The following is a summary of “Cumulative Use of Proton Pump Inhibitors and Risk of Dementia: The Atherosclerosis Risk in Communities Study,” published in the August 2023 issue of Neurology by Northuis et al.

The link between proton pump inhibitor (PPI) use, and dementia shows varying outcomes and lacks analysis of cumulative PPI use effects. Researchers conducted a cohort study to explore the links between ongoing and accumulated PPI utilization and the potential for dementia development in the Atherosclerosis Risk in Communities (ARIC) investigation.

They utilized data from the ARIC cohort (2017), which examined PPI use—medication records from Visits 1 to 5 and annual calls captured usage. The baseline was set at ARIC Visit 5, introducing everyday PPI use. Two approaches assessed use, current status, and pre-Visit 5 duration (Visit 1: 0 days, 1 day – 2.8yrs, 2.8-4.4yrs, >4.4yrs). Incident dementia post-Visit 5 was the outcome. Adjusted Cox models factored in demographics, comorbidities, and other medications.

The results showed 5,712 dementia-free participants at Visit 5 (mean age 75.4±5.1 years; 22% Black; 58% female), with a median 5.5-year follow-up. Cumulative PPI use ranged from 112 days to 20.3 years, and 585 incident dementia cases occurred during follow-up. PPI users at Visit 5 didn’t show higher dementia risk during follow-up (HR: 1.1 [95% CI: 0.9-1.3]). However, >4.4 cumulative years of pre-Visit 5 PPI use saw a 33% increased risk (HR: 1.3 [95% CI: 1.0-1.8]), while lesser use showed no significant associations.

They concluded subsequent research is necessary to grasp potential connections between cumulative PPI use and dementia development.

Source: n.neurology.org/content/early/2023/08/09/WNL.0000000000207747