New link between acid reflux medicines and dementia

New link between acid reflux medicines and dementia
One of the many popular brands of PPIs commonly used in the US
One of the many popular brands of PPIs commonly used in the US
View 1 Image
One of the many popular brands of PPIs commonly used in the US
One of the many popular brands of PPIs commonly used in the US

Previously linked to a higher risk of stroke and heart attack, popular acid reflux medicines have now been connected to an increased likelihood of developing age-related dementia.

The medicines are a specific kind of treatment known as proton pump inhibitors (PPIs), which as the name suggests act on the proton pumps that produce acid released into the stomach. This prevents excess acid flowing into the esophagus and causing heartburn and other serious gastrointestinal issues, which can even lead to cancer.

They’re one of the most commonly used medicines across the globe, with an estimated 15 million Americans taking them annually. They’re both available with prescription and in over-the-counter form.

In the US, you’ll find Omeprazole (Prilosec, Prilosec OTC, Zegerid), Esomeprazole (Nexium, Nexium 24HR), Lansoprazole (Prevacid, Prevacid 24HR), Dexlansoprazole (Dexilant), Pantoprazole (Protonix), Rabeprazole (AcipHex) and Esomeprazole/ Naproxen (Vimovo).

“Proton pump inhibitors are a useful tool to help control acid reflux, however long-term use has been linked in previous studies to a higher risk of stroke, bone fractures and chronic kidney disease,” said study author Kamakshi Lakshminarayan, of the University of Minnesota School of Public Health in Minneapolis. “Still, some people take these drugs regularly, so we examined if they are linked to a higher risk of dementia. While we did not find a link with short-term use, we did find a higher risk of dementia associated with long-term use of these drugs.”

The American Academy of Neurology researchers looked at 5,712 people in the Atherosclerosis Risk in Communities (ARIC) Study, aged 45 to 64, who did not have dementia at the time of their first health assessment (1987-1989).

Nearly 1,500 participants, more than a quarter, took PPIs during the study time. After adjusting figures for age, sex, race and comorbidities such as high blood pressure, the researchers found that those using PPIs for 4.4 years or longer had a 33% higher risk of developing dementia than those who never took the drugs. Some 497 participants reported prolonged PPI use (more than four years, four months) and 58 developed dementia.

However, there was no elevated risk for anyone who had intermittent PPI use or took them for a period less than the statistical red flag of four years and four months.

Of course, this study does not probe causation, but provides a lot of new scope for studying long-term medicine usage and what other mechanisms might be triggered by proton pump inhibition.

“While there are various ways to treat acid reflux, such as taking antacids, maintaining a healthy weight, and avoiding late meals and certain foods, different approaches may not work for everyone,” said Lakshminarayan. “It is important that people taking these medications speak with their doctor before making any changes, to discuss the best treatment for them, and because stopping these drugs abruptly may result in worse symptoms.”

There are also PPI alternatives such as H2 blockers, which act by binding to the histamine type 2 receptors on the surface of gastric parietal cells, disrupting acid production and secretion.

However, the scientists urge caution with altering medications and note that the study has its limitations, such as accuracy in self-reporting, and confounding health links such as the potential elevated risk of dementia due to depleted B12 levels (B12 was not assessed in participants). And not all previous work on PPIs and cognition have offered conclusive negative results.

“More research is needed to confirm our findings and explore reasons for the possible link between long-term proton pump inhibitor use and a higher risk of dementia,” said Lakshminarayan.

The research was published in the journal Neurology.

Source: American Academy of Neurology.

I took one of these drugs years ago when I had acid reflux disease. I also raised the head of my bed about 6",and used that for several years. Eventually,I cured my acid reflux disease that way.
Voice of Reason
In my younger days, I suffered from regular heartburn and vocal chord irritation along with risk for esophageal cancer due to a hiatus hernia and gastric reflux. Since starting omeprazole daily, I have had no symptoms (though they do return if I stop omeprazole for a few days). The alternative is surgery to place a restrictive collar on my esophagus and repair the hernia. At 76 now, I'll stick with the daily omeprazole. thank you.
It has been known for many years, the real cause of the contemporary acid reflux-epidemic (in over 90% of the cases) is stress. Prescribing and taking antacids and/or proton pumps are no cure. (Just the opposite: they are harmful for your body.) It is quite sad, so little research is done about the roots of the problem. Can’t help thinking about the business-aspects of the issue…

This is amazing. Acid reflux is caused by diet. Simply overeating anything is guaranteed to cause you acid reflux. Also eating too much fat is also guaranteed to cause acid reflux especially processed fats like all forms of junk food, fast food, and cheeses, oil, or anything made from processed vegetable oil. A little bit of exercise, a little bit of self restraint and avoidance of these foods, and one never needs acid reflux medicine. I'm 50 and have never taken it. On occasion when I overeat and get acid I drink almond milk, or take a couple of activated carbon tablets, but the best cure is a long walk, or weight lifting, and lots of water. Exercise is by far the best. 15 to 20 minutes in and the reflux is gone.

It's sad how Americans are murdering themselves. They work hard to make money but then they spend that money on horrible foods, eat too much then drive everywhere instead of walking some of that food off, so then they have to spend more money on terrible medicines that in the end cause more harm than good. Yet they freak out over a ONE TIME vaccine, while popping these pills EVERY DAY. Do the math. Which do you think will harm you more? A one or two time vaccine or popping pills every-single-day for years. And mixing and matching all kinds of pills. We can blame the pharmaceutical companies for this but at the end of the day Americans are all about self determination. Well if you want self determination you need to be responsible for your actions and use your brain to think logically and do the math. Eat too much + too much junk snacks - Exercise = Acid reflux and a ton of other health problems. Taking too many pills for problems that you yourself caused will have side effects and consequences. I'm sorry to the be blunt but Americans deserve their own self inflicted suffering. The information is everywhere, why don't' you all understand this?
fofu; I was prescribed PPI's back in the early 90's to cure stomach ulcers, which believe it or not are actually caused by stress in my case, in fact they have discovered recently that when the body is under stress, mental stress, some people can produce a chemical which then stimulates acid generation within the stomach.
I am a fit active 57 year old who only takes PPI's when I need to, so not all the time.

Another consequence of taking PPI's that was kept very quite at the beginning, is if you come off them then the cells that send the signal to generate stomach acid, grow back two fold... And the possibility of Kidney failure etc etc...
I've just been ordered on to an 80mg per day does due to multiple stomach ulcers that are inflaming my duodenum and restricting stomach contents going in to my small intestine. How to stop Reflux Acid without PPI's, vomit, that works for me... But that comes with its own side effects again.

And no I'm not American, and don't have access to fast food.

Don't tar everybody with the same brush.
Just saying...
I had some serious digestive issues that I couldn't tie to a specific cause. An allergist suggested that I might be experiencing fructose malabsorption. After looking into it, I did a dietary challenge by eliminating it as best I could for two weeks. To my surprise, it also eliminated the rather severe bouts of acid reflux that I had been dealing with for many years.

The hardest part of changing my diet was eliminating high fructose corn syrup. It's everywhere, hence the reason I couldn't determine the cause! Even something as basic as chocolate milk can contain it. Incidentally, all of my problems began around the time that soft drink manufacturers changed their recipes.

If you have acid reflux/GERD, a dietary challenge is a safe and simple way to determine if this is an issue ... you just have read the labels.