Over the past week, while covering the inpatient gastroenterology service, we cared for three patients who were hospitalized with gastrointestinal bleeding who were found to have large, potentially life-threating, stomach ulcers. All three of the patients had abruptly stopped their acid-suppressing proton pump inhibitor (PPI) medication in the preceding 1 to 2 weeks. With PPIs being a primary therapy for gastroesophageal reflux and ulcer treatment, why would these patients have stopped their PPIs without medical consultation? Unanimously, they had all heard on the news that a new study found that PPIs might cause dementia.
This past month, a recent study in JAMA Neurology by Gomm and colleagues from the German Center for Neurodegenerative Diseases reported that PPI usage among those over the age of 75 may be associated with a risk of dementia. While the study findings showed a statistical association, it is important to understand the limitations of their findings and how interpretation of these results can lead to significant consequences.
The authors were fair in pointing out certain limitations in their study, and an accompanying editorial by Dr. Kuller further highlighted that while the authors’ findings are potentially important, they are unable to draw the conclusion that PPIs cause dementia. Furthermore, the American Gastroenterological Association (AGA) and other gastrointestinal societies have released statements on how to interpret such a study, and the importance of educating patients on why they are prescribed PPIs and what their risks and benefits may be. Despite these warnings, patients have stopped taking their PPIs because they are concerned about the chance of developing dementia, and as a result, possibly placing themselves at risk.
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via Donald M. Hayes Blog http://donaldmhayessr.blogspot.com/2016/03/dementia-from-ppis-hypothesis-that-may.html