The impact of proton pomp inhibitors on the development of dementia in the elderly population

Abstract

Dementia is a syndrome characterized by progressive decline in cognitive functions, loss of motor skills, and the ability to perform self-care tasks. The global increase in the number of dementia patients each year is attributed to longer life expectancy and aging populations. Currently, there is no standardized approach to dementia treatment, thus primary prevention aimed at mitigating risk factors is a key focus of healthcare systems. Some pharmacological agents have the potential to impact patients' cognitive functions, which should be considered when prescribing them. Proton pump inhibitors (PPIs) are one of the most commonly prescribed classes of medications for elderly patients prone to gastrointestinal diseases. The polymorbidity of this patient group warrants PPI prescription as gastroprotective therapy alongside other medications affecting gastric secretion (NSAID, anticoagulants, glucocorticoids). There are numerous examples of undesirable interactions between proton pump inhibitors (PPIs) and other drugs: reduced absorption of antifungal agents and certain cardiac glycosides, alteration of metabolism, mutual enhancement or reduction of the pharmacological effects of PPIs and another prescribed drug against the background of the first, and an increase in mortality among patients taking PPIs and clopidogrel due to the potential reduction of its antiplatelet effect. The purpose of the work is to analyze and systematize data on the relationship between the use of PPIs and the development of dementia. The potential mechanisms of the influence of PPIs on the cognitive functions of elderly and senile people are considered.