Studies suggest that the use of proton pump inhibitors increases the risk of dementia in the European population. Researchers in Taiwan studied patient data to determine whether this risk is also present in the Asian population.
The various conditions that fall under a dementia diagnosis can be debilitating, and are a significant problem in countries with aging populations. As researchers have studied the conditions under which dementia is more likely to develop, it has become clear that using a proton pump inhibitor (PPI), commonly used to treat ulcers and acid reflux, increases the risk. Since this phenomenon hadn’t been examined in an Asian context, researchers used patient data from the National Health Insurance Research Database in Taiwan to determine whether this risk is relevant to the Asian population.
Researchers searched for patients who began using proton pump inhibitors between 2000 and 2003, were 40 years of age or older, and did not have a prior history of dementia. They also looked for a second group of patients who were not treated with PPI, but whose demographics otherwise matched those of the patients receiving treatment. They ended up with a sample of 15726 patients – half of whom had used PPI and half of whom had not – and followed these patients’ records till 2010. Researchers took note of whether the participants had a variety of other health conditions, including hypertension, depression, and heart disease. In the group treated with PPI, they used prescription records to determine the length of time the drug was used for, and how many doses the patient had taken; this provided some idea about the cumulative impact of PPI use. When a patient was given a dementia diagnosis, researchers could find out how much of the PPI they had been exposed to. Dementia was determined based on a diagnosis from a psychiatrist or neurologist, and either one hospital visit or two out-patient visits for dementia.
During the period studied, 707 of the participants were diagnosed with dementia. Within the group who used proton pump inhibitors, the rate of dementia diagnosis was 5.51 per 1000, while only 4.54 per 1000 within the group who did not use PPI were diagnosed. This means the use of PPI increased the risk of dementia diagnosis. This trend is especially true of males, who were more likely than females to develop dementia after PPI treatment. Researchers also found that the risk of dementia increased as the use of PPI increased. Patients who used PPIs and had depression or diabetes were more likely to develop dementia, as were patients who had heart disease or hypertension. The use of other medications to treat some of these conditions was also associated with the development of dementia in PPI users. Age is an important contributing factor, with patients over the age of 70 at the greatest risk.
This study’s findings suggest that proton pump inhibitors increase the risk of dementia in the Asian population by 22%. This is similar to the findings in European populations. Since PPIs are a common treatment for elderly patients, and age is also associated with an increased risk of dementia, these results should help healthcare providers to make treatment choices that will limit the risk of developing dementia. While Taiwan’s National Health Insurance Research Database is an excellent source for patient records, the authors suggest that their data is limited by the absence of information on variables like smoking habits, level of education, and socioeconomic status. They encourage further clinical research in order to more fully understand the impact of proton pump inhibitors on dementia.
Written By: Ashley Shaw