Proton pump inhibitors (PPIs), such as Nexium and Prilosec, have been associated with a host of health dangers, including osteoporosis, inflammation of the stomach lining, gastrointestinal disorders, magnesium deficiency, and most seriously, severe kidney damage and heart attacks. Recent research has also linked these medications to dementia in older patients.
The study, carried out in Germany and published in the April 2016 issue of JAMA Neurology, involved nearly 74,000 patients over the age of 75 (the average age being 83), examining data collected from a major German medical insurer over the course of seven years. The results indicated that elderly patients who regularly took proton pump inhibitors were at “a significantly increased risk of incident dementia” compared to those who did not take these drugs. Based on their analysis of the insurance company data, the researchers found that patients regularly taking PPIs had a 44% greater chance of developing dementia.
How is this happening? In a JAMA editorial, Dr. Lewis Kuller of the University of Pittsburgh suggests that PPIs are capable of crossing the blood-brain barrier, the permeable cellular structure that separates blood from bodily fluids of the nervous system. As a result, these drugs cause certain proteins to mutate, resulting in the formation of fibers that interfere with healthy tissue function. This, in turn, affects the brain. Dr. Kuller also believes that PPI may reduce levels of vitamin B12 (low levels of B12 have been linked to cognitive decline in the elderly).
Since the German study was observational (as opposed to a controlled laboratory study), the results do not constitute absolute proof of causation. However, the evidence strongly indicates that PPIs may indeed contribute to the development of dementia among people age 75-84. If so, Dr. Kuller says that it “could result in an increase of about 10,000 new cases of incident dementia per year just in this age group.”
Unfortunately, it is highly unlikely that any drug manufacturer will step up to the plate and carry out a formal, randomized, double-blind, long-term research study on this issue. The reason is clear: profits. PPIs are among the most widely over-prescribed medications on the planet. In 2013 alone, sales of proton pump inhibitors generated over $8.5 billion for the industry in the U.S. PPIs are also habit-forming – a fact about which drug manufacturers have been less than forthcoming. Furthermore, according to Dr. Mitchell Katz of San Francisco’s Department of Public Health, as many as 70% of patients who take and/or are prescribed PPI drugs have no medical need. Katz says: “As a culture, we tend to want a pill to deal with our problems, when a lot of people could reduce their heartburn by eating smaller meals, drinking less alcohol, or not smoking…when 60 percent to 70 percent of people don’t need to be taking it, that’s a huge problem.”
Indeed it is…but don’t expect Big Pharma to volunteer any information on this crisis in the making. As is often the case, it will require litigation to force this knowledge into the light of day.