Proton pump inhibitors, or PPIs, are medications used to treat gastrointestinal diseases such as acid reflux (GERD). These medications are commonly prescribed to patients in the community, and even more take their over-the-counter counterparts. This article describes a study done to measure the correlation of the use of PPIs with cognitive decline in older adults. The study analyzed data from a German health insurer to determine the association between patients 75 years or older who had prescribed PPIs such as omeprazole, pantoprazole, lansoprazole, esomeprazole, and rabeprazole and diagnoses of incident dementia from August to November 2015. The study also adjusted for confounding factors such as age, sex, comorbidities, and prescription of other medications. The study found that patients regularly taking PPIs had a significantly increased risk of incident dementia compared to patients not taking PPIs. The study concluded that not taking PPIs may decrease the risk of dementia onset, possibly because the use of PPIs has been associated with increased beta amyloid levels in the brains of mice (a characteristic of dementia patients), which may translate to having the same effects in humans.
Dementia is a health problem that pharmacists will continue to face with increasing frequency, especially as the baby boomer generation reaches the ages when the onset of dementia normally occurs. Since this disease state is one that also puts an extreme burden on the family and caregivers of dementia patients, it is imperative to identify its causes so that its onset can be prevented. I am very interested in seeing further studies done on the correlation between PPIs and dementia, as well the correlation of its onset with other frequently prescribed medications. What do you think the pharmacist’s role in patient education of this new finding will be, and how do you think it will affect the pharmacist’s job in the future?
Gomm W, von Holt K, Thomé F et al. Association of Proton Pump Inhibitors with Risk of Dementia. JAMA Neurol. doi:10.001/jamaneurol.2015.4791 (published 15 February 2016).