Millions of Americans take medications known as proton pump inhibitors daily to treat heartburn and acid reflux, and in recent years these medications, also known as PPIs, have been used to treat kidney failure, stroke. , has been associated with an increased risk of premature death from any disease. cause.
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(CNN) — Millions of Americans take a drug known as proton pump inhibitor Used daily to treat heartburn and acid reflux, these drugs, also known as PPIs, have recently been associated with an increased risk of kidney failure, stroke, and early death from all causes.
and new research It suggests that people who have taken the drug for several years may be at increased risk of dementia.
People over the age of 45 who took PPIs for at least four years had a 33% higher risk of developing dementia than those who didn’t take them, according to a study published Wednesday in the journal. neurology.
Dementia is not a single disease, but an open-ended term that refers to memory loss and cognitive decline caused by damage to brain cells.
PPIs reduce stomach acid by targeting enzymes in the stomach lining that produce stomach acid. It is often used to treat symptoms of acid reflux. gastroesophageal reflux disease Gastroesophageal reflux disease is a severe acid reflux disease in which food or liquid rises from the stomach into the esophagus.
PPIs are widely available over the counter and are often used to treat heartburn, the mild burning sensation caused by acid reflux.
Experts say people who occasionally take these drugs after a barbecue need not worry.
“This study does not prove that acid reflux drugs cause dementia,” study author Dr. Kamakshi Lakshminarayan, a neurologist at the University of Minnesota Graduate School of Public Health, Minneapolis, told CNN in an email. Told. “It just shows an association. Further research is needed to understand sex.”
Association between PPI and dementia
Lakshminarayan and her team analyzed a population-based study consisting of 5,712 people between the ages of 45 and 64 who did not have dementia at the start of the study.
Nearly 1,500 (26%) participants took the PPI during that period.
After controlling for age, gender, race, and health conditions such as diabetes and hypertension, the researchers found that 58 out of 497 people who took PPIs for nearly four and a half years developed dementia. bottom.
Of the 4,222 drug-free participants, 415 developed dementia. The researchers found no increased risk in those taking the drug for less than 4.4 years.
This study had several limitations. Participants were asked about their drug use only once a year for the duration of the study. Therefore, if a participant stopped and resumed using her PPI during check-in, the estimation could be inaccurate. It is also unclear whether participants took over-the-counter PPIs or prescription medications.
The researchers identified B12 deficiency and impaired amyloid metabolism as possible links between PPI overuse and dementia.
“Several studies have shown that the use of acid reflux medications may be associated with low levels of vitamin B12. And low vitamin B12 is associated with poor thinking and poor memory. It’s related,” Lakshminarayan said, adding that her team did not have vitamin B12 data levels of the study participants, so “we cannot comment on this theory.”
Dr. Gregory Day, Associate Professor of Neurology at the Mayo Clinic in Jacksonville, Florida, and Fellow of the American Academy of Neurology, agrees there may be a link between PPIs and their effects on amyloid in the brain. bottom.
Professor Day, who was not involved in the study, said proton pump inhibitors may “change enzymes in the brain” that remove build-up of a protein in the brain called amyloid, a key component of Alzheimer’s disease. said.
PPIs “may lower levels of chemicals in the body that exist to block amyloid in certain ways,” he said. “Theoretically, these drugs increase amyloid in the brain, increasing the risk of Alzheimer’s disease, which is the leading cause of dementia.”
Alternatives to using PPI
Lakshminarayan recommends that people who have been taking proton pump inhibitors for four years or more talk to their doctor about other options.
“Suddenly stopping these drugs can make symptoms worse,” she says.
Experts say people with frequent acid reflux can develop gastroesophageal reflux disease, which can lead to severe gastrointestinal bleeding and esophageal cancer.
There are other ways to treat acid reflux and heartburn, including over-the-counter antacids. Antacids differ from PPIs in that they act on and neutralize acid already in the stomach, Laxminarayan said.
For longer lasting peace of mind, H2 antagonistThere are also options, also called H2 blockers, but they can take several hours to take effect.
Day added that some people may need to reassess their use of PPIs, which could be overused or taken for conditions that are not severe enough. said.
“I would recommend that anyone taking these drugs do so whether they are concerned about their memory or not,” says Day. “I think it’s always reasonable to ask, ‘Why am I taking these drugs?'”
You can reduce your PPI use by changing your diet and avoiding late meals. Losing weight can also help reduce symptoms, as being overweight can also contribute to acid reflux. But these alternatives don’t work for everyone, says Lakshminarayan.
“Our recommendation is for patients to discuss their medications with their doctors and let them know if they are taking over-the-counter medications,” Lakshminarayan said.
CNN wire
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