“Will My PPI Cause Dementia?”

During the past year or two, probably the most common concern that patients expressed to me about a potential medication-related risk was this one: “Do you think I should stop my proton-pump inhibitor? ... I heard that it can cause dementia.” These patients had seen media reports of a 2016 study that suggested this association, but that study had several substantial flaws (NEJM JW Gen Med Jun 15 2016 and JAMA Neurol 2016; 73:410). In 2017, three new studies failed to corroborate any relation between proton-pump inhibitor (PPI) use and dementia or cognitive impairment.

In a Finnish study, prior PPI use was no greater among 70,000 patients with formally diagnosed Alzheimer disease than among 280,000 matched controls (NEJM JW Gen Med Sep 15 201…