Cognitive impact after short-term exposure to different proton pump inhibitors: assessment using CANTAB software

Abstract

IntroductionStudies 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.MethodsSixty 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.ResultsWe 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.ConclusionsThe 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.

Dementia, cognitive impairment and proton pump inhibitor therapy: A systematic review

“…It was demonstrated that a statistically significant reduction occurred in sensorimotor ability, visual memory and learning, reaction time, rapid visual information processing, and spatial working memory in intervention groups . Some variance in results per PPI medication subtype was observed, with omeprazole demonstrating the most significant reduction in cognitive function (seven significant subtest reductions) and esomeprazole demonstrating the least (three significant subtest reductions) . However, all intervention groups demonstrated a general reduction in assessment performance when compared to the placebo group.…”

“…The systematic search strategy identified 1928 unique articles, 1895 of which were excluded during title and abstract screening. Thirty‐three remaining full text articles were assessed for eligibility, and of these, 11 met the inclusion criteria for this systematic review . Reasons for study exclusion are documented using the PRISMA flow diagram (Fig.…”

“…A randomized controlled trial conducted by Akter et al recruited a small population of 60 young (mean age 21–23 years old), healthy, non‐PPI users, to explore the short‐term effect of multiple PPI types on performance while undertaking a series of computerized neuropsychological tests (nine total Cambridge Neuropsychological Test Automated Battery subtypes) . It was demonstrated that a statistically significant reduction occurred in sensorimotor ability, visual memory and learning, reaction time, rapid visual information processing, and spatial working memory in intervention groups . Some variance in results per PPI medication subtype was observed, with omeprazole demonstrating the most significant reduction in cognitive function (seven significant subtest reductions) and esomeprazole demonstrating the least (three significant subtest reductions) .…”

Association of Proton Pump Inhibitors Usage with Risk of Pneumonia in Dementia Patients

“…PPIs were previously reported to impair the immunity function of leukocytes . Furthermore, patients’ cognitive functions can be affected by PPIs . Dementia patients are likely to be vulnerable to this complication because of a high likelihood of dysphagia, impairment of the gag reflex, and decreased levels of consciousness status and immunity .…”

Screening Younger Individuals in a Primary Care Setting Flags Putative Dementia Cases and Correlates Gastrointestinal Diseases with Poor Cognitive Performance

“…Furthermore, GID is associated with aging populations [59]. However, one cannot dismiss the possibility that medications elderly patients take may contribute to GID, and, in fact, an association between pump inhibitors and cognitive impairment has recently been reported [60,61]. Of note, Parkinson disease has also been associated with gastrointestinal dysfunction [62].…”