Abstract
BackgroundPrescriptions for gastric acid–suppressive agents, including proton-pump inhibitors (PPIs) and histamine type-2 receptor antagonists (H2RAs), are rising. However, little data exist regarding their association with dementia in the Asian population. The objective of this study was thus to investigate the impact of the use of PPIs and H2RAs on the risk of dementia in an Asian population with upper gastrointestinal disease (UGID).MethodsWe conducted a population-based retrospective cohort study with a 10-year follow-up using data from 2000 to 2015 derived from Taiwan’s Longitudinal Health Insurance Database. We included 6711 patients with UGID receiving gastric acid–suppressive agents, 6711 patients with UGID not receiving agents, and 6711 patients without UGID or treatment thereof, all at least 20 years of age. Groups were matched for age, sex, and index date. The association between gastric acid–suppressive agent use and dementia was analyzed using a Cox proportional hazards regression model adjusted for potential confounders.ResultsThe adjusted hazard ratio (aHR) of dementia for patients with UGID receiving gastric acid–suppressive agents compared with patients with UGID without gastric acid–suppressive agents was 1.470 (95% confidence interval [CI] 1.267–1.705, p < 0.001). Both PPIs and H2RAs increase the risk of dementia (PPIs: aHR 1.886 [95% CI 1.377–2.582], p < 0.001; H2RAs: aHR 1.357 [95% CI 1.098–1.678], p < 0.01), with PPIs exhibiting significantly greater risk (aHR 1.456 [95% CI 1.022–2.075], p < 0.05).ConclusionsOur results demonstrate an increased risk of dementia in patients with UGID receiving gastric acid–suppressive agents, including PPIs and H2RAs, and the use of PPIs was associated with a significantly greater risk than H2RA use.
Highlights
According to the World Health Organization, dementia is a syndrome usually of a chronic or progressive nature caused by a variety of brain illnesses that affect memory, thinking, behavior, and the ability to perform everyday activities
The adjusted hazard ratio of dementia for patients with upper gastrointestinal disease (UGID) receiving gastric acid– suppressive agents compared with patients with UGID without gastric acid–suppressive agents was 1.470 (95% confidence interval [confidence intervals (CIs)] 1.267–1.705, p < 0.001)
Gastric acid–suppressive agents increases the risk of dementia, a retrospective cohort study
Summary
According to the World Health Organization, dementia is a syndrome usually of a chronic or progressive nature caused by a variety of brain illnesses that affect memory, thinking, behavior, and the ability to perform everyday activities. In 2010, the estimated worldwide cost of dementia was US$604 billion; it was US$818 billion in 2015 and is set to increase in coming years [1,2]. The rising number of prescriptions for gastric acid–suppressive agents including protonpump inhibitors (PPIs) and histamine type-2 receptor antagonist (H2RAs), the standard treatment for upper gastrointestinal disease (UGID), has prompted research regarding whether either medication increases the risk of dementia. Prescriptions for gastric acid–suppressive agents, including proton-pump inhibitors (PPIs) and histamine type-2 receptor antagonists (H2RAs), are rising. Little data exist regarding their association with dementia in the Asian population. The objective of this study was to investigate the impact of the use of PPIs and H2RAs on the risk of dementia in an Asian population with upper gastrointestinal disease (UGID)
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