Proton pump inhibitors (heartburn meds) linked with increased risk of dementia

#1

Post by Urgo » Sat, May 09, 2020, 5:50 PM UTC

Proton pump inhibitors (heartburn meds) linked with increased risk of dementia
alz-journals.onlinelibrary.wiley.com

Re: Proton pump inhibitors (heartburn meds) linked with increased risk of dementia

#2

Post by patall » Sat, May 09, 2020, 6:15 PM UTC

From abstract: "Given that accumulating evidence points at cholinergic dysfunction as a driving force of major dementia disorders, our findings mechanistically explain how prolonged use of PPIs may increase incidence of dementia. This call for restrictions for prolonged use of PPIs in elderly, and in patients with dementia or amyotrophic lateral sclerosis."

This is classical A causes B and B causes C, so A leads to C which is something we have had before with amyloid plaques. This does not tell us this is false, but really just a link and nothing more.

Some beautiful day, we will fully understand the cause of dementia. Today is not that day.

Re: Proton pump inhibitors (heartburn meds) linked with increased risk of dementia

#3

Post by carbocation » Sat, May 09, 2020, 6:19 PM UTC

patall wrote: post #2

From abstract: "Given that accumulating evidence points at cholinergic dysfunction as a driving force of major dementia disorders, our findings mechanistically explain how prolonged use of PPIs may increase incidence of dementia. This call for restrictions for prolonged use of PPIs in elderly, and in patients with dementia or amyotrophic lateral sclerosis." This is classical A causes B and B causes C, so A leads to C…

I agree. The conclusions in the abstract are not warranted by the experiments. It's hard to imagine a situation where in silico docking experiments lead to a clinical conclusion such as "This call (sic) for restrictions for prolonged use of PPIs in elderly, and in patients with dementia or amyotrophic lateral sclerosis."

Re: Proton pump inhibitors (heartburn meds) linked with increased risk of dementia

#4

Post by atian » Sat, May 09, 2020, 6:23 PM UTC

Stomach is known to kill stuff before they become harmful to us. If PPIs let more things through... well that makes sense.

Specifically: - https://www.statnews.com/2020/05/06/researchers-show-herpes-...

There are more relating to opportunistic fungal, bacterial, and so on. Relating to the mechanism of increased susceptibility to infection may be related to our stomach's part in naturally being an infection load regulator through its acid, in combination with our hydration gradient providing for our saliva in (that tract). Someone please credit me in the future if they win a nobel prize.

Re: Proton pump inhibitors (heartburn meds) linked with increased risk of dementia

#5

Post by toastflambe » Sat, May 09, 2020, 6:37 PM UTC

Interesting study linked from this one: "Cognitive impact after short-term exposure to different proton pump inhibitors" https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4696341/

Re: Proton pump inhibitors (heartburn meds) linked with increased risk of dementia

#6

Post by Droobfest » Sat, May 09, 2020, 6:39 PM UTC

This is just anecdotal, but I've had problems with heartburn for years and am having great succes with betaine hcl + pepsin supplements. This actually increases stomach acid. That + dietary changes almost completely cleared my problems. Just throwing it out there. YMMV.

Re: Proton pump inhibitors (heartburn meds) linked with increased risk of dementia

#7

Post by tyingq » Sat, May 09, 2020, 6:40 PM UTC

And untreated chronic heartburn has a fairly strong link to cancer. And some of the better non-PPI drugs, like ranitidine were just pulled by the FDA for impurities. Then, famotidine is in short supply because of some study that it might treat COVID-19. Yikes.

Re: Proton pump inhibitors (heartburn meds) linked with increased risk of dementia

#8

Post by breischl » Sat, May 09, 2020, 6:42 PM UTC

patall wrote: post #2

From abstract: "Given that accumulating evidence points at cholinergic dysfunction as a driving force of major dementia disorders, our findings mechanistically explain how prolonged use of PPIs may increase incidence of dementia. This call for restrictions for prolonged use of PPIs in elderly, and in patients with dementia or amyotrophic lateral sclerosis." This is classical A causes B and B causes C, so A leads to C…

Somewhat tangentially, do you have an opinion on whether PPIs cause dementia, regardless of what the mechanism may be?

Reason I ask is that I've been taking them daily for years to control GERD, so I'm wondering if I'm frying my brain. But I'm not really qualified to understand the intricacies of this kind of research.

Even further tangent: seems like they may also cause acute kidney injury. Yaaaay. I guess everything is a tradeoff. https://www.ncbi.nlm.nih.gov/pubmed/30779194

Re: Proton pump inhibitors (heartburn meds) linked with increased risk of dementia

#9

Post by purplerabbit » Sat, May 09, 2020, 6:46 PM UTC

Droobfest wrote: post #6

This is just anecdotal, but I've had problems with heartburn for years and am having great succes with betaine hcl + pepsin supplements. This actually increases stomach acid. That + dietary changes almost completely cleared my problems. Just throwing it out there. YMMV.

Same here. I guess my issue was inadequate stomach acid, not excess...

Re: Proton pump inhibitors (heartburn meds) linked with increased risk of dementia

#10

Post by golemotron » Sat, May 09, 2020, 6:55 PM UTC

toastflambe wrote: post #5

Interesting study linked from this one: "Cognitive impact after short-term exposure to different proton pump inhibitors" https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4696341/

A good next study would to see if the study participants' decline reversed after being removed from the drugs.