Proton pump inhibitors.
Most people aren’t familiar with these drugs by their medical name. But they are very well known for relieving heartburn and indigestion, treating peptic ulcer disease, GERD, Barrett Syndrome, and a number of other conditions. In the past, experts have recommended that the lowest dosage be taken as needed because of the potential long-terms effects the drugs could have on the bones, gastrointestinal tract, and cardiovascular system. And according to a report published on Feb. 15 in the journal JAMA Neurology, studies conducted in Germany suggest that proton pump inhibitors (PPIs) might actually increase the risk of dementia in seniors. These drugs work to lower the production of acid by blocking the enzyme in the stomach that produces it.
The association between PPIs and dementia is still inconclusive, but what studies have uncovered is that the drugs seem to affect the levels of amyloid beta and tau – proteins related to Alzheimer’s disease. The study conducted in Germany included a focus group of seniors over 75 who regularly took PPIs. After taking the medication over a period of time, the results showed that those participants had a 44 percent increased risk of dementia. But from what Freedom Home Care found is that researchers are still looking for a cause-and-effect to the association between PPIs and dementia. “To evaluate cause-and-effect relationships between long-term PPI use and possible effects on cognition in the elderly, randomized, prospective clinical trials are needed,” said corresponding author Britta Haenisch, from the German Center for Neurodegenerative Diseases in Bonn.
Still with the publishing of these findings, Haenisch recommends that clinicians follow the same guidelines for this line of medication to prevent over-prescription and inappropriate use. A 2013 report by the IMS Institute for Healthcare Informatics says that more than 15 million people in the U.S. used prescription PPIs – totaling more than $10 billion. There is widespread concern that Americans who are using these drugs to treat minor cases of heartburn or acid reflux may also be misusing them – and in many cases, without prior knowledge. The study released in JAMA Neurology reported that 75 percent of people that used PPIs in the U.S. had been given inappropriate prescriptions for the drug by doctors. The study also stated that about 25 percent of long-term PPI users could actually stop taking the medications and not suffer increased acid reflux or heartburn.
Studies done prior to this one have linked H2 blockers with increased risk of dementia. That information was enough for Dr. Malaz Boustani, professor of medicine with the Indiana University Center for Aging Research and a spokesman for the American Federation for Aging Research, who wants to inform his patients of the findings. “I’m going to disclose the finding to my patients and then let them decide whether they will take the risk or not. On Monday I have clinic, and if I have patients taking a PPI or an H2 blocker I will tell them exactly what I’m telling you, and then they can decide.” Before now, Boustani says he has recommend that his patients use PPIs to treat acid reflux without taking Tagamet, Pepcid and Zantac – popular H2 blockers.
Doctors continue to study the connection between PPIs and dementia, warning patients of overuse. While doctors continue to study this, it is important to make sure that your senior is not over using these medications. Make sure you have the proper home care service to ensure a safe environment and healthy senior.