People with acid reflux who take drugs called proton pump inhibitors (PPIs) for four-and-a-half years or more may have a higher risk of dementia, according to a  study looking at prescription medications for the disorder. Acid reflux is when stomach acid flows into the esophagus, usually after a meal or when lying down. People with acid reflux may experience heartburn and ulcers. PPIs reduce stomach acid by targeting the enzymes in the stomach lining that produce that acid.

While the drugs are useful short-term, previous studies have linked them to a higher risk of stroke, bone fractures and chronic kidney disease, according to the authors.  Because some people take PPIs regularly, the researchers assessed the risk of dementia. They did not find a link with short-term use, but did find a higher dementia risk associated with long-term use.

The study included 5,712 people with an average age of 75 who did not have dementia at the start of the study. Among them, 1,490 (26%) had taken PPIs. Analyses of those who took PPIs for up to 2.8 years, 2.8-4.4 years, and for more than 4 years found that, after adjusting for factors such as age, sex and race, as well as health-related factors such as high blood pressure and diabetes, people who had been taking PPIs for more than 4.4 years had a 33% higher risk of developing dementia than people who never took the drugs.

There was no increased risk for people who took the drugs for fewer than 4.4 years.

The study is observational, so it does not prove that PPI use can cause dementia, but the authors advise people with acid reflux to discuss with their doctors the various ways available to treat the disorder, including taking antacids, maintaining a healthy weight, and avoiding late meals and certain foods.

To download the study, published in Neurology, click here