For example, the researchers were not privy to information that may have offered an alternative explanation for individuals' cognitive deterioration, including genetic risk for Alzheimer's, explains lead investigator Britta Haenisch. It is tricky to prove or disprove the proposed PPI-dementia link using an observational study. In a related editorial in the same issue, Kuller estimated that thousands of otherwise avoidable dementia cases could occur in Germany, assuming the risk reported in the study is accurate, even if only 3 percent of the country's elderly use PPIs. nursing home residents use them) and the devastating, difficult-to-treat effects of dementia, says University of Pittsburgh epidemiology researcher Lewis Kuller, who was not involved in the study. The results are potentially worrisome considering the number of elderly individuals who take PPIs (recent studies estimate more than one quarter of U.S. On average, participants who filled a prescription for a PPI at least once every three months were more than 40 percent more likely to develop dementia than their PPI-free counterparts, according to the paper published online in February in JAMA Neurology. After adjusting for age, sex, potentially related conditions such as stroke or depression, and use of other prescription drugs, the team found that dementia diagnoses were more common in individuals with regular PPI prescriptions. The group included 2,950 participants who were routinely prescribed PPIs and 70,729 who had not used such drugs.ĭuring the course of seven years, 29,510 participants developed some form of cognitive decline, ranging from unspecified dementia to Alzheimer's disease. They scrutinized filled prescriptions and disease diagnoses for 73,679 individuals who were aged 75 years or older when the study began in 2004. The team at the German Center for Neurodegenerative Diseases and elsewhere analyzed health insurance claims records for tens of thousands of elderly individuals, obtained from a large provider of mandatory national health insurance in Germany. THE DETAILSĪs was widely reported in the media in February, German researchers discovered a possible link between PPI use and dementia. THE FACTSĪ direct link between PPI use and dementia remains unproved, but the association is plausible and warrants further investigation given the debilitating nature of dementia and lack of effective treatments for it. Routine use of proton-pump inhibitors (PPIs)-drugs such as Nexium and Prilosec, used to treat heartburn, gastroesophageal reflux disease or peptic ulcers-may cause or accelerate dementia in elderly individuals.
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