PMID- 29391266
OWN - NLM
STAT- MEDLINE
DCOM- 20191114
LR  - 20191114
IS  - 1542-7714 (Electronic)
IS  - 1542-3565 (Linking)
VI  - 16
IP  - 5
DP  - 2018 May
TI  - Lack of Association Between Proton Pump Inhibitor Use and Cognitive Decline.
PG  - 681-689
LID - S1542-3565(18)30103-4 [pii]
LID - 10.1016/j.cgh.2018.01.034 [doi]
AB  - BACKGROUND & AIMS: Studies of association between use of proton pump inhibitors 
      (PPI) and dementia have yielded conflicting results. We investigated the effects 
      of PPIs on cognitive decline in a study of middle-aged and elderly twins in 
      Denmark. METHODS: In a prospective study, we collected data from surveys of 
      middle-aged individuals (46-67 years old; the Middle Aged Danish Twin study) and 
      older individuals (the Longitudinal Study of Aging Danish Twins) who underwent 
      cognitive assessments (a 5-component test battery) over a 10-year period 
      (middle-age study, n = 2346) or a 2-year period (longitudinal study of aging: n = 
      2475). We determined cumulative use of PPIs 2 years prior study enrollment and 
      during follow up, in defined daily doses (DDDs) of PPIs, using data from a 
      nationwide prescription register. Multi-variable linear regression models were 
      used to examine associations between cumulative PPI use and a composite score of 
      cognitive function at baseline and decreases in scores during the follow-up 
      periods. RESULTS: Use of PPIs before study enrollment was associated with a 
      slightly lower mean cognitive score at baseline in the middle age study. The 
      adjusted difference in mean score of individuals with high consumption of PPIs 
      (>/=400 DDD) was lower than that of non-users in the middle-age study (mean crude 
      score for high PPI use, 43.4 +/- 13.1 vs for non-use, 46.8 +/- 10.2; adjusted 
      difference of 0.69 points; 95% CI, -4.98 to 3.61). In the longitudinal study of 
      aging twins, individuals with high consumption of PPI had higher adjusted scores 
      than non-users (mean crude score for high PPI use, 35.2 +/- 10.8 vs for non-use, 
      36.2 +/- 11.1; adjusted difference of 0.95 points; 95% CI, -1.88 to 3.79). In 
      analyses of cognitive decline, among individuals with high consumption of PPIs in 
      the longitudinal study of aging, the adjusted mean difference between baseline 
      score and follow-up score was lower than that of non-users (mean crude score for 
      high PPI use at baseline, 36.6 +/- 10.1 and at follow up, 34.3 +/- 12.3 vs for 
      non-use at baseline, 38.1 +/- 10.5 and at follow up, 37.6 +/- 11.3; adjusted 
      difference of -1.22 points; 95% CI, -3.73 to 1.29). In the middle-age study, 
      users with the highest consumption of PPIs (>/=1600 DDD) had slightly less 
      cognitive decline than non-users (baseline mean crude score for high PPI use, 
      43.4 +/- 10.1 and follow-up mean crude score, 41.3 +/- 9.7 vs baseline score of 
      49.1 +/- 10.2 for non-users and follow-up score of 46.3 +/- 9.9 for non-users; 
      adjusted difference of 0.94 points; 95% CI, -1.63 to 3.50). No stated differences 
      in scores between PPI users and non-users were significant. CONCLUSIONS: In 
      analyzing data from 2 large population-based studies of twins in Denmark, we 
      found no association between PPI use and cognitive decline.
CI  - Copyright (c) 2018 AGA Institute. Published by Elsevier Inc. All rights reserved.
FAU - Wod, Mette
AU  - Wod M
AD  - Unit of Epidemiology, Biostatistics, and Biodemography, and the Danish Twin 
      Registry, and the Danish Aging Research Center, Department of Public Health, 
      University of Southern Denmark, Odense, Denmark.
FAU - Hallas, Jesper
AU  - Hallas J
AD  - Clinical Pharmacology and Pharmacy, Department of Public Health, University of 
      Southern Denmark, Odense, Denmark.
FAU - Andersen, Kjeld
AU  - Andersen K
AD  - Department of Psychiatry Odense, Mental Health Services, Region of Southern 
      Denmark, Odense, Denmark.
FAU - Garcia Rodriguez, Luis Alberto
AU  - Garcia Rodriguez LA
AD  - Centro Espanol Investigation Farmacoepidemiologica, Madrid, Spain.
FAU - Christensen, Kaare
AU  - Christensen K
AD  - Unit of Epidemiology, Biostatistics, and Biodemography, and the Danish Twin 
      Registry, and the Danish Aging Research Center, Department of Public Health, 
      University of Southern Denmark, Odense, Denmark.
FAU - Gaist, David
AU  - Gaist D
AD  - Department of Neurology, Odense University Hospital and Department of Clinical 
      Medicine, Faculty of Health Sciences, University of Southern Denmark, Odense, 
      Denmark. Electronic address: dgaist@health.sdu.dk.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20180131
PL  - United States
TA  - Clin Gastroenterol Hepatol
JT  - Clinical gastroenterology and hepatology : the official clinical practice journal 
      of the American Gastroenterological Association
JID - 101160775
RN  - 0 (Proton Pump Inhibitors)
SB  - IM
CIN - MMW Fortschr Med. 2018 Oct;160(18):40. PMID: 30350068
MH  - Aged
MH  - Aged, 80 and over
MH  - Cognitive Dysfunction/*chemically induced
MH  - Denmark
MH  - Female
MH  - Humans
MH  - Longitudinal Studies
MH  - Male
MH  - Middle Aged
MH  - Neuropsychological Tests
MH  - Prospective Studies
MH  - Proton Pump Inhibitors/*adverse effects/*therapeutic use
OTO - NOTNLM
OT  - Acid-Related Diseases
OT  - Epidemiology
OT  - Side-Effects
OT  - Treatment
EDAT- 2018/02/03 06:00
MHDA- 2019/11/15 06:00
CRDT- 2018/02/03 06:00
PHST- 2017/11/14 00:00 [received]
PHST- 2018/01/05 00:00 [revised]
PHST- 2018/01/21 00:00 [accepted]
PHST- 2018/02/03 06:00 [pubmed]
PHST- 2019/11/15 06:00 [medline]
PHST- 2018/02/03 06:00 [entrez]
AID - S1542-3565(18)30103-4 [pii]
AID - 10.1016/j.cgh.2018.01.034 [doi]
PST - ppublish
SO  - Clin Gastroenterol Hepatol. 2018 May;16(5):681-689. doi: 
      10.1016/j.cgh.2018.01.034. Epub 2018 Jan 31.