIC) Study data (data from a US population-based cohort that attended clinics over time) gathered from enrolment from 1987-89 to 2017.

The average follow-up of participants was 5.5 years. A total of 585 (10.2%) participants developed dementia during the follow-up. The authors found that the current PPI use by participants was not associated with heightened dementia risk but its prolonged use was.

“In the community-based cohort we studied, participants with the long-term cumulative (>4.4 years) use of PPIs from mid-to-late life had a modestly higher risk of dementia in late life compared to nonuse. Shorter-term use in midlife, and current use in late life, were not associated with increased risk of dementia in late life,” authors concluded. Experts, however, say people must guard against anxiety.

Senior gastroenterologist Rajeev Jayadevan says the “Neurology” study found that among those who took PPI, 11.6% (58 out of 497) got dementia, and among those who did not use PPIs, 9.8% (415 out of 4,222) got dementia. “The actual difference between the two groups is 1.8%. Previously, a large US study looked at 3,484 older people for 7.5 years and reported no link. So the results are mixed,” he says, adding that PPIs are safe medications but they should be taken only on doctor’s advice. “Since PPIs are available over the counter, their overuse is frequent. People take them twice daily, when once is sufficient mostly. Long-term PPI use is for select conditions only.”