Risk of dementia from proton pump inhibitor use in Asian population: A nationwide cohort study in Taiwan

Risk of dementia from proton pump inhibitor use in Asian population: A nationwide cohort study in Taiwan Shu-Yu Tai, Chen-Yu Chien, Deng-Chyang Wu, Kun-Der Lin, Bo-Lin Ho, Yu-Han Chang, Yang-Pei Chang Risk of dementia from proton pump inhibitor use in Asian population: A nationwide cohort study in Taiwan Shu-Yu Tai, Chen-Yu Chien, Deng-Chyang Wu, Kun-Der Lin, Bo-Lin Ho, Yu-Han Chang, Yang-Pei Chang PLOS x Published: February 15, 2017https://doi.org/10.1371/journal.pone.0171006 Article Authors Metrics Comments Related Content Abstract Introduction Methods Results Discussion Conclusions Supporting information Acknowledgments Author Contributions References Reader Comments (0) Media Coverage (0) Figures Abstract 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.