New research has found that long-term use of proton pump inhibitors (PPIs), a common medication for heartburn and acid reflux, may be linked to a higher risk of dementia. The study, published in the journal Neurology, discovered that people aged 45 and above who took PPIs for more than four years had a 33% increased risk of developing dementia compared to those who never took the drugs. However, the study does not prove that PPIs cause dementia, only that there is an association.
Dementia is an umbrella term for memory loss and cognitive decline caused by damage to brain cells. PPIs work by reducing stomach acid, which can treat symptoms of acid reflux and gastroesophageal reflux disease (GERD). These medications are widely available over the counter and are frequently used to treat heartburn. Experts say that people who occasionally take PPIs should not be concerned, and more research is needed to confirm the link between long-term use of the drugs and dementia risk.
The study examined 5,712 participants aged 45 to 64 who did not have dementia at the beginning of the study. Of these, 26% (approximately 1,500 people) took PPIs. After adjusting for other factors such as age, sex, and underlying health conditions, the researchers found that out of 497 people who took PPIs for nearly 4.5 years, 58 developed dementia. In comparison, 415 out of 4,222 participants who did not take the drugs developed dementia. The study did not find a higher risk for those who took PPIs for less than 4.4 years.
The research team identified potential links between PPI overuse and dementia, including vitamin B12 deficiency and impaired amyloid metabolism. Some studies have shown that acid reflux drugs might contribute to low levels of vitamin B12, which is associated with impaired thinking and memory loss. The researchers did not have B12 data for study participants, so they could not confirm this theory. Another possible link is the effect of PPIs on enzymes in the brain that clear amyloid protein, a key component in Alzheimer’s disease. PPIs might alter these enzymes, leading to an accumulation of amyloid in the brain.
Experts suggest that people who have been taking PPIs for over four years should consult their doctor to explore other options. Suddenly stopping the medication may result in worse symptoms. For acid reflux and heartburn, alternative treatments such as over-the-counter antacids or H2 blockers, which neutralize stomach acid, can provide relief. However, it’s important to note that these alternatives may not work for everyone. Lifestyle changes, such as dietary adjustments and weight loss for individuals who are overweight, can also help reduce symptoms. Patients are advised to discuss their medications with their doctors and inform them about any over-the-counter medications they are taking.