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Proton Pump Inhibitor Use and Risk of Developing Alzheimer’s Disease or Vascular Dementia: A Case–Control Analysis

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A Letter to the Editor to this article was published on 05 October 2018

Abstract

Introduction

Long-term use of proton pump inhibitors (PPIs) has been associated with an increased risk of Alzheimer’s disease (AD) in observational studies. The role of exposure duration, and whether this applies to other dementia subtypes, has not been explored in these studies.

Objective

The aim was to study the association between long-term use of PPIs (or of histamine-2 receptor antagonists [H2RAs], as a negative control) and the risk of developing AD or vascular dementia (VaD).

Methods

We conducted a case–control analysis on the UK-based Clinical Practice Research Datalink (CPRD). We identified 41,029 patients aged ≥ 65 years with newly diagnosed AD or VaD between 1998 and 2015 and matched them 1:1 to dementia-free controls on age, sex, calendar time, general practice, and number of years of recorded history. We applied conditional logistic regression analyses to calculate adjusted odds ratios (aORs), with 95% confidence intervals (CIs), of developing AD or VaD in relation to previous use of PPIs or H2RAs, categorized by exposure duration.

Results

As compared to non-use, long-term PPI use (≥ 100 prescriptions) was not associated with an increased risk of developing AD (aOR 0.88, 95% CI 0.80–0.97) or VaD (aOR 1.18, 95% CI 1.04–1.33). Neither was long-term use of H2RAs (≥ 20 prescriptions) associated with an increased risk of developing AD (aOR 0.94, 95% CI 0.87–1.02) or VaD (aOR 0.99, 95% CI 0.89–1.10).

Conclusion

In this large, case-control analysis, we did not find any evidence for an increased risk of either AD or VaD related to PPI or H2RA use.

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Acknowledgements

We thank Pascal Egger for the programming and technical support.

Author information

Authors and Affiliations

  1. Basel Pharmacoepidemiology Unit, Division of Clinical Pharmacy and Epidemiology, Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland

    Patrick Imfeld & Christoph R. Meier

  2. Hospital Pharmacy, University Hospital Basel, Basel, Switzerland

    Patrick Imfeld & Christoph R. Meier

  3. Medical Clinic, Zuger Kantonsspital, Baar, Switzerland

    Michael Bodmer

  4. Boston Collaborative Drug Surveillance Program, Lexington, MA, USA

    Susan S. Jick & Christoph R. Meier

  5. Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA

    Susan S. Jick

Authors
  1. Patrick Imfeld
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  4. Christoph R. Meier
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Correspondence to Christoph R. Meier.

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Funding

This study did not receive any funding.

Conflict of interest

Patrick Imfeld, Michael Bodmer, Susan S. Jick, and Christoph R. Meier have no conflicts of interest.

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Imfeld, P., Bodmer, M., Jick, S.S. et al. Proton Pump Inhibitor Use and Risk of Developing Alzheimer’s Disease or Vascular Dementia: A Case–Control Analysis. Drug Saf 41, 1387–1396 (2018). https://doi.org/10.1007/s40264-018-0704-9

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  • DOI: https://doi.org/10.1007/s40264-018-0704-9

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