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Long-Term Usage of Acid Reflux Drugs Linked to Potential Increase in Dementia Risk
Individuals who use proton pump inhibitors, a type of acid reflux medication, for an extended period of four and a half years or more, might face an elevated risk of dementia compared to those who don't utilize these medications, as indicated by recent research published in the August 9, 2023, online edition of Neurology®, the medical journal of the American Academy of Neurology. This study doesn't establish a direct cause-and-effect relationship between acid reflux drugs and dementia; it merely establishes a connection.
Acid reflux occurs when stomach acid moves into the esophagus, typically after eating or while lying down. People with acid reflux might experience heartburn and ulcers. Prolonged acid reflux can lead to gastroesophageal reflux disease (GERD), which could potentially result in esophageal cancer.
Proton pump inhibitors function by targeting the stomach lining enzymes responsible for producing stomach acid.
"While proton pump inhibitors are effective in managing acid reflux, previous studies have associated long-term usage with an increased risk of stroke, bone fractures, and chronic kidney disease," stated study author Kamakshi Lakshminarayan, MBBS, Ph.D., from the University of Minnesota School of Public Health in Minneapolis, and a member of the American Academy of Neurology. "Though some individuals regularly take these drugs, we delved into whether there's a connection to a heightened risk of dementia. Although we didn't find a correlation with short-term usage, we did discover an elevated risk of dementia associated with prolonged use."
The study encompassed 5,712 participants aged 45 and above, without pre-existing dementia. Their average age was 75.
Researchers determined participants' use of acid reflux medications by analyzing their medications during study visits and yearly phone conversations. Out of the participants, 1,490 individuals, constituting 26%, had used these drugs. The participants were divided into four groups based on their drug usage and duration, namely: those who didn't take the drugs, those who used them for up to 2.8 years, those who used them for 2.8 to 4.4 years, and those who used them for over 4.4 years.
These participants were then monitored for a median span of 5.5 years. During this time, 585 participants, equivalent to 10%, developed dementia.
Of the 4,222 participants not taking the drugs, 415 individuals developed dementia, translating to 19 cases per 1,000 person-years. Person years denote both the number of people in the study and the time each person spends in it. Among the 497 individuals who used the drugs for over 4.4 years, 58 individuals developed dementia, amounting to 24 cases per 1,000 person-years.
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Upon accounting for factors like age, gender, race, and health-related variables such as high blood pressure and diabetes, researchers observed that individuals who had been using acid reflux drugs for more than 4.4 years faced a 33% elevated risk of developing dementia compared to those who had never used such medications. Conversely, individuals who had taken these drugs for less than 4.4 years did not exhibit a heightened risk of dementia.
"Further research is required to validate our findings and delve into the potential association between prolonged usage of proton pump inhibitors and an increased risk of dementia," Lakshminarayan stated. "While there are various approaches to manage acid reflux, such as taking antacids, maintaining a healthy weight, and avoiding late meals and specific foods, these strategies may not suit everyone. It's crucial for individuals using these medications to consult their doctor before altering their regimen, to discuss the optimal treatment for their situation, as abruptly stopping these drugs could lead to exacerbated symptoms."
The study had a limitation in that participants were inquired about their medication use annually, resulting in estimated use between these intervals. If participants stopped and resumed using acid reflux drugs within these periods, the estimation of their usage might not have been precise. The authors also couldn't evaluate whether participants used over-the-counter acid reflux medications.
Support for the study was provided by the National Institutes of Health, including the National Heart, Lung, and Blood Institute.
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