Clinical Use of Acid Suppressants and Risk of Dementia in the Elderly: A Pharmaco-Epidemiological Cohort Study

Liang-Yu Chen, Huey-Juan Lin, Wen-Tung Wu, Yong-Chen Chen, Cheng-Li Chen, Jing Kao, San-Lin You, Yu-Ching Chou and Chien-An Sun
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Liang-Yu Chen: Department of Pharmacy Practice, Tri-Service General Hospital, National Defense Medical Center, Taipei City 114, Taiwan
Huey-Juan Lin: Department of Neurology, Chi-Mei Medical Center, Tainan City 710, Taiwan
Wen-Tung Wu: Department of Pharmacy Practice, Tri-Service General Hospital, National Defense Medical Center, Taipei City 114, Taiwan
Yong-Chen Chen: Department of Medicine, College of Medicine, Fu-Jen Catholic University, New Taipei City 242, Taiwan
Cheng-Li Chen: School of Public Health, National Defense Medical Center, Taipei City 114, Taiwan
Jing Kao: School of Public Health, National Defense Medical Center, Taipei City 114, Taiwan
San-Lin You: Department of Medicine, College of Medicine, Fu-Jen Catholic University, New Taipei City 242, Taiwan
Yu-Ching Chou: School of Public Health, National Defense Medical Center, Taipei City 114, Taiwan
Chien-An Sun: Big Data Research Center, College of Medicine, Fu-Jen Catholic University, New Taipei City 242, Taiwan

IJERPH, 2020, vol. 17, issue 21, 1-12

Abstract: Background: Results of studies regarding the potential link between acid suppressant use and dementia risk are inconsistent. This study aimed to evaluate the association of cumulative exposure to histamine 2 receptor antagonists (H2RAs) and proton pump inhibitors (PPIs) with dementia risk in an Asian older cohort aged ≥65 years. Methods: Patients initiating H2RA (the H2RA user cohort, n = 21,449) or PPI (the PPI user cohort, n = 6584) and those without prescription for H2RA (the H2RA non-user cohort, n = 21,449) or PPI (the PPI non-user cohort, n = 6584) between 1 January 2000 and 31 December 2005 without a prior history of dementia were identified from Taiwan’s National Health Insurance Research Database (NHIRD). The outcome of interest was all-cause dementia. Patients’ exposure to H2RAs or PPIs was followed-up from dates of initial prescription to the earliest outcome of incident dementia, death, or the end of 2013. Potential associations between acid suppressant use and dementia risk were analyzed using time-dependent Cox regression estimated hazard ratios (HRs) and 95% confidence intervals (CIs). Results: After mutual adjustment for H2RA and PPI use and other potential confounders, patients with H2RA use had significantly higher risk of developing dementia as compared to those not treated with H2RAs (adjusted HR, 1.84; 95% CI, 1.49–2.20). Likewise, PPI users had significantly elevated risk of dementia compared to PPI non-users (adjusted HR, 1.42; 95% CI, 1.07–1.84). Conclusions: Our results indicate that exposures to H2RAs and PPIs are associated with increased dementia risk.

Keywords: dementia; histamine 2 receptor antagonist; proton pump inhibitors; retrospective cohort study (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
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