Do proton pump inhibitors increase the risk of dementia?

  • Zhang Y & al.
  • Eur J Clin Pharmacol
  • 21 Nov 2019

  • curated by Sarfaroj Khan
  • UK Clinical Digest
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Takeaway

  • This meta-analysis found that the use of proton pump inhibitors (PPIs) was a risk factor for dementia.
  • The risk was higher in individuals using PPIs aged ≥ 65 years.

Why this matters

  • Active screening for long-term PPIs use and re-evaluation of medication after appropriate investigations and diagnosis should be included in routine geriatric care practices.

Study design

  • Meta-analysis included 6 studies (n=166,146) after a search across PubMed, Web of Science and other databases.
  • Funding: None disclosed.

Key results

  • PPIs use vs no use was associated with an increased risk for dementia (HR, 1.29; 95% CI, 1.12-1.49; I2=61.2%).
  • In subgroup analyses:
    • PPIs use was significantly associated with an increased risk for dementia in participants aged ≥40 years (HR, 1.29; 95% CI, 1.12-1.49; I2=61.2%) and ≥65 years (HR, 1.39; 95% CI, 1.17-1.65).
    • The risk for dementia was higher among PPIs users during follow-up time ≥5 years (HR, 1.28; 95% CI, 1.12-1.46; I2=59.1%) and
    • In the case of regional impact, participants from Europe showed an overall pooled HR estimate of 1.46 (95% CI, 1.23-1.73).
    • No significant association was observed between PPIs use and the risk for dementia in participants from Asia (HR, 1.17; 95% CI, 0.98-1.38) and North America (HR, 1.13; 95% CI, 0.82-1.56).

Limitations

  • Heterogeneity among studies.
  • Risk of bias.