Long-term use of popular acid reflux medications may increase dementia risk, say investigators. But careful short-term use in elders remains safe, they claim.
Proton pump inhibitors are used by millions of people worldwide to treat gastrointestinal conditions such as heartburn, gastritis and stomach ulcers. But population studies have shown higher dementia rates in people using the medications. The new study proposes that the drugs affect synthesis of the neurotransmitter acetylcholine, which plays a significant part in conditions such as Alzheimer’s disease, reports researcher Taher Darreh-Shori, from the Karolinska Institute, Sweden.
“Since there’s no effective treatment for the disease, it’s important to avoid risk factors. We therefore want to draw attention to this so that the drugs aren’t used needlessly for a long time,” he said in a statement.
The researchers caution that “special care” should be taken when prescribing the drugs to patients diagnosed with dementia and muscle weakness diseases such as amyotrophic lateral sclerosis. In these cases, doctors should use PPIs that have the weakest effect and prescribe them at lowest dose for the shortest time possible, said Darreh-Shori.
Limited-time use is safe in the elderly, he added. “Our nervous system is pretty flexible when it comes to tolerating short-term impact.”
The lab study needs to be replicated in humans, the researchers caution. But in the laboratory, the ingredients with the strongest effects were found in omeprazole, esomeprazole, tenatoprazole and rabeprazole. In contrast, pantoprazole and lansoprazole had the weakest effects.
Full findings are published in the journal Alzheimer’s & Dementia.
