Researchers at Copenhagen University Hospital and Aarhus University in Denmark have explored the potential connection between proton pump inhibitors (PPIs), commonly used antacid medications that reduce stomach acid production, and an increased risk of dementia.
Their study, titled “Proton pump inhibitors and dementia: A nationwide population-based study,” was published in Alzheimer’s & Dementia.
The research reveals significant associations between the use of PPIs, the duration of use, and a heightened risk of dementia.
A Comprehensive Study
The study encompassed a nationwide Danish cohort of 1,983,785 individuals aged 60 to 75 from 2000 to 2018. It specifically included participants who had not received a prior dementia diagnosis or dementia-specific treatment.
Among the study group, 99,384 individuals developed dementia, while 469,920 served as a control group.
PPIs and Dementia Risk
The research showed that the use of PPIs was linked to an increased risk of all-cause dementia, with a more pronounced association observed among individuals aged 60 to 69 at the time of diagnosis.
For this age group, the incidence rate ratio ranged from 1.25 to 1.59 based on the duration of PPI use, and the overall ratio was 1.36 for those who had ever used a PPI.
In the 70 to 79 and 80 to 89 age groups, the elevated risk was less significant, with ratios of 1.12 and 1.06, respectively, for those who had ever used PPIs.
No substantial association between PPI use and dementia risk was detected for individuals over 89 years old at the time of diagnosis.
Duration Matters
The study further revealed that longer cumulative use of PPIs was associated with higher risk estimates for all-cause dementia occurring before the age of 90.
The findings suggest that the younger the individuals were when they used PPIs, the more prominent the potential risk.
Unclear Causality
It’s essential to note that the study does not establish a direct cause-and-effect relationship between PPI use and dementia.
The connection could be more complex, involving factors like reverse causality, where increased stomach acid production occurs early in the development of dementia, prompting the use of PPIs to alleviate symptoms.
Alternatively, PPI treatment might disrupt processes that contribute to dementia.
Gut-Brain Connection
The study also considers the gut-brain connection, involving the enteric nervous system and specific gut microbiota populations. Disruptions in these systems could potentially contribute to the observed associations.
The Need for Further Research
The authors emphasize the necessity for additional research to delve into the underlying mechanisms of this association and to determine if it varies among different subtypes of dementia.
While the study suggests a correlation between PPI use and dementia risk, more comprehensive investigations are required to uncover the intricacies of this relationship and its potential implications for healthcare and treatment strategies.
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The research findings can be found in Alzheimer’s & Dementia.
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