A new study has shed light on one of the long-term effects of proton pump inhibitors (PPIs). These drugs are commonly used to treat gastroesophageal reflux disease (GERD), heartburn, and peptic ulcers. PPIs (omeprazole, lansoprazole, esomeprazole, pantoprazole, and others) help reduce the amount of stomach acid made by glands in the lining of the stomach.
Research published online on February 15 in JAMA Neurology showed that there may be an association between chronic use of PPIs and an increased risk of dementia. Experts compared prescription PPI intake and diagnosis of dementia among approximately 74,000 adults ages 75 and older. In the study, chronic PPI use was defined as at least one prescription every three months in an 18-month window. The most common PPIs in use were omeprazole (Prilosec), pantoprazole (Protonix), and esomeprazole (Nexium). All participants were free of dementia at the study’s beginning. Yet, after the eight-year follow-up, chronic PPI users had a 44% increased risk of dementia compared with those who did not take any medication. Men were at a slightly higher risk than women. Occasional users of PPIs had a much lower risk.
Putting the results in perspective
The researchers were quick to stress that this study only provided a statistical association between PPI use and risk of dementia, and that taking PPIs does not automatically mean you will get dementia. However, the study continues the ongoing discussion about the impact of long-term medication use, according to Dr. Houman Javedan, clinical director of inpatient geriatrics at Harvard-affiliated Brigham and Women’s Hospital. “Older adults take more medications as they age, and often continue them long after they are still necessary,” he says. “They either get used to taking it, and do not think to ask their doctor if they should stop, or they are afraid of what might happen if they do.”
Many older adults also take multiple drugs at one time, a situation known as polypharmacy. In fact, an estimated 44% of men and 57% of women older than age 65 take five or more medications; 12% of both men and women in this age group take 10 or more. “How different drugs interact with each other, and what the consequences of long-term use are, continues to be explored by scientists, as the researchers tried to do in this case with PPIs,” says Dr. Javedan.
It is not clear how PPIs might make a person more vulnerable to dementia. Evidence suggests parts of the drug may cross the blood–brain barrier, which becomes more porous as a person ages, and interact with brain enzymes. In initial animal studies, PPIs were shown to increase levels of beta amyloid in the brains of mice, and higher amounts of this protein have been linked to dementia and Alzheimer’s disease. Other research has shown a possible connection between chronic PPI use and vitamin B12 deficiencies, as well as an increased risk of osteoporosis. “There still may be other mechanisms at work that are unknown,” says Dr. Javedan. “But this study raises the question whether chronic PPI usage is safe, especially among the older population.”
What you should do if you take PPIs
If you currently take PPIs every day, or have for more than 18 months, you should consult with your doctor about whether to continue at your current dosage, Dr. Javedan suggests. “You only may need it when you have symptoms and not endlessly.”
Related Information: The Sensitive Gut
Bible verses for today’s meditation and inspiration: Matthew E. McLaren
Take delight in the Lord, and he will give you the desires of your heart. Psalm 37:4 NIV
Each of you should give what you have decided in your heart to give, not reluctantly or under compulsion, for God loves a cheerful giver. 2 Corinthians 9:7 NIV
A cheerful heart is good medicine, but a crushed spirit dries up the bones. Proverbs 17:22 NIV
My son, do not forget my teaching, but keep my commands in your heart, for they will prolong your life many years and bring you peace and prosperity. Proverbs 3:1-2 NIV
The wise in heart accept commands, but a chattering fool comes to ruin. Proverbs 10:8 NIV
I seek you with all my heart; do not let me stray from your commands. Psalm 119:10 NIV
Be strong and take heart, all you who hope in the Lord. Psalm 31:24 NIV
Teach us to number our days, that we may gain a heart of wisdom. Psalm 90:12 NIV
I will praise you with an upright heart as I learn your righteous laws. Psalm 119:7 NIV
Blessed are those who keep his statutes and seek him with all their heart. Psalm 119:2 NIV
Truly I tell you, if anyone says to this mountain, ‘Go, throw yourself into the sea,’ and does not doubt in their heart but believes that what they say will happen, it will be done for them. Mark 11:23 NIV
May these words of my mouth and this meditation of my heart be pleasing in your sight, Lord, my Rock and my Redeemer. Psalm 19:14 NIV
But be very careful to keep the commandment and the law that Moses the servant of the Lord gave you: to love the Lord your God, to walk in obedience to him, to keep his commands, to hold fast to him and to serve him with all your heart and with all your soul. Joshua 22:5 NIV
Psalm 38:3 There is no soundness in my flesh because of Your indignation; There is no health in my bones because of my sin.
Matthew 9:12-13 But when Jesus heard this, He said, “It is not those who are healthy who need a physician, but those who are sick. “But go and learn what this means: ‘I DESIRE COMPASSION, AND NOT SACRIFICE,’ for I did not come to call the righteous, but sinners.”
Luke 5:31-32 And Jesus answered and said to them, “It is not those who are well who need a physician, but those who are sick. “I have not come to call the righteous but sinners to repentance.”
Exodus 15:2 “The LORD is my strength and song, And He has become my salvation; This is my God, and I will praise Him; My father’s God, and I will extol Him.
Acts 3:16 “And on the basis of faith in His name, it is the name of Jesus which has strengthened this man whom you see and know; and the faith which comes through Him has given him this perfect health in the presence of you all.
Exodus 23:25 “But you shall serve the LORD your God, and He will bless your bread and your water; and I will remove sickness from your midst. Philippians 4:6-7
Be anxious for nothing, but in everything by prayer and supplication with thanksgiving let your requests be made known to God.
Psalm 32:4-5 For day and night Your hand was heavy upon me; My vitality was drained away as with the fever heat of summer. Selah. I acknowledged my sin to You, And my iniquity I did not hide; I said, “I will confess my transgressions to the LORD”; And You forgave the guilt of my sin.
Recommended contacts for prayer request and Bible study