Proton Pump Inhibitors and Risk for Mild Cognitive Impairment and Dementia

 
   Lead Investigator:    Felicia Goldstein
   Institution      :     
   E-Mail           :    fgoldst@emory.edu
   Proposal ID      :    822


   Publications:


1  Goldstein FC, Steenland K, Zhao L, Wharton W, Levey AI, Hajjar I
   Proton Pump Inhibitors and Risk of Mild Cognitive Impairment and Dementia
   Journal Article  J Am Geriatr Soc,65:1969-1974,2017,

   PUBLISHED





   Proposal Description:
   Background/Objective: Controversy exists over whether proton pump inhibitors (PPIs) pose an    increased risk for dementia in older adults. This study examined the risk associated with PPIs on    conversion to mild cognitive impairment (MCI), dementia, and specifically Alzheimer?s disease    (AD).    Design: Observational, longitudinal study.    Setting. NIA/NIH National Alzheimer?s Coordinating Center database.    Participants: Research volunteers gt 50 years old with 2 to 6 annual visits. Eight hundred and    eighty four participants were taking PPIs at every visit, whereas 7,677 persons never reported    taking PPIs at any visit. All were diagnosed with baseline normal cognition or MCI.    Measurements: Multivariable Cox regression analyses were performed to evaluate the    association between PPI use (always vs. never) and decline in baseline diagnosis of cognitive    function, controlling for demographics, vascular comorbidities, and mood.    Results: The use of PPIs was associated with a decreased risk of a decline in cognitive function    (HR 0.78, 95 CI 0.66-0.92, p=.003) and a decreased risk of conversion to MCI or dementia due    to AD (HR 0.80, 95 CI 0.67-0.96, p=.014). This reduced risk of decline in cognitive status    was found for persons with either normal cognition (HR 0.74, 95 CI 0.55-0.98, p=.035) or    MCI (HR 0.81, 95 CI 0.66-1.00, p=.048).    Conclusion: In this large cohort of cognitively well characterized individuals, consistent use of    PPIs was not associated with greater risk of dementia or of AD, in contrast to two recent reports    of an increased risk of dementia. Prospective studies with measurement of AD biomarkers are    needed to confirm these results in order to guide empirically based clinical treatment    recommendations.