Proton pump inhibitors (PPI) are widely prescribed drugs for patients with gastroesophageal reflux disease with symptoms like heartburn, burping and also other common gastric and oesophageal diseases. They work by a potently inhibiting gastric acid secretion and belong to the most prescribed drugs in gastroenterology. In recent years, some studies have highlighted that the long-term use of PPIs may be associated with side effects such as pneumonia, bone fractures, renal dysfunction, low magnesium levels and the progression of dementia. However, the clinical relevance of most of these side effects is debated and; in particular, it remains unclear if PPIs have any significant role in the development of dementia.
A recent study (1) evaluated the impact of PPIs on brain function by measuring the cognitive function of nurses in the so-called Nurses’ Health Study. For this purpose, a neuropsychological test has been applied to measure brain functions such as learning speed, memory and others. These cognitive functions predict the risk for dementia in later life. The data of 13864 nurses was analysed. There was only a very modest association between brain function and the intake of PPIs and it was not more frequent than with the use of histamine 2-blockers, which are another group of acid suppressing drugs.
Prof. Dr. Fried, Board Certified Gastroenterologist at Double Check commented: “PPIs do not seem to cause dementia nor do they significantly accelerate the progression of dementia. However, the potential of multiple long-term side effects of PPIs, though debated, calls for a cautious indication of these potent and important drugs. Thus, a clear medical indication is always needed, in particular if these drugs are taken for prolonged time and this indication should be repeatedly questioned by the treating physician.