Some feel it creeping up on them after a lavish meal. Others know they can expect it after certain foods. Whatever the case may be, heartburn is a dreaded discomfort that affects more than 60 million Americans monthly and 15 million daily, according to the American College of Gastroenterology. Over-the-counter medicines have become a go-to solution for man looking for relief from the pain. But according to a study, one popular type of heartburn medication could considerably raise your dementia risk. Read on to see which pills could be a cause for concern.
Taking proton pump inhibitors such as Protonix, Prilosec, and Nexium for heartburn could raise your dementia risk.
A study published in the journal JAMA Neurology in February 2016 looked for any possible connection between over-the-counter proton pump inhibitors (PPIs) commonly used to treat heartburn, gastroesophageal reflux disease (GERD), and peptic ulcers and the onset of dementia. A research team analyzed data from 73,679 participants aged 75 or older who were verified to not be suffering from dementia. They then checked chronic intake of PPIs such as omeprazole, esomeprazole, and pantoprazole—sold under the brand names Nexium, Prilosec, and Protonix, respectively—which was defined as using at least one prescription every three months over an 18-month window.
The team then conducted a follow-up with participants after eight years to assess how many had been diagnosed with cognitive decline. Results showed that those who regularly took the heartburn medication had a 44 percent higher risk of dementia compared to participants who didn't take the medicine.
The study's authors were quick to caution that more research was needed to establish a cause-and-effect link.
The results also revealed that men taking PPIs were at a slightly higher risk than women and that participants who only occasionally took them were at a much lower risk overall. But despite the findings, the study's authors emphasized that more thorough research was needed to establish a link beyond a statistical association between heartburn medication and dementia.
"To evaluate cause-and-effect relationships between long-term PPI use and possible effects on cognition in the elderly, randomized, prospective clinical trials are needed," Britta Haenisch, MD, PhD, one of the study's authors from the German Center for Neurodegenerative Diseases in Bonn, said in a statement. She clarified that for the time being, "clinicians should follow guidelines for PPI prescription, to avoid overprescribing PPIs and inappropriate use."
Research has found that PPIs may affect enzymes in the brain that are associated with dementia.
Though there is still need for more research, the relationship between heartburn medication and dementia observed in the study has been explored. Previous research has found that PPIs may be able to cross the blood-brain barrier more easily in older adults as it becomes more porous, allowing them to interact with specific enzymes and ultimately leading to an increase in levels of amyloid-beta and tau proteins that are associated with Alzheimer's disease. And other studies have found that PPI use can lead to vitamin B12 deficiency, which is also associated with dementia, according to WebMD.
"There still may be other mechanisms at work that are unknown," Houman Javedan, MD, a clinical director of inpatient geriatrics at Brigham and Women's Hospital in Boston who was not involved in the study, told Harvard Health Publishing. "But this study raises the question whether chronic PPI usage is safe, especially among the older population."
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Check with your doctor to see if you're taking the correct dosage of heartburn medication.
Experts say the study results also expose the tendency for many patients to continue medical regimens they may no longer need. "Older adults take more medications as they age, and often continue them long after they are still necessary," Javedan told Harvard Health Publishing. "They either get used to taking it, and do not think to ask their doctor if they should stop, or they are afraid of what might happen if they do."
Still, others are planning on using the connection established in the study to allow patients to make up their minds about the medications. "I'm going to disclose the finding to my patients and then let them decide whether they will take the risk or not," Malaz Boustani, MD, a professor of medicine with the Indiana University Center for Aging Research and a spokesman for the American Federation for Aging Research, told WebMD.
According to Boustani, anyone looking to ween themselves off of heartburn medications can often do so by taking some preventative measures to reduce excess acid and prevent acid reflux. He suggests avoiding large meals and overeating, not lying down for a few hours after eating, and avoiding certain triggering items like caffeine and chocolate.