Abstract
Proton pump inhibitors (PPIs) are among the most prescribed medications. Previous epidemiological studies have presented contradictory results about PPIs and the risk of dementia. Our objective was to investigate the association between the use of PPIs and an increasing risk of incident AD or non-AD dementias. A community-based retrospective cohort study was conducted based on the data available from 1st January 2002 to 31st December 2015 in the Catalan health service (CatSalut) system. This cohort included all PPI users (N = 36,360) and non-users (N = 99,362). A lag window of 5 years was considered between the beginning of the PPI treatment and the diagnosis of dementia. PPI use was not associated with the risk of AD (adjusted odds ratio (OR) 1.06) (95% CI 0.93–1.21; p = 0.408). A weakly but significantly increased risk of non-AD dementias was observed among PPI users (adjusted OR 1.20, 95% CI 1.05–1.37; p = 0.007). A higher dose of PPIs was not associated with an increased risk of either AD or non-AD dementias (OR 1.20; 95% CI 0.91–1.61 and OR 0.95; 95% CI 0.74–1.22, respectively). Regarding the number of PPIs used, we observed an increased risk of AD (OR 1.47; 95% CI 1.18–1.83) and non-AD dementias (OR 1.38; 95% CI 1.12–1.70) in users of two types of PPIs compared with those who used only one type. We did not find a higher incidence of AD among PPI users, but a weak increase in the risk of non-AD dementias among PPI users was observed.
Highlights
Proton pump inhibitors (PPIs) are among the most prescribed medications
128,113 were excluded because they were younger than 45 at the beginning of the study, 8,593 were excluded because they were diagnosed with dementia or Alzheimer’s disease (AD) before the start of the study or in less than 5 years from the beginning of PPI usage, 33,021 were excluded because they died or moved out of Sanitary Region of Lleida (SRL) for different reasons during the period of the study, and 10,157 were excluded because of benzodiazepine use (Fig. 1)
We evaluated the risk of PPI use and the incidence of AD and other types of dementia in a community-based retrospective cohort
Summary
Proton pump inhibitors (PPIs) are among the most prescribed medications. Previous epidemiological studies have presented contradictory results about PPIs and the risk of dementia. Recent studies have shown the relationship between chronic use of different drugs in older people and the development of AD and other dementias. This association appears stronger with benzodiazepines (BZD)[15], and to a lesser extent, with a ntidepressants[16] and anticholinergic drugs[16]. PPIs are indicated for the treatment of gastroesophageal reflux, Barrett’s oesophagus, Zollinger–Ellison syndrome, idiopathic chronic ulcer, and digestive bleeding problems[20] They are among the most frequently prescribed medications, and the current evidence indicates that 25–70% of PPIs prescriptions have no appropriate indication and lead to the overuse of P PIs21. The use and results of expert systems in machine learning in everyday practice are still u nreliable[31,32,33]
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