Proton pump inhibitors (PPIs) are commonly used for gastroesophageal reflux disease. Previous studies have raised concerns about the impact of PPIs on cognition in older adults, but with a limited amount of evidence available to support this concern, a new systematic review has been conducted by authors Xiaoyi Gao, Zi Yi Shao, Noam Grysman, George T Grossberg. It was published in the journal touchREVIEWS in Neurology on 20 February 2023.
The systematic review looked at relevant studies conducted between 2015 and 2022. Seventeen such studies were identified. Limitations to available research data included the fact that studies were mainly observational, used heterogeneous study methods and did not account for confounding variables such as B12 deficiency, Helicobacter pylori infection, and thyroid dysfunction. Overall, this review did not find a compelling association between PPI use and cognitive decline. The review concluded that studies have overall demonstrated conflicting results regarding the association between long-term PPI use and cognitive decline, and that the extent of the impact of PPIs on cognitive functions remains controversial. Despite a variety of studies and sample sizes, the overall quality of evidence for PPIs' adverse effects on cognition is low, the authors state.
Future studies should take into account confounding factors and have a stringent study design, including the patient inclusion and exclusion criteria and study duration, they say, noting that more high-quality, long-term, controlled studies and investigations of purported pathophysiological mechanisms are needed. Read the article, here: