Long-Term Use of Acid Reflux Drugs Linked to Dementia Risk

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Aug. 10, 2023 – Prolonged use of acid reflux medications called proton pump inhibitors could increase the risk of dementia, a new study shows.

Previous studies gave conflicting advice on whether the medicines were linked to dementia. This latest research, published Wednesday in the journal Neurology, found that simply taking a proton pump inhibitor did not necessarily result in a higher risk. The key was the amount of time that a person took one of the medicines.

The risk showed up after people used the drugs for more than 4 years. People who used proton pump inhibitors for that duration or longer had a 33% greater risk of developing dementia. (The term dementia refers to a group of conditions marked by abnormal and progressive brain changes, the most common of which is Alzheimer’s disease.)

Proton pump inhibitors include the drugs esomeprazole, lansoprazole, and omeprazole. Some well-known brand names for these medicines are Nexium, Prevacid, and Prilosec. They work by reducing stomach acid in people whose stomach acid flows into the esophagus, usually after a meal or when lying down. The condition is called acid reflux and can result in heartburn, ulcers, or a more serious reflux disorder that is linked to cancer of the esophagus.

“Proton pump inhibitors are a useful tool to help control acid reflux, however long-term use has been linked in previous studies to a higher risk of stroke, bone fractures and chronic kidney disease,” study author Kamakshi Lakshminarayan, MBBS, PhD, of the University of Minnesota School of Public Health, said in a statement. “Still, some people take these drugs regularly, so we examined if they are linked to a higher risk of dementia. While we did not find a link with short-term use, we did find a higher risk of dementia associated with long-term use of these drugs.”

For the study, researchers analyzed data for 5,712 people ages 45 years and older who did not have dementia at the start of the study. Their average age was 75 years old, 22% of them were Black, and 58% were women. The amount of time people were followed during the study varied, but centered around 5 years and 6 months.

Of the 4,222 people in the study who did not take the acid reflux drugs, 415 people developed dementia during the follow-up period. Among the 497 people in the study who took the drugs for more than 4.4 years, 58 people developed dementia.

Having acid reflux once in a while is common. A 2019 study estimated that 60 million people in the U.S. have the condition once a month or more. 

“More research is needed to confirm our findings and explore reasons for the possible link between long-term proton pump inhibitor use and a higher risk of dementia,” Lakshminarayan said. “While there are various ways to treat acid reflux, such as taking antacids, maintaining a healthy weight, and avoiding late meals and certain foods, different approaches may not work for everyone. It is important that people taking these medications speak with their doctor before making any changes, to discuss the best treatment for them, and because stopping these drugs abruptly may result in worse symptoms.”