They’re among the most used medications on the planet because they work so well at relieving uncomfortable symptoms of heartburn and acid reflux. But, there’s also a dark side to these drugs.
Research reveals long term use of proton pump inhibitors (PPIs) is linked to many serious health problems including diseases of the liver and kidneys, stroke, bone fractures, inflammatory bowel disease and cancer. Now, a new study also links PPIs to dementia.
People who have overindulged may suffer heartburn and reach for antacids like Tums to provide immediate relief. But those who suffer with regular heartburn may turn to an over-the-counter protein pump inhibitor like Omeprazole, which stops acid production at the source.
Most PPIs are prescription only and are used for a variety of conditions such as gastroesophageal reflux disease (GERD), stomach and small intestine ulcers, and inflammation of the esophagus.
While PPIs are mostly prescribed for no more than three months at a time, many folks take these drugs long-term, leading to concerns they’re overused and cause widespread harm.
People Can Take These Drugs For Decades
As we reported in 2019, studies looking at whether PPIs increase the risk of dementia have been mixed. Some studies show there is a loss of cognitive function in PPI users, but others show PPIs have no effects on cognition. To bring more clarity, a new study was conducted by researchers from the University of Minnesota, who only included people who used prescription PPIs regularly.
The study included 5,712 dementia-free Americans who took part in the Atherosclerosis Risk in Communities (ARIC) study that began in 1985. All participants were aged 45 and older and 1,490 (26 percent) had taken prescription PPIs. The minimum cumulative PPI use was 112 days, while others, astonishingly, had been taking these drugs constantly for more than twenty years.
The research team divided the participants into four groups according to how long they took PPIs, ranging from zero to 4.4 years or longer. Then the team followed them for 5½ years. During this time, 585 people, or ten percent, developed dementia.
Of the 4,222 people who didn’t take these drugs, 415 people developed dementia. Of the 497 people who took them for more than 4.4 years, 58 developed dementia.
Long Term Use Increases Dementia Risk By 33 Percent
After adjusting for age, gender, race, and health-related factors such as high blood pressure and diabetes, researchers found people who had been taking PPIs for less than 4.4 years had no increased risk of dementia. But those taking them for longer had a 33 percent higher risk of developing dementia than people who never took the drugs.
Previous studies suggest three mechanisms by which PPIs could increase the risk of dementia. These include:
- Slowing the brain’s clean-up of plaque: Some PPIs cross the blood brain barrier and interact with certain enzymes that clear amyloid beta proteins from the brain, leading to the accumulation of plaque.
- Promoting amyloid protein buildup in the brain: PPIs may also inhibit acidification in certain brain cells to reduce amyloid degradation and enhance levels of these memory-robbing proteins.
- Triggering malabsorption of vitamin B12: Science shows that poor vitamin B12 status negatively affects cognition and promotes neurological damage. Studies suggest that PPIs interrupt the process of healthy vitamin B12 absorption.
Are PPIs Worth The Risk?
Senior author Kamakshi Lakshminarayan, MBBS, PhD suggests PPIs should be used as a last resort to manage acid reflux. He advises that people try different approaches to dealing with the discomfort of acid reflux such as maintaining a healthy weight and avoiding late meals as well as the consumption of certain problem foods. I couldn’t agree more.
I suggest making healthy lifestyle tweaks, first. For temporary relief, try this old home remedy: sodium bicarbonate (baking soda) mixed in a glass of water. It neutralizes acidity quite well and can even be safely done for a few days. But from what I understand, it’s not safe as a long-term solution.
It’s important to note that this most recent study doesn’t prove acid reflux drugs cause dementia; it only shows an association. This means the debate will continue, and no doubt new studies will be carried out that are larger, longer, and more robust.
If your heartburn or acid reflux persists, consult with a trusted healthcare professional.
Best Regards,
The Awakening From Alzheimer’s Team
https://www.aan.com/PressRoom/Home/PressRelease/5107
https://jamanetwork.com/journals/jamaneurology/fullarticle/2487379
