Common Acid Reflux Medication Could Elevate Dementia Risk by a Third
A widely prescribed medication taken by millions of people across the United Kingdom may significantly increase the likelihood of developing dementia, according to a new scientific study. The research indicates that individuals who use these tablets for longer than 4.4 years could face a 33% greater risk of dementia compared to those who have never taken them.
Study Details and Participant Analysis
The 2023 research, published in Neurology, the medical journal of the American Academy of Neurology, involved 5,712 participants aged 45 and above who were initially free from dementia. The average age of participants was 75 years old. Scientists focused on proton pump inhibitors (PPIs), medications that reduce stomach acid by targeting enzymes in the stomach lining responsible for acid production.
Among the study group, 1,490 individuals, representing approximately 26%, had used these drugs. Participants were categorised into four distinct groups based on their medication usage patterns: those who had never taken the medication; individuals who used them for up to 2.8 years; those taking them between 2.8 and 4.4 years; and people who had been on them for more than 4.4 years.
Understanding Acid Reflux and Its Treatment
Acid reflux occurs when stomach acid flows back into the oesophagus, often after meals or while lying down. This condition can cause symptoms like heartburn and may lead to ulcers. Persistent acid reflux can develop into gastro-oesophageal reflux disease (GORD), which carries a potential risk of oesophageal cancer.
"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," explained study author Kamakshi Lakshminarayan, MBBS, PhD, of the University of Minnesota School of Public Health in Minneapolis, and a member of the American Academy of Neurology.
"Still, some people take these drugs regularly, so we examined if they are linked to a higher risk of dementia. Whilst 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."
Research Findings and Dementia Incidence
Participants were monitored for an average period of 5.5 years. During this time, dementia developed in 585 individuals, equating to 10% of the total group. Among the 4,222 participants who did not take the drugs, 415 developed dementia, which translates to 19 cases per 1,000 person-years. Person-years is a statistical measure that combines the number of people in the study and the duration each person spends in the research.
Out of the 497 participants who took the drugs for more than 4.4 years, 58 developed dementia, or 24 cases per 1,000 person years. After adjusting for variables such as age, sex, race, and health-related factors like high blood pressure and diabetes, researchers discovered that those who had been taking acid reflux drugs for over 4.4 years had a 33% increased risk of developing dementia compared to those who never took the drugs.
Important Limitations and Researcher Recommendations
The study did not identify an increased dementia risk for those who used the drugs for less than 4.4 years. Crucially, this research does not establish a causal link between acid reflux medication and dementia; it merely indicates a correlation that requires further investigation.
Lakshminarayan emphasised the need for additional research: "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." He added that while there are various methods to manage acid reflux, such as taking antacids, maintaining a healthy weight, and avoiding late meals and certain foods, these strategies may not be effective for everyone.
"While there are various ways to treat acid reflux, such as taking antacids, maintaining a healthy weight, and avoiding late meals and certain foods, different approaches may not work for everyone. 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."
Study Limitations and Funding Sources
One limitation of the study was the annual frequency of medication usage inquiries, which led researchers to estimate usage between yearly check-ins. If participants discontinued and then resumed their acid reflux medication within these intervals, the estimated usage could have been inaccurate. Additionally, the authors could not determine if participants were using over-the-counter acid reflux medication.
The research was funded by the National Institutes of Health, including the National Heart, Lung, and Blood Institute. This comprehensive study highlights the importance of ongoing medical supervision for individuals using proton pump inhibitors long-term, particularly given their widespread prescription across the UK healthcare system.
