Is There A Link Between Proton Pump Inhibitors and Dementia?

MedicalResearch.com Interview with:
Dr. Britta Haenisch PhD

German Center for Neurodegenerative Diseases (DZNE) 

Medical Research: What is the background for this study?

Dr. Haenisch: Proton pump inhibitors (PPIs) are widely used for the treatment of gastrointestinal diseases, but have also been shown to be potentially involved in cognitive decline: There were hints from recent other studies that PPIs might affect cognition, e.g. Lam et al. (2013) report a significant association of PPI use with vitamin B12 deficiency in a population-based sample. Vitamin B12 deficiency has been shown to be associated with cognitive decline. In another study, PPIs were observed to enhance amyloid beta peptide (Aβ) levels in mouse brain by affecting the enzymes β- and γ-secretase which leads to increased Aβ levels in mice.

Medical Research: What are the main findings?

Dr. Haenisch: The current study provides a statistical association (applying a time-dependent analysis) between proton pump inhibitors prescription and occurrence of dementia with a focus on long-term regular PPI prescription in patients aged 75 years and older. In our analysis we focused on long-term regular PPI prescription for at least 18 months. It does not prove that proton pump inhibitors cause dementia.

References

-Lam JR, Schneider JL, Zhao W, Corley DA. Proton pump inhibitor and histamine 2 receptor antagonist use and vitamin B12 deficiency. JAMA. 2013;310(22):2435-2442.

-Badiola N, Alcalde V, Pujol A, et al. The proton-pump inhibitor lansoprazole enhances amyloid beta production. PLoS One. 2013;8(3):e58837

Medical Research: What should clinicians and patients take away from your report?

Dr. Haenisch: Patients should take proton pump inhibitors according to their doctor’s instructions. Clinicians should follow guidelines for PPI prescription to avoid overprescribing PPIs and inappropriate use.

To evaluate cause and effect relationships between long-term proton pump inhibitors use and possible effects on cognition in the elderly randomized, prospective clinical trials are needed.

Medical Research: What recommendations do you have for future research as a result of this study?

Dr. Haenisch: To evaluate cause and effect relationships between long-term  proton pump inhibitors use and possible effects on cognition in the elderly randomized, prospective clinical trials are needed. Furthermore, the possible underlying causal biological mechanism has to be explored in future studies.

Citation:

Dr. Britta Haenisch (2016). Is There A Link Between Proton Pump Inhibitors and Dementia? MedicalResearch.com

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