Long-term use of common drug linked to 33 per cent higher dementia risk

Long-term use of a certain type of acid reflux drug increases the risk of dementia by a third, according to new research.

Scientists discovered that individuals who take proton pump inhibitors, or PPIs, for four and a half years or more were 33 per cent more likely to develop the debilitating condition.

Acid reflux is when stomach acid flows back into the eosophagus, typically after eating or when lying down. Those with acid reflux may experience heartburn and ulcers, while those who suffer frequent bouts of acid reflux may develop gastroesophageal reflux disease, or GORD, which can lead to cancer of the oesophagus.

GORD is a very common condition, with up to 40 per cent of the UK population experiencing regular heartburn. PPIs reduce stomach acid by targeting the enzymes in the stomach lining that produce it.

However, the medication has been previously linked to a higher risk of stroke, broken bones and kidney disease. The American research team, whose findings were published in the journal Neurology, say the study does not prove that acid reflux drugs cause dementia – it only shows an association.

Study author Professor Kamakshi Lakshminarayan stated: “Proton pump inhibitors are a useful tool to help control acid reflux – however long-term use has been linked in previous studies to a higher risk of stroke, bone fractures and chronic kidney disease. Still, some people take these drugs regularly, so we examined if they are linked to a higher risk of dementia.”

“While we did not find a link with short-term use, we did find a higher risk of dementia associated with long-term use of these drugs.”

The investigation involved over 5,700 individuals aged 45 and older who were free from dementia at the study’s commencement. The average age of participants was 75.

To ascertain whether subjects were consuming acid reflux medications, the research team reviewed their medication records during study visits and annual telephone interviews.

Out of the participants, 1,490 (26 per cent) had used these medications. They were then categorized into four groups based on their duration of drug use: those who hadn’t taken the drugs; individuals who used them for up to 2.8 years; participants who took them between 2.8 and 4.4 years; and those who consumed them for more than 4.4 years.

Following the participants for an average span of about 5.5 years, it was found that 585 (10 per cent) developed dementia. Among the 4,222 non-users of the drugs, there were 415 cases of dementia, equating to 19 instances per 1,000 person-years.

Person-years is a metric that combines the number of people in the study with the length of time each individual participates. Of the 497 individuals who had been taking the drugs for over 4.4 years, 58 developed dementia, which corresponds to 24 cases per 1,000 person years.

After adjusting for factors like age, gender, and ethnicity, as well as health-related issues such as high blood pressure and diabetes, the researchers found that individuals who had been on acid reflux medication for over 4.4 years had a 33 per cent increased risk of developing dementia compared to those who hadn’t taken the drugs.

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The study didn’t show an elevated risk of dementia for people who used the drugs for less than 4.4 years. Prof Lakshminarayan from the University of Minnesota School of Public Health commented: “More research is needed to confirm our findings and explore reasons for the possible link between long-term proton pump inhibitor use and a higher risk of dementia.”

She noted that while there are various ways to manage acid reflux, including taking antacids, maintaining a healthy weight, and avoiding late meals and certain foods, not all methods may suit every individual.

Prof Lakshminarayan further advised: “It is important that people taking these medications speak with their doctor before making any changes, to discuss the best treatment for them, and because stopping these drugs abruptly may result in worse symptoms.”

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