A really common medication found associated with a higher incidence of newly diagnosed dementia
A recent study, published in the online edition of Neurology®, the medical journal of the American Academy of Neurology, suggests that individuals who take proton pump inhibitors, a type of acid reflux medication, for four and a half years or more may face an increased risk of dementia compared to those who do not use these medications.
It’s important to note that this study establishes an association and does not definitively prove that acid reflux drugs cause dementia.
Acid reflux is a condition where stomach acid flows into the esophagus, typically occurring after meals or while lying down. Individuals with acid reflux often experience symptoms such as heartburn and ulcers, and frequent acid reflux can progress to gastroesophageal reflux disease (GERD), which is linked to esophageal cancer.
Proton pump inhibitors work by reducing stomach acid production by targeting the enzymes responsible for acid production in the stomach lining.
Lead study author Kamakshi Lakshminarayan, MBBS, PhD, from the University of Minnesota School of Public Health in Minneapolis and a member of the American Academy of Neurology, commented on the findings: “Proton pump inhibitors are a useful tool to help control acid reflux, however, long-term use has been linked in previous studies to a higher risk of stroke, bone fractures, and chronic kidney disease.
“Still, some people take these drugs regularly, so we examined if they are linked to a higher risk of dementia. While we did not find a link with short-term use, we did find a higher risk of dementia associated with long-term use of these drugs.”
The study involved 5,712 participants aged 45 and older who did not have dementia at the study’s outset, with an average age of 75. Researchers determined participants’ usage of acid reflux medications through regular assessments during study visits and annual phone calls. Among the participants, 1,490 individuals, or 26%, had used these medications.
They were divided into four groups based on whether they had used the medications and for how long: those who did not use the drugs, those who used them for up to 2.8 years, those who used them for 2.8 to 4.4 years, and those who used them for more than 4.4 years.
Over a median follow-up period of 5.5 years, 585 participants, or 10%, developed dementia.
Among the 4,222 individuals who did not use the drugs, 415 developed dementia, corresponding to 19 cases per 1,000 person-years. (Person-years is a measure that combines the number of people in the study with the amount of time each person spends in the study.) Among the 497 participants who used the drugs for over 4.4 years, 58 developed dementia, equivalent to 24 cases per 1,000 person-years.
After adjusting for factors like age, gender, race, high blood pressure, and diabetes, the researchers found that those who had taken acid reflux drugs for more than 4.4 years had a 33% higher risk of developing dementia compared to those who had never used these medications. No increased risk of dementia was observed for those who had taken the drugs for less than 4.4 years.
Lakshminarayan emphasized the need for further research to confirm these findings and investigate the underlying reasons for the potential association between long-term use of proton pump inhibitors and a heightened dementia risk. She also stressed the importance of individuals taking these medications and discussing potential treatment alternatives with their healthcare providers because abruptly discontinuing these drugs could worsen symptoms.
One limitation of the study was that participants reported their medication use only once a year, so researchers had to estimate usage between these annual check-ins. Additionally, the study did not account for over-the-counter acid reflux medications.
This research received support from the National Institutes of Health, including the National Heart, Lung, and Blood Institute.
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