Can Long-Term Use of Some Acid Reflux Meds Raise Your Risk of Dementia?

Gastroesophageal reflux disease (GERD), known mostly as “acid reflux,” is a common reason millions of U.S. adults yearly are referred to gastroenterologists, who specialize in disorders of the digestive system. And many U.S. adults take medications known as proton pump inhibitors, or PPIs, every day to treat heartburn and acid reflux.

Raphael Wald, Psy.D., a neuropsychologist with Marcus Neuroscience Institute at Boca Raton Regional Hospital.

 

But numerous studies have linked the long-term use of PPIs to higher risks of chronic kidney disease, stroke, and other serious health issues. The newest study indicates that people aged 45 or older who take PPIs for more than four years have a 33 percent higher risk of developing dementia, than people who never take the meds.

The study, published in the journal Neurology, has gotten much attention because acid reflux is very common, and PPIs are widely available over the counter. They are often used to treat heartburn, the mild burning sensation you get with acid reflux.

More people than ever are having acid reflux symptoms, which include heartburn, a discomfort that can crawl up your abdomen and chest; regurgitation of stomach acid; bloating; and sometimes nausea after eating. 

“This study does indeed indicate that long-term use of proton pump inhibitors can be a risk factor for dementia,” said Raphael Wald, Psy.D., a neuropsychologist with Marcus Neuroscience Institute at Boca Raton Regional Hospital, part of Baptist Health. “This is also the case because kidney issues and stroke – which have also been linked to long-term use of PPIs -- are risk factors for dementia as well.” 

Doctors prescribe medications to combat chronic acid reflux because the condition, if left untreated, can cause inflammation of the esophagus (esophagitis), which increases the risk of pre-cancerous cells in the esophagus. The bottom line: It’s best to adopt dietary changes to avoid having to take these meds for a prolonged period of time, gastroenterologists say.

Consult with your doctor if you have been prescribed PPIs or if you have not been checked for acid reflux symptoms and you’re taking the meds over-the-counter, said Dr. Wald.

“Do not discontinue the use of prescribed PPIs without talking to your doctor first,” he cautions. “Every medication has side effects. There is always a question of ‘does the benefit of this medication outweigh any risks.’  This is always a conversation that you should have with your doctor before making any decisions.”

In the new study, researchers reviewed data on 5,712 people, ages 45 to 64, who did not have dementia at the start. About 1,500 participants, or 26 percent, took PPIs during that time. Researchers adjusted for age, sex and race, and other health conditions such as diabetes and high blood pressure. The results: Of the 497 people who took PPIs for more than four years, 58 of them developed dementia.

The latest study identified B12 deficiency and impaired amyloid metabolism – two conditions which can contribute to cognitive decline – as potential links between PPIs and dementia. The study’s authors conceded, though, that more research is needed on the link between PPIs and dementia.

“B12 deficiency and impaired amyloid metabolism certainly could be links between the long-term use of PPIs and dementia,” said Dr. Wald. “However, it would be helpful to confirm this and other possible causes so that we can better understand risk factors.”

Gastroenterologists advise patients with acid reflux to make necessary dietary modifications to reduce portion sizes and eliminate the triggers that cause acid reflux, such as spicy or greasy foods and excessive amounts of caffeine or alcohol. They also make other recommendations, such as not eating for about 3 hours before going to bed or staying upright after a meal — much like those naps some tend to take after a Thanksgiving feast.