There is no link between a common class of acid reflux medications and increased dementia risk, say the authors of a systematic review and meta-analysis.
Recent studies have tied proton pump inhibitors to long-term adverse effects, including heightened dementia risk. The new review analyzed all published observational studies examining this link and found no evidence for it, reported corresponding author Colin W. Howden, M.D., FACG, from the University of Tennessee. More than 640,000 participants were included in the analysis, including PPI users and non-users.
“[W]e found no statistically significant or clinically meaningful association between PPI use and the development of dementia from all known causes or from Alzheimer disease specifically,” wrote Howden and his physician co-authors.
While as many as one in five older adults takes PPIs, reports citing a possible link to adverse outcomes may have scared off some users. A recent web-based survey of U.S. patients on PPI therapy revealed substantial levels of concern. Many of those surveyed reported discontinuing treatment without medical advice, the authors noted.
Based on the current review’s findings, clinicians should continue to judiciously prescribe proton pump inhibitors to reduce gastrointestinal distress as indicated in older adults, Howden concluded. “If PPI use in an elderly patient is for an appropriate indication, there is no justification to stop it because of concerns about dementia,” he wrote.
However, the researchers did note the ongoing problem with PPI overuse. The drugs have been notoriously been overprescribed in healthcare settings, including nursing homes and rehabilitation centers. Once prescribed, many adults continue to use the drugs without oversight by a physician, wrote Howden and colleagues.
Dr. Howden is a consultant for a number of pharmaceutical companies. His co-authors reported no conflicts of interest.
The study was published online this month in the American Journal of Gastroenterology.
