Proton pump inhibitors (PPIs) are among the most prescribed medications. Previous epidemiological studies have presented contradictory results about PPIs and the risk of dementia. Our objective was to investigate the association between the use of PPIs and an increasing risk of incident AD or non-AD dementias. A community-based retrospective cohort study was conducted based on the data available from 1st January 2002 to 31st December 2015 in the Catalan health service (CatSalut) system. This cohort included all PPI users (N = 36,360) and non-users (N = 99,362). A lag window of 5 years was considered between the beginning of the PPI treatment and the diagnosis of dementia. PPI use was not associated with the risk of AD (adjusted odds ratio (OR) 1.06) (95% CI 0.93–1.21; p = 0.408). A weakly but significantly increased risk of non-AD dementias was observed among PPI users (adjusted OR 1.20, 95% CI 1.05–1.37; p = 0.007). A higher dose of PPIs was not associated with an increased risk of either AD or non-AD dementias (OR 1.20; 95% CI 0.91–1.61 and OR 0.95; 95% CI 0.74–1.22, respectively). Regarding the number of PPIs used, we observed an increased risk of AD (OR 1.47; 95% CI 1.18–1.83) and non-AD dementias (OR 1.38; 95% CI 1.12–1.70) in users of two types of PPIs compared with those who used only one type. We did not find a higher incidence of AD among PPI users, but a weak increase in the risk of non-AD dementias among PPI users was observed.

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Background Benzodiazepines and Z-drugs (BZDRs) are among the most prescribed medications for anxiety and insomnia, especially among older adults. Our objective was to investigate the association between the use of BZDRs and the risk of dementia. Methods A community-based retrospective cohort study was conducted based on the data available from 2002 to 2015 in Catalan Health Service (CatSalut). This cohort included all BZDR users (N=83,138) and nonusers (N=84,652) older than 45 years old. A minimum 5-year lag window and an adjustment for psychiatric problems were applied for the data analysis. Results The hazard ratio (HR) for the risk of incident dementia among BZDR users was 1.22 (95% CI 1.15-1.31). This risk was not significant after adjusting the data confounding factors (HR 1.01; 95% CI 0.94-1.08). We observed a higher risk with short-to-intermediate half-life BZDs (HR 1.11; 95% CI 1.04-1.20) and Z-drugs (HR 1.20; 95% CI 1.07-1.33) than for intermediate-to-long half-life BZDs (HR 1.01; 95% CI 0.94-1.08). We demonstrated a higher risk of incident dementia (HR 1.23; 95% CI 1.07-1.41 and OR 1.38; 95% CI 1.27-1.50, respectively) in patients who received 91-180 DDD and > 180 DDD compared to patients who received < 90 DDD. Regarding patient sex, the risk of dementia was higher in women than in men. Conclusion We found that the incidence of dementia was not higher among all BZDR users. Short half-life BZDs and Z-drugs increased the risk of dementia at the highest doses, especially in female patients, showing a dose-response relationship.