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Proton pump inhibitors may be associated with increased risk of dementia

The JAMA Network Journals

The use of proton pump inhibitors, the popular medications used to treat gastroesophageal reflux and peptic ulcers, may be associated with an increased risk of dementia in a study using data from a large German health insurer, according to an article published online by JAMA Neurology.

The use of proton pump inhibitors (PPIs) has increased among older patients and PPIs are among the most frequently used classes of drugs.

Britta Haenisch, Ph.D., of the German Center for Neurodegenerative Diseases, Bonn, Germany, and coauthors examined the association between the use of PPIs and the risk of dementia using data from 2004 to 2011 on inpatient and outpatient diagnoses and drug prescriptions. Regular PPI use was at least one PPI prescription in each quarter of an 18-month interval.

The study population included 218,493 individuals 75 or older before 144,814 individuals were excluded, leaving 73,679 individuals included in the final analysis. The authors identified 29,510 patients who developed dementia during the study period.

Regular users of PPIs (2,950 patients, mostly female and average age nearly 84) had a 44 percent increased risk of dementia compared with those (70,729 patients, mostly female and average age 83) not receiving PPI medication, according to the results.

Limitations to the study include the authors only being able to integrate some other risk factors for dementia into the analysis from the data.

"The present study can only provide a statistical association between PPI use and risk of dementia. The possible underlying causal biological mechanism has to be explored in future studies. To evaluate and establish direct cause and effect relationships between PPI use and incident dementia in the elderly, randomized, prospective clinical trials are needed," the study concludes.

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JAMA Neurol. Published online Feb. 15, 2016. doi:10.1001/jamaneurol.2015.4791. Available pre-embargo to the media at http://media.jamanetwork.com.

Editor's Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

Editorial: Do Proton Pump Inhibitors Increase the Risk of Dementia

"Gomm et al have provided an important and interesting challenge to evaluate the possible association of the use of PPIs and the risk of dementia. This is a very important issue given the very high prevalence of pharmacological drugs' long-term use in elderly populations that have a very high risk of dementia," writes Lewis H. Kuller, M.D., Dr.PH., of the University of Pittsburgh, in a related editorial.

JAMA Neurol. Published online Feb. 15, 2016. doi:10.1001/jamaneurol.2015.4931. Available pre-embargo to the media at http://media.jamanetwork.com.

Editor's Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

Media Advisory: To contact corresponding author Britta Haenisch, Ph.D., email britta.haenisch@dzne.de. To contact editorial author Lewis H. Kuller, M.D., Dr.PH., call Allison Hydzik at 412-647-9975 or email hydzikam@upmc.edu.

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