Abstract
IntroductionStudies have shown that proton pump inhibitors (PPIs) increase the brain burden of amyloid-beta (Aβ) and also create vitamin B12 deficiency. However, these two phenomena have deleterious effect on cognition and Alzheimer’s disease (AD). Since the use of PPIs has increased tremendously for the last few years, it is of great public health importance to investigate the cognitive impact of PPIs. Hence, the purpose of this study was to investigate the degree of neuropsychological association of each PPI with different cognitive functions.MethodsSixty volunteers of either gender were recruited and divided randomly into six groups: five test groups for five classes of PPIs and one control group. All the groups participated in the five computerized neuropsychological tests (nine subtests) of the Cambridge Neuropsychological Test Automated Battery twice: at the beginning of the study and 7 days thereafter.ResultsWe found statistically and clinically significant impairment in visual memory, attention, executive function, and working and planning function. One-way analysis of variance findings showed that all PPIs had a similar negative impact on cognition. However, paired-samples t tests indicated that omeprazole showed significant (p < 0.05) results in seven subtests; lansoprazole and pantoprazole showed significant results in five subtests; and rabeprazole showed significant results in four subtests. Among five classes of PPIs, esomeprazole showed comparatively less impact on cognitive function with significant results in three subtests.ConclusionsThe present study reveals for the first time that different PPIs have varying degrees of influence on different cognitive domains and have associations with AD. These findings should be considered when balancing the risks and benefits of prescribing these medications. A study done for a longer period of time with a larger sample size might yield better results.
Highlights
Studies have shown that proton pump inhibitors (PPIs) increase the brain burden of amyloid-beta (Aβ) and create vitamin B12 deficiency
The present study reveals for the first time that different PPIs have varying degrees of influence on different cognitive domains and have associations with Alzheimer’s disease (AD)
We found that the participants had a significant reduction in capacity to follow the instructions, as well as an increase in time needed to complete the respective tasks accurately
Summary
Studies have shown that proton pump inhibitors (PPIs) increase the brain burden of amyloid-beta (Aβ) and create vitamin B12 deficiency These two phenomena have deleterious effect on cognition and Alzheimer’s disease (AD). There is evidence that elderly patients are unnecessarily prescribed PPIs at the time of hospital admission as “gastroprotection” with the sole aim of avoiding potential legal prosecution of physicians in charge for ignoring medical care [13, 14]. Such overprescribing and overuse of PPIs raises concern about the aftermath of PPI-induced health hazards. Multicenter cohort study involving primary care elderly patients, Haenisch et al [17] showed that patients receiving PPI medication had a significantly increased risk of any dementia as well as Alzheimer’s disease (AD)
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