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2017 ; 12
(2
): e0171006
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English Wikipedia
Risk of dementia from proton pump inhibitor use in Asian population: A nationwide
cohort study in Taiwan
#MMPMID28199356
Tai SY
; Chien CY
; Wu DC
; Lin KD
; Ho BL
; Chang YH
; Chang YP
PLoS One
2017[]; 12
(2
): e0171006
PMID28199356
show ga
INTRODUCTION: Concerns have been raised regarding the potential association
between proton pump inhibitor (PPI) use and dementia. OBJECTIVE: This study aimed
to examine this association in an Asian population. METHODS: Patients initiating
PPI therapy between January 1, 2000 and December 31, 2003 without a prior history
of dementia were identified from Taiwan's National Health Insurance Research
Database. The outcome of interest was all-cause dementia. Cox regression models
were applied to estimate the hazard ratio (HR) of dementia. The cumulative PPI
dosage stratified by quartiles of defined daily doses and adjusted for baseline
disease risk score served as the primary variables compared against no PPI use.
RESULTS: We analyzed the data of 15726 participants aged 40 years or older and
free of dementia at baseline. PPI users (n = 7863; average follow-up 8.44 years)
had a significantly increased risk of dementia over non-PPI users (n = 7863;
average follow-up 9.55 years) (adjusted HR [aHR] 1.22; 95% confidence interval:
1.05-1.42). A significant association was observed between cumulative PPI use and
risk of dementia (P for trend = .013). Subgroup analysis showed excess frequency
of dementia in PPI users diagnosed with depression (aHR 2.73 [1.91-3.89]),
hyperlipidemia (aHR 1.81 [1.38-2.38]), ischemic heart disease (aHR 1.55
[1.12-2.14]), and hypertension (aHR 1.54 [1.21-1.95]). CONCLUSIONS: An increased
risk for dementia was identified among the Asian PPI users. Cumulative PPI use
was significantly associated with dementia. Further investigation into the
possible biological mechanisms underlying the relationship between dementia and
PPI use is warranted.
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