Millions who take common heartburn drugs ‘at greater risk of developing dementia’
MILLIONS of people who take common heartburn drugs are at a "greater risk of developing dementia", scientists have warned.
Those using acid reflux drugs, especially the elderly, could run the risk of losing their memory.
Researchers at the Karolinska Institute in Sweden have claimed that long term usage of the popular drugs such as omeprazole, sold under the brand name Nexium, could have an impact on the way the nerve cells send signals to other cells in the body.
The results of the study, published in the Journal of Alzheimer’s and Dementia showed how proton pump inhibitors (PPIs), used to treat conditions like heartburn, affect the synthesis of the neurotransmitter acetylcholine, which is an organic chemical that functions in the brain and body.
A senior researcher at the Department of Neurobiology, Care Sciences and Society at the Karolinska Institute said because there is no effective treatment for conditions such as Alzheimer’s and dementia, it’s important to avoid putting people through unnecessary risk.
Taher Darreh-Shori said: "We therefore want to draw attention to this so that the drugs aren't used needlessly for a long time."
PPI drugs such as Nexium and Zantac work by blocking the pumps in the body that transport acid from the cells that form the mucus.
When the pumps are out of action, acid reduces and damages the tissue.
What is dementia and are there different types?
Dementia is a general term used to describe the deterioration of a person's mental ability that is severe enough to interfere with their daily life.
It is known for the problems it causes with thinking, reasoning and memory - as these are the areas in the brain that become damaged.
There are two main groups dementia can be split into:
- Cortical, which causes severe memory loss like that seen in Alzheimer's,
- Sub-cortical, which affects thinking speed and activity as seen with Parkinson's disease.
Vascular dementia and Alzheimer's are two of the most common forms and they both cause problems with memory.
Both are rare in those under 65 years old.
Other common forms of dementia are Frontotemporal dementia, mostly diagnosed in those under 65 years old, and dementia with Lewy bodies, where nerve damage gradually gets worse over time causing slowed movement.
Scientists recently discovered a new form of dementia that has often been mistaken for Alzheimer's.
They say it is part of the reason why finding a cure to dementia has failed so far.
Population studies have previously showed higher rates of dementia in people using PPIs, but it was not clear why.
In order to determine why there is a link between PPIs and dementia, researchers used 3D computer simulations to examine six different PPI variants.
This was carried out in order to determine how different substances interacted with the enzyme that synthesizes the acid from the cells that form the mucus.
Acetylcholine is needed for passing signals between nerve cells, but this only works effectively if enough of the substance is produced.
The research showed that they were able to bind together, the effect of which was that the drug then inhibited the enzyme.
Drugs based on the active ingredients such as omeprazole (sold in brand names Prilosec and Losec and Nexium) and rabeprazole (brand name Pariet) had the greatest affinity and were therefore the strongest inhibitors of the enzyme.
Others such as pantoprazole (brand name Protonix) and lansoprazole (Prevacid) were the weakest.
While more tests need to be done to determine whether the lab tests are the same as what would occur in the body, Darreh-Shori says it’s advisable to not use PPIs for long periods of time.
"Special care should be taken with the more elderly patients and those already diagnosed with dementia.
"The same also applies to patients with muscle weakness diseases such as ALS, as acetylcholine is an essential motor neurotransmitter. In such cases, doctors should use the drugs that have the weakest effect and prescribe them at lowest dose and for as short a time as possible."
He went on to stress elderly people can still use such medication if done safely and correctly and only for a limited time when needed.
"Our nervous system is pretty flexible when it comes to tolerating short term impact", he added.