PPIs and Dementia: A Link?

I’ve been bothered by this article in Scientific American, which argues that regular use of proton pump inhibitors (PPIs), is associated with a number of health problems, including dementia, heart disease, and kidney disease. PPIs are used to combat gastroesophageal reflux disease (GERD), and are very widely prescribed among seniors. I take generic omeprazole myself, but PPIs also include Nexium, Prevacid, and Prilosec.

I’m not sure I could get through the night without my omeprazole, but I sure would like to avoid dementia. Particularly bothersome is the inability of scientists so far to identify any causal pathway that might explain why people taking PPIs tend to have higher rates of dementia. Perhaps it’s that lower levels of stomach acid due to PPI use inhibit the absorption of vitamin B12, needed for brain health. I’m already taking a B12 supplement, so maybe I’m OK. Or maybe not.

Another theory is that seniors tend to take many drugs — a phenomenon known as
“polypharmacy” — and that this in itself has been shown to be associated with memory loss. So the problem might not be PPIs in particular.  Some suggest that people practicing polypharmacy are likely to be people who see physicians regularly, increasing their chances of being diagnosed with something or other, including dementia. Maybe that’s the problem.

Anyway, I’m planning do discuss the PPI issue with my own physician, next time I’m in.



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