What the Latest Dementia Study Says about Links with Certain Medicines

Recent research challenges earlier concerns about a potential connection between certain acid-reflux medications and dementia risk in older adults.

Study Findings

A comprehensive analysis of nearly 19,000 participants found no association between proton pump inhibitors (PPIs) or histamine H2 receptor antagonists (H2RAs) and increased dementia risk, mild cognitive impairment, or cognitive decline in individuals over 65 years old.

As Dr. Raaj Shishir Mehta from Massachusetts General Hospital explained: “While deprescribing efforts are important, especially when medications are not indicated, these data provide reassurance about the cognitive impacts of long-term use of PPIs in older adults.”

Background on the Controversy

The concern originated from a 2016 study published in JAMA Neurology suggesting a 44% increased dementia risk associated with PPI use over five years among German residents aged 75 and older. However, that research relied on claims data, which can introduce inaccuracies in dementia diagnosis classification.

Research Methodology

The current study, drawn from ASPREE (a large aspirin trial), examined medication records from in-person visits with expert confirmation of dementia outcomes. Researchers tracked 18,846 participants from 2010-2014, with 566 developing incident dementia. The analysis included comprehensive data on lifestyle factors, comorbidities, hospitalizations, and overall health status – addressing limitations of earlier investigations.

Implications

The findings suggest that concerns about cognitive effects from long-term PPI use in older adults may be unfounded, though physicians continue emphasizing appropriate medication use when clinically necessary.

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