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Proton Pump Inhibitors and Dementia: Deciphering the Data

Moayyedi, Paul MD, PhD1; Lewis, Maxine A MD, MMedSc2

American Journal of Gastroenterology: December 2017 - Volume 112 - Issue 12 - p 1809–1811
doi: 10.1038/ajg.2017.415

Abstract: Proton pump inhibitors (PPIs) are effective and suppressing acid, and therefore have efficacy against gastric acid-related disorders. The long-term safety of PPIs is less clear and there have been a number of studies raising concerns regarding risk of pneumonia, fracture,Clostridium difficile, chronic renal failure, and dementia. This latter concern is addressed by a study in this issue of AJG using health care registry data and found there was no association between PPI use and Alzheimer’s dementia. Furthermore, there was no increased risk of dementia with long-term use of PPIs or higher doses of PPIs. Discrepancies between studies probably relate to multiple testing and residual confounding and currently there is insufficient evidence to suggest that the association between PPIs and dementia is causal.

1Farncombe Family Digestive Health Research Institute, Gastroenterology Division, McMaster University, Hamilton, Ontario, Canada

2Department of Psychiatry, St Joseph’s University Health Care, McMaster University, Hamilton, Ontario, Canada

Correspondence: Paul Moayyedi, MD, PhD, Farncombe Family Digestive Health Research Institute, Gastroenterology Division, McMaster University, 1200 Main Street West, Hamilton, Ontario, Canada L8N3Z5. E-mail:

Received 19 September 2017; accepted 20 September 2017

Guarantor of the article: Paul Moayyedi, MD, PhD.

Specific author contributions: PM and MAL contributed equally to this manuscript.

Financial support: None.

Potential competing interests: PM has received honoraria for advisory boards from Allergan, Shire, and Salix Pharmaceuticals; he has received speaker fees from Allergan and Abbvie, and has research support from Allergan and Takeda. None of this income relates to PPI therapy and most PPIs are now generic in most countries. MAL has no conflicts of interests.

© The American College of Gastroenterology 2017. All Rights Reserved.
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