Heartburn is pretty common in the United States, with about seven million people experiencing some symptoms. Naturally, researchers have come up with a few medications to combat heartburn (known medically as gastroesophageal reflux disease), the most popular of which are proton pump inhibitors (PPIs), which work by lowering the amount of acid produced by the stomach. A new study, however, found that these medications may be affecting more than just stomach acid — findings suggest PPIs may raise a senior’s risk of dementia.
German researchers collected and analyzed data from a large German health insurance firm, and ended up with information on 74,000 seniors aged 75 and older. They found those who regularly take PPIs, which encompass Prilosec, Nexium, and Prevacid, had a 44 percent increased risk of dementia compared to seniors not using the drugs. The research was published in JAMA Neurology, and marks only an association, not a cause-and-effect link.
“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,” Britta Haenisch, corresponding author from the German Center for Neurodegenerative Disease in Bonn, told CBS News.
Before this can happen, clinicians should be paying closer attention to the guidelines for PPI prescriptions, Haenisch said. In a November 2015 study, over prescription of PPIs was found in 73.9 percent of older patients. A second study found 25 percent of long-term PPI users could stop taking the medication without an increase in acid reflux or heartburn. The PPI use, however, could be negatively affecting health — the medications have been linked to a 20 to 50 percent higher risk of chronic kidney disease.
Dr. Malaz Boustani, a leading expert on aging, told CBS the findings are surprising enough that he plans to share the information with patients. He said that previous studies had linked another type of antacid, H2 blockers, to an increased risk of dementia as well. Up until now, he had recommended patients use PPIs to treat acid reflux instead of H2 blockers like Pepcid, Zantac, and Tagamet.
“I’m going to disclose the findings to my patients and then let them decide whether they will take the risk or not,” said Boustani, a professor of medicine with the Indiana University center for Aging Research and a spokesman for the American Federation for Aging Research. “On Monday I have clinic and if I have patients taking a PPI or an H2 blocker, I will tell them exactly what I’m telling you, and then they can decide.”
Some doctors believe the study is intriguing, but not enough so that doctors should wean patients off PPI use just yet. Keith Fargo, director of scientific programs and outreach for the Alzheimer’s Association, believes there simply isn’t enough evidence.
“It does not tell us anything that should change medical practice right now,” Fargo said. “I don’t think there’s going to be an uprising among doctors telling patients not to take their PPIs. This doesn’t rise anywhere near the level of evidence you would need for that.”
Source: Gomm W, von Holt K, Thome F, Broich K, Maier W, Fink A, et al. Association of Proton Pump Inhibitors With risk of Dementia. JAMA Neurology. 2016.