Proton Pump Inhib Itor Use And Risk Of Dementia

Purpose:The association between proton pump inhibitor(PPI)use and the risk of dementia remains controversial.This meta-analysis aimed to clarify this issue.Methods:PubMed,EMBASE and the Cochrane Library were searched up to March 2018.Cohort studies that reported risk estimates of PPI use and risk of dementia were eligible for inclusion.A random-effects model was employed to estimate the pooled effect size.I~2 statistic was employed to quantitatively describe the statistical heterogeneity.Subgroup analysis and sensitivity analysis were performed.Results:A total of 1,762 literatures were obtained from database search.Five studies,involving 95,913 participants,were included in this meta-analysis.PPI use was found to be significantly associated with an increased risk of all-cause dementia[hazard ratio(HR)1.41,95%confidence interval(CI)1.16-1.73],with significant heterogeneity observed(I2=79.6%).Sensitivity analysis showed that the aforementioned results remained significant(HR 1.28,95%CI 1.10-1.49)but presented low heterogeneity(I2=19.1%)after excluding one of the included studies.Based on two studies,we failed to find a significant association of PPI use with the risk of Alzheimer’s disease(AD)(HR 1.28,95%CI 0.99-1.66,I2=7.2%).Conclusion:Our study suggests that PPI use may increase the risk of dementia.However,our findings should be treated with caution and needed to be validated by future studies.