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Heartburn Medication May Increase Dementia Risk

Heartburn meds, such as the familiar proton pump inhibitors (PPIs), are meant to provide relief but may deliver something far more sinister later in life.

These acid reflux and ulcer drugs could significantly increase the risk of dementia when taken for a long time, new research suggests.

The findings, recently published in Neurology, ring alarm bells for the more than 15 million Americans prescribed PPIs—the most common of which are esomeprazole (Nexium), omeprazole (Prilosec), and lansoprazole (Prevacid)—to treat their chronic gastric woes.

Risk Observed Only With Long-Term Use

The study analyzed 5,712 people over 45 (average age 75) without dementia symptoms. Researchers reviewed medications during study visits and annual phone calls, finding 1,490 people, or over one-quarter, used PPIs.

Participants were split into four groups: nonusers, short-term users (around three years), users who took them between 2.8 and 4.4 years, and long-term users (over 4.4 years). Over 5.5 years, 10 percent developed dementia. Of the nonusers, 415 developed dementia. Of long-term PPI users, 58 developed dementia.

After adjusting for factors like age, sex, race, blood pressure, and diabetes, use over 4.4 years was linked to a 33 percent higher dementia risk versus nonusers. No increased risk was seen with short-term use.

Patients should talk to their doctors before changing medications, as stopping abruptly could worsen symptoms, Kamakshi Lakshminarayan, who holds a doctorate in cognitive science and is a coauthor of the study, told The Epoch Times, emphasizing that the study showed an association, not causation.

There are several notable limitations of the research.

Medication use was self-reported once a year, possibly missing nuances. Also, over-the-counter (OTC) PPI use wasn’t assessed. OTC formulations are often at a lower dose than prescription PPIs, Dr. Henry Jen, who specializes in advanced gastroenterology at Northwell Long Island Jewish Forest Hills in New York and is not involved in the study, told The Epoch Times.

But Short-Term Use May Have Risks, Too

Adding to evidence of cognitive risks with PPIs, a small 2015 study found even short-term use may impair function.

The research randomly divided 60 volunteers into six groups; five tested different PPIs (omeprazole, lansoprazole, rabeprazole, pantoprazole, and esomeprazole), while one was a control.

All groups took five computerized neuropsychological tests of the Cambridge Neuropsychological Test Automated Battery—once at the beginning and once a week after the end of the study.

The findings showed “statistically and clinically significant impairment in visual memory, attention, executive function, and working and planning function” among PPI users versus the control group.

“All the PPIs have some exacerbated effects on cognition,” the authors concluded. Though these adverse effects may go unnoticed initially, long term, they may contribute to Alzheimer’s disease development, they added.

PPIs May Cause Nutrient Deficiency, Affecting Cognition

Antacid drugs can deplete levels of several vitamins and minerals crucial for brain health, including vitamin B12, vitamin C, calcium, iron and magnesium.

“While these risks are considered to be relatively low in the general population, they may be notable in elderly and malnourished patients, as well as those on chronic hemodialysis and concomitant PPI therapy,” the study authors noted.

(The Epoch Times)

B-12 supplementation may only be effective if started before neuron damage begins in middle age, according to some research.

Alternatives to PPIs

While some conditions, like Barrett’s esophagus, where the esophagus becomes damaged by acid reflux, or hyper-secreting tumors, necessitate PPIs, these drugs are often over-prescribed and overused unnecessarily, Dr. Jen said. “Especially long-term.”

Potential health risks could be reduced by constantly reevaluating the need for PPIs and discontinuing them if no longer beneficial, he added.

Lifestyle changes can also minimize symptoms, including losing weight, avoiding food triggers and late snacking, and elevating the head in bed. “These modifications can often reduce or eliminate the need for PPIs,” Dr. Jen said.

Non-drug options may include surgery or newer endoscopic procedures like transoral incisionless fundoplication (TIF). This minimally invasive treatment reinforces the muscle between the esophagus and stomach to prevent reflux without surgery.