Title:Proton Pump Inhibitors and Cognitive Health: Review on Unraveling the
Dementia Connection and Co-morbid Risks
Volume: 20
Issue: 11
Author(s): Zuber Khan, Sidharth Mehan*, Mohd. Anas Saifi, Ghanshyam Das Gupta, Acharan S. Narula and Reni Kalfin
Affiliation:
- Division of Neuroscience, Department of Pharmacology, ISF College of Pharmacy, Moga, Punjab, India (Affiliated to
IK Gujral Punjab Technical University), Jalandhar, Punjab, 144603, India
Keywords:
Proton-pump inhibitor, dementia, amyloid-beta, neurodegeneration, adverse effects, amyloid-beta (Aβ), peptides.
Abstract: Dementia, an international health issue distinguished by the impairment of daily functioning
due to cognitive decline, currently affects more than 55 million people worldwide, with
the majority residing in low-income and middle-income countries. Globally, dementia entails significant
economic burdens in 2019, amounting to a cost of 1.3 trillion US dollars. Informal caregivers
devote considerable hours to providing care for those affected. Dementia imposes a greater
caregiving and disability-adjusted life-year burden on women. A recent study has established a
correlation between prolonged Proton Pump Inhibitor (PPI) usage and dementia, in addition to
other neurodegenerative conditions. PPIs are frequently prescribed to treat peptic ulcers and
GERD (gastroesophageal reflux disease) by decreasing stomach acid secretion. They alleviate
acid-related symptoms through the inhibition of acid-secreting H+-K+ ATPase. In a number of observational
studies, cognitive decline and dementia in the elderly have been linked to the use of
PPIs. The precise mechanism underlying this relationship is unknown. These drugs might also alter
the pH of brain cells, resulting in the accumulation of amyloid-beta (Aβ) peptides and the development
of Alzheimer's disease (AD). Despite the compelling evidence supporting the association
of PPIs with dementia, the results of studies remain inconsistent. The absence of a correlation
between PPI use and cognitive decline in some studies emphasizes the need for additional research.
Chronic PPI use can conceal underlying conditions, including cancer, celiac disease, vitamin
B12 deficiency, and renal injury, highlighting dementia risk and the need for further investigations
on cognitive health.