Links Between Memory and Heartburn Medicines
Dementia is primarily a disease of aging, and as the world’s population lives longer, the number of people diagnosed with such diseases is expected to double every 20 years. In the United States, one of every three seniors dies with dementia, and more than 3 million Americans are diagnosed with dementia every year.
Americans as a group seem to be preoccupied with the horrors of this group of diseases, especially Alzheimer’s disease. Because we seem unable to track down the primary reasons why dementia occurs, other than obvious factors like genetics, stroke and clogged arteries, there is a sense that we’re helpless against this growing onslaught.
Thus, a new study out of Germany that points a finger at proton pump inhibitors as one possible source of dementia is of special interest. And it tends to support an earlier study that drew a link between these drugs and dementia.
|Thus, a new study out of Germany that points a finger at proton pump inhibitors as one possible source of dementia is of special interest. And it tends to support an earlier study that drew a link between these drugs and dementia.|
Proton pump inhibitors (let’s call them PPIs) is a fancy name for a group of heartburn drugs, most of them sold over the counter. You’ve probably heard of these drugs because they are the most popular medicines consumed in this country. They go by names such as Prilosec, Zegerid, Prevacid and Nexium, among many others. Sales of PPIs exceed $10 billion in the United States each year, and one of them — Nexium — has more than once been the highest-selling drug of the year.
It’s a little sloppy to call PPIs heartburn drugs, but that’s primarily why many people take them. When you have heartburn, often your body is trying to tell you that what you’re eating isn’t good for you. Millions of Americans take PPIs so they can eat the bad meals they love. In more serious cases, the drugs are prescribed to treat gastric ulcers and acid reflux disease.
The abuse of PPIs is so rampant that most clinicians now agree they are both overprescribed and overused, and as many as 70% of such consumers would be better off substituting a simple antacid such as Maalox.
Of course, the best approach would be to lose weight, exercise more, consume fewer fatty foods and notice if spicy or acidic foods simply don’t work well for you. But as my personal physician often says: “I give hundreds of my patients advice like that, and only a handful actually take it.”
The study in Germany included nearly 200,000 patients. Of these, about 3,000 patients were regular or daily users of PPIs. Although there was a clear correlation between how often the drugs were used over a long period of time and the onset of dementia, those who took PPIs regularly had a much higher frequency of dementia diagnosis.
No one knows for certain how the drugs could increase dementia, but one theory is that they cross the blood-brain barrier and change the action of certain enzymes. In mice, PPIs have been shown to increase beta amyloids, which we associate with Alzheimer’s disease. Sometimes patients who use PPIs have low levels of vitamin B-12, which has been linked to memory problems. (Taking B-12 as a supplement is unlikely to produce good results if your diet is decent and you have not been diagnosed as having a B-12 deficiency.)
The study, published inJAMA Neurology, was accompanied by an editorial pointing out that if the results are correct — and they do need to be confirmed with follow-up studies — even a tiny increased risk from PPIs could result in tens of thousands of new cases every year. Critics point to flaws in the design of the study and say some correlations may be weak. But everyone seems to agree that too many people take too many PPIs, so this study at worst could create a discussion between physicians and patients about whether they actually should be taking these drugs.
The study had one other interesting side note: Incidence of dementia was significantly increased among patients taking five or more prescription medicines. The cross interactions between the vast majority of modern medicines remain a mystery.
To your health and wealth,