Sanjida Akter, Md Rajib Hassan, Mohammad Shahriar, Nahia Akter, Md Golam Abbas, Mohiuddin Ahmed Bhuiyan
Journal: Alzheimer's research & therapy 2016;7():79
PMID: 26714488
Recent studies have indicated that proton pump inhibitors (PPIs) may have a deleterious effect on cognition and Alzheimer’s disease. The use of PPIs has increased drastically in recent years and it is essential to investigate the cognitive impact of PPIs. The aim of this study was to investigate the degree of neuropsychological association of various PPIs with different cognitive functions. Sixty participants were randomly assigned to six groups, five test groups of five classes of PPIs and one control group, and then participated in computerised neuropsychological tests at the beginning of the study and 7 days after. This study indicates that different PPIs have varying degrees of influence on different cognitive domains and have associations with Alzheimer’s disease. The authors conclude that these findings should be considered when prescribing these medications, and suggest larger studies with longer follow-up be done to investigate the impact of long-term PPI use.
INTRODUCTION
Studies have shown that proton pump inhibitors (PPIs) increase the brain burden of amyloid-beta (Aβ) and also create vitamin B12 deficiency. However, these two phenomena have deleterious effect on cognition and Alzheimer's disease (AD). Since the use of PPIs has increased tremendously for the last few years, it is of great public health importance to investigate the cognitive impact of PPIs. Hence, the purpose of this study was to investigate the degree of neuropsychological association of each PPI with different cognitive functions.
METHODS
Sixty volunteers of either gender were recruited and divided randomly into six groups: five test groups for five classes of PPIs and one control group. All the groups participated in the five computerized neuropsychological tests (nine subtests) of the Cambridge Neuropsychological Test Automated Battery twice: at the beginning of the study and 7 days thereafter.
RESULTS
We found statistically and clinically significant impairment in visual memory, attention, executive function, and working and planning function. One-way analysis of variance findings showed that all PPIs had a similar negative impact on cognition. However, paired-samples t tests indicated that omeprazole showed significant (p < 0.05) results in seven subtests; lansoprazole and pantoprazole showed significant results in five subtests; and rabeprazole showed significant results in four subtests. Among five classes of PPIs, esomeprazole showed comparatively less impact on cognitive function with significant results in three subtests.
CONCLUSIONS
The present study reveals for the first time that different PPIs have varying degrees of influence on different cognitive domains and have associations with AD. These findings should be considered when balancing the risks and benefits of prescribing these medications. A study done for a longer period of time with a larger sample size might yield better results.
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