Prilosec and Dementia (Alzheimer's)

A recent study about PPIs suggested that their long term use was associated with increased risk of dementia.

jamaneurol.2015.4791

I had a patient who immediately stopped her prilosec without discussing this with me!

In the study, German researchers simply looked at their health system database of over 70,000 patients over age 75. Using the data they looked at patients who did not have a dementia diagnoses in 2004; then did have one in 2011. Then they looked at medication use in those almost 30,000 who had this diagnosis, and found that, of the 2,800 original patients who had chronic use of PPI there were about 1600 diagnoses of dementia as opposed to expected 1200.

This is an absolute increase of 400 patients in over 30,000 cases. As well, this study depended on the proper diagnosis being sent to the insurance company. Furthermore, patients who took over the counter PPIs, like prilosec could not be controlled for.

Unlike newspaper headlines that stated this was a cause and effect (it certainly was far from it) the researchers stated that the association was interesting and rated further studies.

I prefer not giving any medication if possible. However if there is a clear need for a PPI; such as an ulcer, gastritis, or reflux, the risk of stopping the drug is probably much worse than that of dementia!