Proton-pump Inhibitors and the Risk of Dementia: A Systematic Review and Meta-analysis

Yoon, Kyu-Tae; Bang, Chang Seok; Kim, Joon Sung

doi:10.7704/kjhugr.2020.0057

Cited by 2 publications

(3 citation statements)

References 41 publications

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“…Statistical heterogeneity and small‐study effect are known as two major issues affecting the validity of meta‐analyses 34 . Although heterogeneity in our primary analysis is substantial (

I^{2}

= 99%), it is consistent with the ones from previous meta‐analyses by Wang et al (

I^{2}

= 98.5%), 15 Khan et al (

I^{2}

= 96%), 53 Desai et al (

I^{2}

= 93%) 52 and Yoon et al (

I^{2}

= 91%) 54 . If the studies become very large, the sampling error tends to null and

I^{2}

comes close to 1.…”

Section: Discussionsupporting

confidence: 89%

“…A recent meta‐analysis with five studies 54 found a pooled HR of 1.17 (95% CI = 0.91; 1.49). The authors assessed the risk of bias of each study using the risk of bias assessment tool for non‐randomized studies (RoBANS) 55 .…”

Section: Discussionmentioning

confidence: 99%

“…(I 2 = 96%), 53 Desai et al (I 2 = 93%) 52 and Yoon et al (I 2 = 91%). 54 If the studies become very large, the sampling error tends to null and I 2 comes close to 1. On the other hand, a description of the underlying between-study variability can best be obtained by estimating the between-study variance, τ 2 .…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Do proton pump inhibitors increase the risk of dementia? A systematic review, meta‐analysis and bias analysis

Ahn

Nolde

Krause

et al. 2022

Brit J Clinical Pharma

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Aim: Previous studies on the association between proton pump inhibitor (PPI) intake and the increased risk of dementia has shown discrepancies in their conclusions. We aimed to provide updated evidence based on extensive bias assessments and quantitative sensitivity analyses. Methods:We searched the databases PubMed, EMBASE, SCOPUS, CENTRAL and clinicaltrials.gov for prospective studies that examined an association between PPI use and dementia, up to February 2022. Each study was assessed using the Cochrane risk of bias assessment tools for non-randomized studies of interventions (ROBINS-I) or randomized trials (RoB2). Pooled risk ratios (RRs) and 95% prediction intervals were computed using random-effects models. Sensitivity analyses were adjusted for small-study bias.Results: We included nine observational studies with 204 108 dementia cases in the primary analysis on the association between PPI use vs. non-use and dementia, and the RR was 1.16 (95% CI = 1.00; 1.35). After adjusting for small-study bias by Copas selection model and Rücker's shrinkage procedure, the RR was 1.16 (1.02; 1.32) and 1.15 (1.13; 1.17), respectively. A subgroup analysis of PPI use vs. non-use regarding Alzheimer's disease risk yielded an RR of 1.15 (0.89; 1.50). The secondary analysis on the risk of dementia by use of PPI vs. histamine-2 receptor antagonist showed an RR of 1.03 (0.66; 1.62). Conclusion:This meta-analysis provided no clear evidence for an association between PPI intake and the risk of dementia. Due to discrepancies in sensitivity analyses, however, some risk of dementia by PPI use cannot be ruled out. Since an unequivocal conclusion is still pending, further research is warranted.

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“…Statistical heterogeneity and small‐study effect are known as two major issues affecting the validity of meta‐analyses 34 . Although heterogeneity in our primary analysis is substantial (