Individuals who take acid reflux disorder medications called proton pump inhibitors for four-and-a-half years or more could have a better risk of dementia in comparison with individuals who don’t take these medications, in line with recent research published within the August 9, 2023, online issue of Neurology®, the medical journal of the American Academy of Neurology. This study doesn’t prove that acid reflux disorder drugs cause dementia; it only shows an association.

Acid reflux disease is when stomach acid flows into the esophagus, often after a meal or when lying down. Individuals with acid reflux disorder may experience heartburn and ulcers. Individuals with frequent acid reflux disorder may develop gastroesophageal reflux disease, or GERD, which may result in cancer of the esophagus.

Proton pump inhibitors reduce stomach acid by targeting the enzymes within the stomach lining that produce that acid.

“Proton pump inhibitors are a useful gizmo to assist control acid reflux disorder, nevertheless long-term use has been linked in previous studies to a better risk of stroke, bone fractures and chronic kidney disease,” said study writer Kamakshi Lakshminarayan, MBBS, PhD, of the University of Minnesota School of Public Health in Minneapolis, and a member of the American Academy of Neurology. “Still, some people take these drugs frequently, so we examined in the event that they are linked to a better risk of dementia. While we didn’t discover a link with short-term use, we did find a better risk of dementia related to long-term use of those drugs.”

The study included 5,712 people, age 45 and older, who didn’t have dementia at the beginning of the study. That they had a median age of 75.

Researchers determined if participants took acid reflux disorder drugs by reviewing their medications during study visits and through yearly phone calls. Of the participants, 1,490 people, or 26%, had taken the drugs. Participants were then divided into 4 groups based on whether or not they had taken the drugs and for the way long, as follows: individuals who didn’t take the drugs; those that took the drugs for as much as 2.8 years; those that took them for two.8 to 4.4 years; and other people who took them for greater than 4.4 years.

Participants were then followed for a median duration of 5.5 years. During this time, 585 people, or 10%, developed dementia.

Of the 4,222 individuals who didn’t take the drugs, 415 people developed dementia, or 19 cases per 1,000 person-years. Person-years represent each the number of individuals within the study and the period of time all and sundry spends within the study. Of the 497 individuals who took the drugs for greater than 4.4 years, 58 people developed dementia, or 24 cases per 1,000 person years.

After adjusting for aspects comparable to age, sex and race, in addition to health-related aspects comparable to hypertension and diabetes, researchers found individuals who had been taking acid reflux disorder drugs for greater than 4.4 years had a 33% higher risk of developing dementia than individuals who never took the drugs.

Researchers didn’t find a better risk of dementia for individuals who took the drugs for fewer than 4.4 years.

“More research is required to substantiate our findings and explore reasons for the possible link between long-term proton pump inhibitor use and a better risk of dementia,” said Lakshminarayan. “While there are numerous ways to treat acid reflux disorder, comparable to taking antacids, maintaining a healthy weight, and avoiding late meals and certain foods, different approaches may not work for everybody. It can be crucial that individuals taking these medications speak with their doctor before making any changes, to debate the most effective treatment for them, and since stopping these drugs abruptly may lead to worse symptoms.”

A limitation of the study was that participants were asked every year about medication use, so researchers estimated use between annual check-ins. If participants stopped and restarted acid reflux disorder drugs in between check-ins, estimation of their use could have been inaccurate. The authors were also unable to evaluate if participants took over-the-counter acid reflux disorder drugs.

The study was supported by the National Institutes of Health, including the National Heart, Lung, and Blood Institute.

Source:

American Academy of Neurology