April 2016

Do Proton Pump Inhibitors Increase the Risk of Dementia?

Author Affiliations
  • 1Graduate School of Public Health, Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania

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JAMA Neurol. 2016;73(4):379-381. doi:10.1001/jamaneurol.2015.4931

In 2015, the German Study on Aging, Cognition and Dementia in Primary Care Patients reported that among 2911 persons 75 years of age or older, the use of proton pump inhibitors (PPIs) was associated with an increased risk of dementia (hazard ratio [HR], 1.33 [95% CI, 1.04-1.83) and an increased risk of Alzheimer disease (HR, 1.44 [95% CI, 1.01-2.06]).1 The study by Gomm et al2 used a large German insurance database to link PPI use and subsequent incidence of dementia using both inpatient and outpatient medical records. They have found a similar increase in the risk of dementia among PPI users (HR, 1.44 [95% CI, 1.36-1.52]).2 Determining the relatively low prevalence of PPI use among older individuals required a very large database with available follow-up information about incidence of dementia to evaluate the association of PPI use and dementia. The use of an administrative database restricts the quality of the diagnosis of dementia and types of dementia. The availability of their prior study with a smaller sample size but a more detailed evaluation of dementia enhances the possible validity of their conclusions.

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