Proton Pump Inhibitors and Risk of Dementia: A Hypothesis Generated but Not Adequately Tested
Mishah Azhara b✉, Lawrence M. Fiedlerc, Patricio S Espinosad, Charles H. Hennekensc
- aPGY-3 Internal Medicine Resident, Charles E. Schmidt College of Medicine, Graduate Medical Education Consortium (Bethesda Hospital, Boca Raton Regional Hospital, Delray Medical Center, St Mary’s Medical Center, West Boca Raton Hospital), Florida Atlantic University, Boca Raton, FL, USA
- bPGY-3 Internal Medicine Resident, Charles E. Schmidt College of Medicine, Graduate Medical Education Consortium (Bethesda Hospital, Boca Raton Regional Hospital, Delray Medical Center, St Mary's Medical Center, West Boca Raton Hospital), Florida Atlantic University, Boca Raton, FL, USA
- cCharles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL, USA
- dNeurologist in Private Practice, Boca Raton, FL, USA
- ✉Corresponding author
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Abstract
We reviewed the evidence on proton pump inhibitors (PPIs) and dementia. PPIs are among the most widely utilized drugs in the world. Dementia affects roughly 5% of the population of the United States (US) and world aged 60 years and older. With respect to PPIs and dementia, basic research has suggested plausible mechanisms but descriptive and analytic epidemiological studies are not inconsistent. In addition, a single large-scale randomized trial showed no association. When the evidence is incomplete, it is appropriate for clinicians and researchers to remain uncertain. Regulatory or public health authorities sometimes need to make real-world decisions based on real-world data. When the evidence is complete, then the most rational judgments for individual patients the health of the general public are possible At present, the evidence on PPIs and dementia suggests more reassurance than alarm. Further large-scale randomized evidence is necessary to do so.