PMID- 29134629
OWN - NLM
STAT- MEDLINE
DCOM- 20190830
LR  - 20240315
IS  - 1532-5415 (Electronic)
IS  - 0002-8614 (Print)
IS  - 0002-8614 (Linking)
VI  - 66
IP  - 2
DP  - 2018 Feb
TI  - Proton Pump Inhibitor Use and Dementia Risk: Prospective Population-Based Study.
PG  - 247-253
LID - 10.1111/jgs.15073 [doi]
AB  - OBJECTIVES: To determine whether higher cumulative proton pump inhibitor (PPI) 
      exposure is associated with greater dementia risk. DESIGN: Prospective 
      population-based cohort study. SETTING: Kaiser Permanente Washington, an 
      integrated healthcare delivery system in Seattle, Washington. PARTICIPANTS: 
      Individuals aged 65 and older without dementia at study entry (N = 3,484). 
      MEASUREMENTS: Participants were screened for dementia every 2 years, and those 
      who screened positive underwent extensive evaluation. Dementia outcomes were 
      determined using standard diagnostic criteria. Time-varying PPI exposure was 
      determined from computerized pharmacy data and consisted of total standardized 
      daily doses (TSDDs) dispensed to an individual in the prior 10 years. We also 
      assessed duration of use. Multivariable Cox regression was used to estimate the 
      association between PPI exposure and time to dementia or Alzheimer's disease 
      (AD). RESULTS: Over a mean follow-up of 7.5 years, 827 participants (23.7%) 
      developed dementia (670 with possible or probable AD). PPI exposure was not 
      associated with risk of dementia (P = .66) or AD (P = .77). For dementia, the 
      risk for specific levels of cumulative exposure compared to no use was: 365 TSDDs 
      (HR 0.87, 95% CI 0.65-1.18), 1,095 TSDDs (HR 0.99, CI 0.75-1.30) and 1,825 TSDDs 
      (HR 1.13, CI 0.82-1.56). These TSDD levels represent approximately 1, 3 and 5 
      years of daily use respectively. Duration of PPI use was not associated with 
      dementia outcomes either. CONCLUSION: Proton pump inhibitor use was not 
      associated with dementia risk, even for people with high cumulative exposure. 
      Although there are other safety concerns with long-term PPI use, results from our 
      study do not support that these medications should be avoided out of concern 
      about dementia risk.
CI  - (c) 2017, Copyright the Authors Journal compilation (c) 2017, The American Geriatrics 
      Society.
FAU - Gray, Shelly L
AU  - Gray SL
AD  - School of Pharmacy, University of Washington, Seattle, Washington.
FAU - Walker, Rod L
AU  - Walker RL
AD  - Kaiser Permanente Washington Health Research Institute, Seattle, Washington.
FAU - Dublin, Sascha
AU  - Dublin S
AD  - Kaiser Permanente Washington Health Research Institute, Seattle, Washington.
AD  - Department of Epidemiology, School of Public Health and Community Medicine, 
      University of Washington, Seattle, Washington.
FAU - Yu, Onchee
AU  - Yu O
AD  - Kaiser Permanente Washington Health Research Institute, Seattle, Washington.
FAU - Aiello Bowles, Erin J
AU  - Aiello Bowles EJ
AD  - Kaiser Permanente Washington Health Research Institute, Seattle, Washington.
FAU - Anderson, Melissa L
AU  - Anderson ML
AD  - Kaiser Permanente Washington Health Research Institute, Seattle, Washington.
FAU - Crane, Paul K
AU  - Crane PK
AD  - Division of General Internal Medicine, Department of Medicine, University of 
      Washington, Seattle, Washington.
FAU - Larson, Eric B
AU  - Larson EB
AD  - Kaiser Permanente Washington Health Research Institute, Seattle, Washington.
AD  - Division of General Internal Medicine, Department of Medicine, University of 
      Washington, Seattle, Washington.
LA  - eng
GR  - U01 AG006781/AG/NIA NIH HHS/United States
GR  - Z01 AG000678/ImNIH/Intramural NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
DEP - 20171114
PL  - United States
TA  - J Am Geriatr Soc
JT  - Journal of the American Geriatrics Society
JID - 7503062
RN  - 0 (Proton Pump Inhibitors)
SB  - IM
CIN - J Am Geriatr Soc. 2018 Feb;66(2):224-226. PMID: 29134626
MH  - Aged
MH  - Aged, 80 and over
MH  - Dementia/*chemically induced
MH  - Female
MH  - Humans
MH  - Inappropriate Prescribing
MH  - Male
MH  - Prospective Studies
MH  - Proton Pump Inhibitors/*adverse effects/*therapeutic use
MH  - Risk Factors
MH  - Washington
PMC - PMC5809315
MID - NIHMS897827
OTO - NOTNLM
OT  - Alzheimer disease
OT  - aged
OT  - cohort study
OT  - dementia
OT  - pharmacoepidemiology
OT  - proton pump inhibitor
COIS- Conflicts of Interest: EBL receives royalties from UpToDate; RLW received funding 
      as a biostatistician from a research grant awarded to Group Health Research 
      Institute from Pfizer; OY received funding as a biostatistician from research 
      grants awarded to Group Health Research Institute from Bayer; and SLG, SD, EJAB, 
      PKC, MLA have no financial interests that may be relevant to the submitted work. 
      [Table: see text]
EDAT- 2017/11/15 06:00
MHDA- 2019/08/31 06:00
PMCR- 2019/02/01
CRDT- 2017/11/15 06:00
PHST- 2017/11/15 06:00 [pubmed]
PHST- 2019/08/31 06:00 [medline]
PHST- 2017/11/15 06:00 [entrez]
PHST- 2019/02/01 00:00 [pmc-release]
AID - 10.1111/jgs.15073 [doi]
PST - ppublish
SO  - J Am Geriatr Soc. 2018 Feb;66(2):247-253. doi: 10.1111/jgs.15073. Epub 2017 Nov 
      14.