In Reply First, we thank the authors of the letters for their interest and comments concerning our article.1
Keller raises the issue that aluminum-containing antacids may have contributed to the onset of dementia. While the involvement of aluminum in the etiology of dementia still seems to be a matter of debate,2,3 this issue is interesting to examine in further studies. For our analysis, we were not able to include aluminum-containing antacids as these drugs are often not covered by the statutory health insurance in Germany. In a previous primary data analysis by our group, aluminum-containing antacids did not affect the results of proton pump inhibitor (PPI) exposure and dementia risk; however, this aspect was not included in the final publication.4