Evidence Against an Alleged Association Between PPIs and Dementia

When a widely publicized 2016 study from Germany reported an association between use of proton-pump inhibitors (PPIs) and dementia, many PPI users were alarmed and asked their physicians about it (NEJM JW Gen Med Jun 15 2016 and JAMA Neurol 2016; 73:410). That study had several flaws: It came from an administrative claims database, dementia diagnoses were not confirmed, and adjustment for confounding variables was limited. Now, two new studies — both with substantial adjustment for confounding variables — have been published.

In one study, researchers took advantage of a database that includes all people in Finland with formally diagnosed Alzheimer disease. Prior PPI use was similar in the 70,000 Alzheimer patients and 280,000 age- and sex-m…