BACKGROUND AND PURPOSE:

• Northuis et al. (Neurology, 2023) evaluated the associations between current and cumulative PPI use and risk of incident dementia

METHODS:

• Secondary analysis of community-based cohort study
  • Data derived from the Atherosclerosis Risk in Communities (ARIC) Study
• Population
  • Participants in the ARIC study from time of enrollment (1987 to 89) through 2017
• Exposures
  • PPI use
    • Current use at baseline
    • Duration of use prior to baseline: 0 days | 1 day to 2.8 years | 2.8 to 4.4 years | >4.4 years
• Study design
  • ARIC Visit 5 (2011 to 2013) was used as baseline, since this was the first visit in which PPI use was common
  • Cox Proportional Hazards models were used
    • Adjustments: Demographics | Co-morbid conditions | Other medication use
• Primary outcome
  • Incident dementia after visit 5

RESULTS:

• 5,712 dementia-free participants at visit 5
  • Mean age 75.4 (SD, 5.1) years
  • Black: 22% | Female: 58%
  • Median follow-up: 5.5 years
  • Minimum cumulative PPI use: 112 days | Maximum use: 20.3 years
• Incident dementia: 585 cases
• Participants using PPIs at Visit 5 were not at a significantly higher risk of developing dementia during subsequent follow-up than those not using PPIs
  • HR 1.1 (95% CI, 0.9 to 1.3)
• Those who used PPIs for >4.4 cumulative years prior to Visit 5 were at a higher risk of developing dementia during follow-up than those who reported no use
  • HR 1.3 (95% CI, 1.0 to 1.8)
• Associations were not significant for lesser amounts of PPI use

CONCLUSION:

• The use of PPIs for more than 4.4 years was associated with a higher risk of dementia in this population of adults aged 45 and older
• The authors state

Future studies are needed to understand possible pathways between cumulative PPI use and the development of dementia

Learn More – Primary Sources:

Cumulative Use of Proton Pump Inhibitors and Risk of Dementia: The Atherosclerosis Risk in Communities Study