Weiss Avraham, Gingold-Belfer Rachel, Boltin Doron, Beloosesky Yichayaou, Koren-Morag Nira, Meyerovitch Joseph, Sharon Eran, Schmilovitz-Weiss Hemda
Department of Geriatrics, Rabin Medical Center - Beilinson Hospital, Petach Tikva, 4941492, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, 6997801, Israel.
Gastroenteroloy Division, Rabin Medical Center - Beilinson Hospital, Petach Tikva, 4941492, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, 6997801, Israel.
Dig Liver Dis. 2022 May;54(5):622-628. doi: 10.1016/j.dld.2021.11.018. Epub 2021 Dec 20.
The association between proton pump inhibitor (PPI) use and increased risk of dementia is controversial.
Investigating this issue in a large population of community-dwelling elders.
Our database was retrospectively searched for all community-dwelling patients aged ≥65 years who newly diagnosed with dementia/cognitive decline (DCD) between January 2002 - December 2012. Receiving ≥11 prescriptions of PPIs/year was categorized as PPI users. Clinical data were collected from the medical files. Risk of DCD in PPI users was analyzed by Cox regression models.
Included 48,632 elders of whom 8,848 were diagnosed with DCD (18.2%). PPI use was documented in 10,507, of whom 1,959 were subsequently diagnosed with DCD (18.6%). Among 38,125 non-PPI users, 6,889 (18.1%) were diagnosed with DCD. The hazard ratio for occurrence of DCD in PPI users compared to non-users was 0.85 (95% CI: 0.81-0.89, P <0.001) in an un-adjusted Cox regression model and 0.83 in a Cox regression model adjusted for age and sex (95% CI: 0.79-0.87, P <0.001). Multivariate Cox regression accounting for background diseases, marital status, and socioeconomic state yielded a hazard ratio of 0.77 (95% CI: 0.73-0.81, P <0.001).
PPI use wasn't associated with DCD development in chronic PPI users.
质子泵抑制剂（PPI）的使用与痴呆风险增加之间的关联存在争议。
在大量社区居住的老年人中调查此问题。
我们的数据库被回顾性搜索，以查找2002年1月至2012年12月期间新诊断为痴呆/认知功能下降（DCD）的所有年龄≥65岁的社区居住患者。每年接受≥11张PPI处方的患者被归类为PPI使用者。临床数据从医疗档案中收集。通过Cox回归模型分析PPI使用者中DCD的风险。
纳入48,632名老年人，其中8,848人被诊断为DCD（18.2%）。有10,507人记录了使用PPI，其中1,959人随后被诊断为DCD（18.6%）。在38,125名非PPI使用者中，6,889人（18.1%）被诊断为DCD。在未调整的Cox回归模型中，PPI使用者与非使用者相比发生DCD的风险比为0.85（95%CI：0.81-0.89，P<0.001），在调整年龄和性别的Cox回归模型中为0.83（95%CI：0.79-0.87，P<0.001）。考虑背景疾病、婚姻状况和社会经济状况的多变量Cox回归得出风险比为0.77（95%CI：0.73-0.81，P<0.001）。
长期使用PPI与DCD的发生无关。
