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Long-term proton-pump inhibitor use in older adults with mild-to-moderate Alzheimer's disease: Are there cognitive consequences?

      Proton-Pump Inhibitors (PPIs) are commonly prescribed medications indicated for the treatment of various acid-related disorders including duodenal/gastric ulcers, erosive oesophagitis and Helicobacter Pylori eradication
      • Maes ML
      • Fixen DR
      • Linnebur SA
      Adverse effects of proton-pump inhibitor use in older adults: a review of the evidence.
      ,
      • Schoenfeld AJ
      • Grady D
      Adverse effects associated with proton pump inhibitors.
      . PPIs are frequently used without appropriate indication in older adults and are associated with numerous adverse effects including bone loss, fractures, community acquired pneumonia and chronic kidney disease
      • Maes ML
      • Fixen DR
      • Linnebur SA
      Adverse effects of proton-pump inhibitor use in older adults: a review of the evidence.
      ,
      • Schoenfeld AJ
      • Grady D
      Adverse effects associated with proton pump inhibitors.
      . Strikingly, several studies have also reported a greater risk of dementia in those receiving a long-term PPI
      • Gomm W
      • von Holt K
      • Thome F
      • Broich K
      • Maier W
      • Fink A
      • et al.
      Association of proton pump inhibitors with risk of dementia: a pharmacoepidemiological claims data analysis.
      ,
      • Haenisch B
      • von Holt K
      • Wiese B
      • Prokein J
      • Lange C
      • Ernst A
      • et al.
      Risk of dementia in elderly patients with the use of proton pump inhibitors.
      . By contrast, in rigorous studies in both the UK and Finland, no association between PPI use and dementia occurrence was observed
      • Imfeld P
      • Bodmer M
      • Jick SS
      • Maier CR
      Proton pump inhibitor use and risk of developing alzheimer's disease or vascular dementia: a case-control analysis.
      ,
      • Taipale H
      • Tolppanen AM
      • Tihonen M
      • Tanskanen A
      • Tihonen J
      • Hartikanienen S
      No association between proton pump inhibitor use and risk of Alzheimer's disease.
      . Thus, it appears that early alarming reports of dementia risk associated with long-term PPI use may have been overstated.
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