The impact of proton pump inhibitors on the development of dementia in the elderly population

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Dementia is characterized by progressive decline in cognitive functions and loss of motor skills and the ability to perform self-care tasks. The global increase in the number of dementia patients each year is attributed to longer life expectancy and aging populations. Currently, there is no standardized approach to dementia treatment; thus, primary prevention aimed at mitigating risk factors is a key focus of healthcare systems.

Some pharmacological agents have potential effects on patients’ cognitive functions, which should be considered during prescribing them.

Proton pump inhibitors (PPIs) are commonly prescribed for elderly patients prone to gastrointestinal diseases. The polymorbidity of this patient group warrants PPI prescription as gastroprotective therapy alongside other medications affecting gastric secretion (i.e., nonsteroidal anti-inflammatory drugs, anticoagulants, glucocorticoids).

There are several undesirable interactions between PPIs and other drugs: reduced absorption of antifungal agents and certain cardiac glycosides, alteration of metabolism, mutual enhancement or reduction of the pharmacological effects of PPIs and another prescribed drug against the background of the first, and increased mortality among patients taking PPIs and clopidogrel due to the possible reduction of its antiplatelet effect.

This study aimed to analyze and systematize data on the relationship between the use of PPIs and the development of dementia. The potential influence of PPIs on the cognitive functions of elderly and senile people were considered.

Analysis of the literature data showed that the risks of developing dementia vary across different patient cohorts depending on age, comorbidities, duration of medication use, vitamin B12 levels, presence of apolipoprotein E alleles ε4, beta-amyloid concentration, and the ability of PPIs to inhibit the cholinergic enzyme. In prescribing PPIs to elderly patients, it is crucial to consider all risk factors and individual patient characteristics and conduct a thorough assessment of the risk/benefit ratio of the therapy.

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作者简介

Oksana Bolshakova

I.P. Pavlov First Saint Petersburg State Medical University

编辑信件的主要联系方式.
Email: oxanabolshakowa2015@yandex.ru
ORCID iD: 0009-0008-6899-4052
俄罗斯联邦, Saint Petersburg

Angelina Krivonos

I.P. Pavlov First Saint Petersburg State Medical Universi

Email: ang.krivonos@gmail.com
ORCID iD: 0009-0004-7435-1695
俄罗斯联邦, Saint Petersburg

Anastasia Rogozina

I.P. Pavlov First Saint Petersburg State Medical University

Email: anas.rogozina2015@yandex.ru
ORCID iD: 0009-0006-3101-9304
俄罗斯联邦, Saint Petersburg

Veronika Lindover

Saint Petersburg State Pediatric Medical University

Email: nika.lindover@yandex.ru
ORCID iD: 0009-0009-0687-1302
SPIN 代码: 2721-2690
俄罗斯联邦, Saint Petersburg

Maria Englas

Military Medical Academy named after S.M. Kirov

Email: maria.englas@yandex.ru
ORCID iD: 0009-0001-9720-0257
俄罗斯联邦, Saint Petersburg

Kirill Rayevsky

Military Medical Academy named after S.M. Kirov

Email: sicarius001@gmail.com
ORCID iD: 0000-0002-9939-3443
SPIN 代码: 9133-3802
俄罗斯联邦, Saint Petersburg

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СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
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