Dr. Bray Links

Tuesday, March 8, 2016

Reflux medication higher risk for dementia than diabetes?


A new study from the German Center for Neurodegenerative Diseases published online February 15, 2016 in JAMA Neurology, has confirmed the suspected link between PPIs and dementia. The study used the largest mandatory public health insurer in Germany, which includes one third of the overall population and as much as 50% of the elderly population. Its database includes information on diagnoses and drug prescriptions.

The analysis included 73,679 subjects aged 75 years or older who initially did not have dementia at baseline. The results showed that the patients who were regularly using a PPI had a 44% greater risk for dementia compared with those not taking PPIs. It did not seem to matter what brand/form of PPI was used. The results were similar for all of them.

In addition to the link between PPIs and vitamin B12 deficiency, there is evidence that PPIs may get into the brain and cause an increase in the beta-amyloid deposits characteristic of Alzheimer’s disease.

Having diabetes and being prescribed five or more drugs other than the PPI (defined as polypharmacy) were also associated with significantly elevated dementia risk, but the risk was about a 16% increase. That was much lower than the 44% increased risk due to regular PPI use.

These results of the study highlight the need for first eliminating inappropriate PPI prescribing and then looking to natural alternatives for peptic ulcers, GERD, and other conditions currently being treated with PPIs.

Gomm W, von Holt K, Thomé F, et al. Association of Proton Pump Inhibitors With Risk of Dementia: A Pharmacoepidemiological Claims Data Analysis. JAMA Neurol. 2016 Feb 15. doi: 10.1001/jamaneurol.2015.4791. [Epub ahead of print]


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