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Proton pump inhibitors use and dementia risk: a meta-analysis of cohort studies

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Abstract

Purpose

The aim of this study was to explore the relationship between proton pump inhibitors use and the risk of dementia.

Methods

A comprehensive literature search was conducted in English and Chinese databases from origination to December 2018. The pooled hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated with a random-effects model. Subgroup analyses and sensitivity analyses were also conducted. Cochran’s Q test and the I2 statistic were used to evaluate the heterogeneity. Publication bias was assessed by Begg’s test and Egger’s test.

Results

Six studies were included, which contained a total of 166,146 participants. The overall result demonstrated a significant increase in dementia risk with proton pump inhibitors use (HR = 1.29, 95% CI = 1.12–1.49). In subgroup analyses, a significant association was detected between proton pump inhibitors use and the risk of dementia in Europe (HR = 1.46, 95% CI = 1.23–1.73) and among participants aged ≥ 65 years (HR = 1.39, 95% CI = 1.17–1.65). For the factor follow-up time ≥ 5 years, the pooled HR was 1.28 (95% CI = 1.12–1.46), demonstrating a 1.28-fold increase in the risk of dementia among proton pump inhibitors users. In the case of regional impact, participants from Europe showed an overall pooled HR estimate of 1.46 (95% CI = 1.23–1.73). There was no evidence of publication bias.

Conclusions

The overall result of this meta-analysis supports the hypothesis that proton pump inhibitors increase the risk of dementia. Furthermore, high-quality cohort studies are needed to confirm these findings.

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Author information

Author notes

  1. Yun Zhang and Mingming Liang contributed equally to this work.

Authors and Affiliations

  1. Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China

    Yun Zhang, Mingming Liang, Tingting Shi, Min Min & Yehuan Sun

  2. AMITA Health Saint Joseph Hospital Chicago, 2900 N. Lake Shore Drive, Chicago, 60657, Illinois, USA

    Chenyu Sun

  3. Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD, USA

    Evelyn J. Song

  4. Cape Fear Valley Medical Center, 1638 Owen Dr, Fayetteville, 28304, North Carolina, USA

    Ce Cheng

  5. Center for Evidence-Based Practice, Anhui Medical University, Hefei, 230032, Anhui, China

    Yehuan Sun

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  1. Yun Zhang
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Contributions

Yun Zhang and Mingming Liang conceived and designed the study, with substantial contributions from Chenyu Sun, Tingting Shi, Min Min, Evelyn J. Song, Ce Cheng, and Yehuan Sun. Yun Zhang and Mingming Liang collected, analyzed, and interpreted the data and drafted the manuscript. All authors revised it critically for important intellectual content and approved the final manuscript.

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Correspondence to Yehuan Sun.

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Zhang, Y., Liang, M., Sun, C. et al. Proton pump inhibitors use and dementia risk: a meta-analysis of cohort studies. Eur J Clin Pharmacol 76, 139–147 (2020). https://doi.org/10.1007/s00228-019-02753-7

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