Dementia risk is not elevated for older PPI users

  • J Am Geriatr Soc

  • Susan London
  • Clinical Essentials
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Takeaway

  • Compared with nonusers, proton pump inhibitor (PPI) users did not have a significantly elevated risk for dementia regardless of cumulative exposure or duration of use.

Why this matters

  • PPIs are commonly prescribed and have been linked to dementia risk in some studies.
  • Older adults already have higher dementia incidence.

Key results

  • Overall, 23.7% of the cohort developed dementia.
  • Relative to nonusers, PPI users were not more likely to develop dementia risk (P=.66) or Alzheimer’s disease specifically (P=.77).
  • There was no significant elevation of risk with cumulative PPI exposure corresponding to daily use of approximately 1 y (HR, 0.87; 95% CI, 0.65-1.18), 3 y (HR, 0.99; 95% CI, 0.75-1.30), or 5 y (HR, 1.13; 95% CI, 0.82-1.56).
  • Additionally, findings were similar regardless of duration of PPI use.

Study design

  • A population-based prospective cohort study of 3484 dementia-free patients aged 65 y and older (median, 74 y) from an integrated health system.
  • Main outcome was incident dementia during mean follow-up of 7.5 y.
  • Funding: National Institute on Aging.

Limitations

  • Cumulative dose was assessed for a 10-y period.
  • Most patients were of European descent.
  • The group with high level of PPI use was small.