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No dementia risk even at high PPI exposure levels

28 Nov 2017
The government will focus on building "community networks" to support those with dementia instead.

Even at high cumulative exposure levels, proton pump inhibitors (PPIs) do not appear to elevate the risk of dementia, a recent study has shown.

The study findings were “consistent across a wide range of cumulative doses, including high levels of cumulative PPI exposure. For example, people with PPI exposure consistent with 5 years of daily use did not have an increased risk for dementia compared with those with no use,” researchers said.

Time-varying exposure to PPIs was determined, using computerized pharmacy data, for the study sample of 3,484 elderly adults (median age 74 years; 59 percent female) without dementia at baseline. Every 2 years, participants were screened for the development of dementia.

Cox regression models were used to determine the relationship between PPI use and the incidence of all-cause dementia and probable Alzheimer’s disease.

Over a mean follow-up time of 7.5±5.0 years, 23.7 percent (n=827) developed dementia, of whom 670 were thought to have possible or probable AD.

Compared with no cumulative PPI exposure or zero total standardized daily doses (TSDDs), approximately 1 (365 TSDDs; hazard ratio [HR], 0.87; 95 percent CI, 0.65 to 1.18), 3 (1,095 TSDDs; HR, 0.99; 0.75 to 1.30) and 5 (1,825 TSDDs; HR, 1.13; 0.82 to 1.56) years of daily PPI use did not increase the risk of dementia.

Overall, there was no association between PPI use and the risk of dementia (p=0.66) and AD (p=0.77).

Even subgroup analysis by total duration of use, longest duration of continuous use or sex did not produce statistically significant associations between PPI use and dementia risk. Adjustments for comorbidity index produced the same null result.

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