Research published this week in the journal Neurology has linked use of proton pump inhibitor (PPI) medication used for acid reflux to dementia.
According to a “classification of evidence” included in the study, it indicates that use of prescribed PPIs for more than 4.4 years by individuals age 45 and older is associated with a higher incidence of newly diagnosed dementia.
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Acid reflux & PPIs
While “stomach acid is natural, a valuable chemical contributor to orderly digestion,” according to Harvard Health Publishing, excess stomach acid can lead to heartburn, acid reflux and gastroesophageal reflux disease or GERD.
“Gastroesophageal reflux disease (GERD) is a more severe and long-lasting condition,” that can lead to complications over time, said the National Institute of Diabetes and Digestive and Kidney Diseases.
PPIs “are medicines that work by reducing the amount of stomach acid made by glands in the lining of your stomach,” per the National Library of Medicine. A 2010 study explained that they work by blocking “the gastric H,K-ATPase, inhibiting gastric acid secretion,” to reduce stomach acid.
Common PPIs include Prilosec (an over the counter medication) and Nexium. Antacids are another type of medicine used to treat acid reflux symptoms.
PPIs & dementia
Authors of the recent study said that research into the “association between proton pump inhibitor (PPI) use and dementia report mixed results and do not examine the impact of cumulative PPI use,” prompting them to study the impact of long-term use. They used data from participants involved in a community-based cohort (ARIC) from the time of enrollment spanning from the late eighties through 2017.
A total of 5,712 participants who were dementia-free at a certain part of the study were included in the researchers’ analysis. There were 585 cases of incident dementia over a median follow up time, said the study.
“Dementia is not a specific disease but is rather a general term for the impaired ability to remember, think, or make decisions that interferes with doing everyday activities. Alzheimer’s disease is the most common type of dementia,” according to the U.S. Centers for Disease Control and Prevention.
Millions of adults in the U.S. are currently diagnosed with dementia, and numbers are expected to rise to 14 million by 2060. While some memory changes are expected with aging, dementia is not considered a normal part of aging.
Dr. Gregory Day – an associate professor in the Department of Neurology at the Mayo Clinic in Jacksonville, Florida, and a fellow of the American Academy of Neurology – told CNN that PPIs may be linked to dementia due to the way they alter enzymes. He was not involved in the study.
He said PPIs may “decrease the level of the body’s chemical that is there to cut off the amyloid in specific ways,” which, in theory, could “increase amyloid in the brain, increasing the risk of Alzheimer’s disease, and Alzheimer’s is the number one cause of dementia.”
Amyloid protein aggregate deposits found in the brain have been linked to Alzheimer’s disease.
Going forward
“Future studies are needed to understand possible pathways between cumulative PPI use and the development of dementia,” authors of the recent study concluded.
In a statement provided to CNN, study author Dr. Kamakshi Lakshminarayan, a neurologist at the University of Minnesota School of Public Health in Minneapolis and a member of the American Academy of Neurology, said that their research doesn’t prove PPIs cause dementia.
“It only shows an association,” she explained. “More research is needed to confirm our findings in other large study groups and understand the possible link between long-term proton pump inhibitor use and higher risk of dementia.”
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