A study out of Germany has found a link between heartburn drugs and dementia, but for now, no one is being told to shelve their Nexium pills just yet.
At the very least, the link between heartburn drugs and dementia only suggests that this class of medicine is not quite as safe as doctors once believed. The study also adds to a growing list of troublesome side effects suffered by regular users of Prilosec, Nexium, and Prevacid.
In the U.S., these proton pump inhibitors are widely used, perhaps too much: 15 million Americans reported to be taking the prescription, CBS News reported. These days, the most popular of these are available over-the-counter, adding to growing concern that people are popping the pills to treat minor cases of heartburn or acid reflux.
A recent estimate suggests that 70 percent of all these prescriptions are unnecessary, and a quarter of those who take them could stop without any ill effects.
And now that PPIs and cognitive decline have been linked, however tenuously at the moment, this new possible side effect of long-term use may be enough to convince some of those patients to stop for good. While some doctors have reacted to this study with caution, others aren’t convinced that they’re quite so harmful.
“I don’t think there’s going to be an uprising among doctors telling patients not to take their (pills),” said Keith Fargo, the director of scientific programs and outreach for the Alzheimer’s Association. “This doesn’t rise anywhere near the level of evidence you would need for that.”
German researchers linked heartburn drugs to dementia by collecting data on 74,000 seniors aged 75 and up. Among that group, 2,950 were regular users, and 44 percent of them had an increased risk of the disease compared to those not taking the med. For now, that link is statistical and does not prove a direct cause, Reuters added.
Trouble is, Nexium, Prilosec, and the rest have already been linked to some pretty serious health problems in other studies. They’ve been linked to a 20 to 50 percent increased risk of chronic kidney disease, bone fracture, low magnesium levels, stomach infections, pneumonia, and Clostridium difficile infection. According to United Press International, PPIs may cause heart disease and a deficiency in vital vitamins, including B12.
And it’s the effect heartburn drugs have on B12 that’s most interesting, because B12 deficiency has been associated with cognitive decline, and there is already some evidence out there that PPIs could have a negative effect on the ability to reason. Recent studies have also uncovered the relationship as well — rodents on the meds were found to have more plaque in the brain, which led to dementia.
Despite this apparent link to another negative side effect, scientists have no clue why they’re connected. The medicines may cross the blood-brain barrier and, therefore, have some effect on brain enzymes. They also could affect the levels of proteins amyloid beta and tau, both of which have been associated with Alzheimer’s.
But the study has its flaws. Firstly, it didn’t address whether PPIs are only available by prescription in Germany or can be purchased over-the-counter, like in the U.S. If they are more easily available, their use may be more widespread and the link to dementia therefore weakened.
But perhaps the most damning flaw in the study is the fact that the researchers didn’t consider other risk factors. And the fact is, the same health problems that cause dementia — poor diet and obesity — also lead a person to take heartburn drugs. In other words, people taking them may have already been at a higher risk to begin with.
Nonetheless, the link is there, and researchers have said that to strengthen that connection they need to conduct clinical trials.
“The teaching for many years was that these drugs were quite safe,” John Clarke, a gastroenterologist at Johns Hopkins Hospital, reflected. “But there is data that’s emerging that suggests PPIs may not be as safe as we think they are.”[Image via 9nong/Shutterstock]