A large observational study from Germany establishes an association between the use of PPIs- proton pump inhibitors – and a heightened risk of dementia. PPIs are prescribed for those with severe heartburn, peptic ulcers and acid reflux and are sold under the trade names of Nexium, Prilosec and Prevacid. The study was published in JAMA Neurology today.

The study reviewed the pharmaceutical profiles of 73,600 Germans aged 75 and older from 2004 through 2011. This database captured roughly one third of all Germans and almost half of all Germans over 75. The number of people included and the length of the study give its findings high credence.

During the study period, those who routinely used PPIs were diagnosed with dementia at a rate that was 44% higher than those who were not taking PPIs. Routine use was defined as having a prescription filled for a PPI at least once a quarter within 18 month intervals.

The study does not conclude that PPIs cause dementia. It only establishes that there is a statistically significant correlation between the continuing use of these drugs and the onset of dementia. It is not known why those taking these drugs are at a higher risk for dementia.

One theory is that the PPIs reduce the amount of gastric acids in one’s stomach. These acids are necessary to break down foods into their vitamin and nutrient components. It is known that those on PPIs have lowered levels of vitamin B12. It is also known that Vitamin B12 deficiencies can result in dementia. Another theory, based on studies with mice, is that the PPIs stimulate the production of Beta Amyloid, the protein considered to be a hallmark of Alzheimer’s disease.

PPIs are widely prescribed drugs, but they are not intended to be taken for long periods of time. Now there is new reason to make sure that people do not stay on these drugs any longer than necessary and to explore other ways to control gastric acid imbalances.