Is PPI use connected to dementia risk?

The prolonged use of PPI drugs, which are designed to control acid reflux and other gastrointestinal disorders, may raise the risk of dementia, according to a new study in Neurology.

The study included 5,712 older adults who were dementia-free at baseline, defined as visit 5 in the ongoing ARIC study.

The researchers reported that participants in the ARIC cohort who used PPIs for >4.4 years had a higher risk of dementia compared with those reporting no PPI use.

The participants were placed into four groups: those not using PPIs, those using them for up to 2.8 years, those using them for 2.8–4.4 years, and those using them for more than 4.4 years. Overall, 1,490 participants used PPIs, ranging from a minimum cumulative PPI use of 112 days to a maximum use of 20.3 years. Median use was 3.8 years, while mean use was 4.4 years. Over a median of 5.5 years, 585 people developed dementia. Only the participants who used PPIs for more than 4.4 cumulative years prior to visit 5 had a higher risk of developing dementia compared with those not using PPIs.

In a secondary analysis, the researchers examined the relationship between PPIs and dementia with histamine-2 receptor antagonists (H2Ras) as an active comparator. The results were similar, as more than 4.4 cumulative years of exposure to PPIs were associated with greater dementia risk compared with H2Ras. However, there was no association with use for shorter durations or current use.