Acid suppressants use and the risk of dementia: A population-based propensity score-matched cohort study

Abstract

In this population-based propensity score matched (PSM) cohort study, we aimed to investigate the risk of developing dementia with the use of acid suppressants, including proton pump inhibitors (PPIs) and histamine-2 receptor antagonists (H2 antagonists). Cohorts of PPI users (n = 2,778), H2 antagonist users (n = 6,165), and non-users (n = 86,238) were selected from a dataset covering the years 2000 to 2010 in Taiwan’s National Health Insurance Research Database. Patients in the three groups were PSM at a ratio of 1:1 within each comparison cohort (CC). Three CCs were created: (1) PPI users compared to non-users (CC1, n = 2,583 pairs); (2) H2 antagonist users compared to non-users (CC2, n = 5,955 pairs); and (3) PPI users compared to H2 antagonist users (CC3, n = 2,765 pairs). A multivariable robust Cox proportional hazard model was used to estimate the adjusted hazard ratio (aHR) and the 95% confidence interval (CI) for the risk of developing dementia. The multivariable analysis results show that the aHR of developing dementia during the follow-up period was 0.72 (CC1: 95% CI = 0.51–1.03, P = 0.07) for PPI users and 0.95 (CC2: 95% CI = 0.74–1.22, P = 0.69) for H2 antagonist users, when compared to non-users. Between the patients using acid suppressants, there was no difference between PPI and H2 antagonist users in the risk of developing dementia (CC3: aHR = 0.82, 95% CI = 0.58–1.17, P = 0.28). In conclusion, no association was observed between the use of acid suppressants and the risk of developing dementia in any of the three CCs. Further, randomized controlled trials are warranted to confirm this relationship.

No association between acid suppressant use and risk of dementia: an updated meta-analysis

“…The full texts of the remaining 53 articles were examined in detail, of which 36 articles were excluded according to the selection criteria. Finally, 17 studies were included for the present meta-analysis [3,[12][13][14][15][17][18][19][20][21][22][23][24][25][26][27][28]. A flowchart of the literature search is presented in Fig.…”

Shared Genetic Architecture Between Alzheimer’s Disease and Gastrointestinal Tract Disorders: A Large-scale Genome-wide Cross-trait Analysis

“…along with this UKB GWAS data. The genetic correlation between the 'clinically diagnosed AD' and the 'AD-by proxy' is high at 0.81 [23], providing strong evidence or justi cation for combining them as more comprehensively described in the associated publication [23]. *PGM: medications for PUD and GERD.…”

“…First, is there a risk-increasing association between AD and GIT disorders (including medicines commonly used for PUD, GERD, or gastritis-duodenitis)? This question assumes great importance in the face of contrasting evidence and longstanding debates on the potential roles of GIT traits in the risk of AD [18, [21][22][23]. Second, is there a cause-and-effect relationship between AD and GIT disorders (vertical pleiotropy)?…”

Gastric acid suppressants and cognitive decline in people with or without cognitive impairment

“… 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 Clinically, physicians or patients may be confronted with choosing either a PPI or an H2RA when potent gastric acid suppression is necessary; therefore, it is important to determine whether one class is associated with a slower rate of cognitive decline compared to the other. Because few studies have specifically compared PPI versus H2RA monotherapy, with mixed evidence, 14 , 24 , 25 the present study investigates whether there is a difference in cognitive decline between H2RA versus PPI monotherapy users.…”