In the United States, the use of medications to control acid reflux and the resulting heartburn it can cause has risen dramatically. Known as Proton Pump Inhibitors (PPIs) the medications work by turning off or reducing the production of acid in the stomach. One study shows that the number of prescriptions written for PPIs in the emergency departments of hospitals nearly doubled in the period from 2001 to 2010. Another study, from Johns Hopkins suggested the use of these medications was associated with and increased risk of chronic kidney disease.
The latest information on the drugs comes from a study done in Germany and it suggests an association between the use of PPI medications and the incidence of dementia. The recent study involved German researchers collecting data from a large health insurance firm on almost 74,000 seniors aged 75 or older. The information in the data based included the period from 2004 to 2011, as well as information on patient diagnoses and prescription histories. The researchers reported that about 2,950 patients used PPI medications on a regular basis, which was defined in the study as at least one prescription for the medication every three months over an 18 month period.
About 2,950 patients regularly used PPIs, which for this study was defined as at least one PPI prescription in each quarter of an 18-month interval. These patients were found to have a 44% increased risk of dementia compared to patients who did not report the use of acid reducing medications. CBS news reported on the findings, but also asked experts not involved in the study what the implications could be for patients using acid controlling medications. Dr. Arun Swaminath, director of the inflammatory bowel disease program at Lenox Hill Hospital in New York City told CBS that the study isn’t clear about the over-the-counter availability of the medications and that could mean the risk of dementia is overestimated in the study.
In a press release about the study author Britta Haenisch, from the German Center for Neurodegenerative Diseases in Bonn said, “To evaluate cause-and-effect relationships between long-term PPI use and possible effects on cognition in the elderly, randomized, prospective clinical trials are needed. Clinicians should follow guidelines for PPI prescription, to avoid overprescribing PPIs and inappropriate use."
It’s important to note that the study authors only suggested an association between dementia and PPI medications. In the study conclusion they wrote, “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.”
Take a look at the video below for more information on this study. While no causal relationship is found in the most recent research, it’s important to know how these medications work and what the risks might be.
, Eureka Press Release CBS News
, German Center for Neurodegenerative Diseases
, JAMA Neurology