Acid reflux drugs linked to Dementia

Long-term PPI use linked to increased Dementia risk.

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A recent study has found a potential connection between taking certain medications for acid reflux for an extended period and an elevated risk of developing Dementia. Acid reflux, also known as gastroesophageal reflux disease (GERD), is where stomach acid flows back into the esophagus, causing discomfort and heartburn. Medications like proton pump inhibitors (PPIs) is commonly prescribed to manage acid reflux symptoms.

Taking acid reflux medications known as proton pump inhibitors for four and a half years or longer might increase the risk of Dementia, according to a new study published in the medical journal Neurology. The research suggests a link between these medications and higher dementia risk. However, it doesn’t prove that the medicines directly cause Dementia.

Acid reflux happens when stomach acid enters the throat, usually after eating or lying down. It can cause heartburn and ulcers. If acid reflux occurs often, it can turn into a more serious condition called gastroesophageal reflux disease (GERD), which might lead to throat cancer. Proton pump inhibitors work by reducing stomach acid. They target the enzymes in the stomach lining responsible for making acid.

Study author Kamakshi Lakshminarayan, MBBS, Ph.D., of the University of Minnesota School of Public Health in Minneapolis, and a member of the American Academy of Neurology said, “Proton pump inhibitors are a useful tool to help control acid reflux. However, previous studies have linked long-term use 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 looked at 5,712 people who were 45 years old or older and didn’t have Dementia when the study began. Their average age was 75.

The researchers checked if the participants used acid reflux drugs by reviewing their medications during visits and phone calls each year. Of these people, 1,490, or 26%, had used the drugs. The participants were divided into four groups based on whether they used the drugs and for how long: people who didn’t 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 people who used them for over 4.4 years.

The participants were followed for about 5.5 years on average. During this time, 585 people, or 10% of the group, developed Dementia.

Of the 4,222 people who didn’t use the drugs, 415 developed Dementia. “It equates to about 19 cases for every 1,000 person-years.” “Person-years” is a way to count the number of people in the study and the time each person spends there. Of the 497 people who used the drugs for more than 4.4 years, 58 developed Dementia, or about 24 cases for every 1,000 person-years.

The researchers examined factors like age, gender, and health problems such as high blood pressure and diabetes. They found that using acid reflux drugs for over 4.4 years raised the risk of Dementia by 33% compared to those who never used these drugs. However, using the medications for under 4.4 years didn’t show a higher dementia risk.

Lead researcher Lakshminarayan noted that more research is needed to confirm these findings and understand why long-term use of these drugs might be connected to greater dementia risk. He suggested that since different methods work for other people in managing acid reflux, consulting a doctor before altering medications is crucial, as sudden cessation could worsen symptoms.

One limitation of the study is that participants were asked about their medication use once a year, leading to estimates between check-ins, which might not be accurate if drug use changed. The study also couldn’t determine if participants used over-the-counter acid reflux drugs. Support for the study came from the National Institutes of Health, including the National Heart, Lung, and Blood Institute.

Journal Reference:

  1. Carin Northuis, Elizabeth Bell, et al., Cumulative Use of Proton Pump Inhibitors and Risk of Dementia: The Atherosclerosis Risk in Communities Study. Neurology. DOI: 10.1212/WNL.0000000000207747.