Use of gastric acid-suppressive agents increases the risk of dementia in patients with upper gastrointestinal disease: A population-based retrospective cohort study.

<h4>Background</h4>Prescriptions for gastric acid-suppressive agents, including proton-pump inhibitors (PPIs) and histamine type-2 receptor antagonists (H2RAs), are rising. However, little data exist regarding their association with dementia in the Asian population. The objective of this...

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Autores principales: Hsiu-Chen Lin, Kuan-Tzu Huang, Hsiu-Li Lin, Yow-Sheng Uang, Yi Ho, Joseph Jordan Keller, Li-Hsuan Wang
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Publicado: Public Library of Science (PLoS) 2021
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spelling oai:doaj.org-article:74d5bf0fabcf46dcac18911b398d24e12021-11-25T06:19:25ZUse of gastric acid-suppressive agents increases the risk of dementia in patients with upper gastrointestinal disease: A population-based retrospective cohort study.1932-620310.1371/journal.pone.0249050https://doaj.org/article/74d5bf0fabcf46dcac18911b398d24e12021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0249050https://doaj.org/toc/1932-6203<h4>Background</h4>Prescriptions for gastric acid-suppressive agents, including proton-pump inhibitors (PPIs) and histamine type-2 receptor antagonists (H2RAs), are rising. However, little data exist regarding their association with dementia in the Asian population. The objective of this study was thus to investigate the impact of the use of PPIs and H2RAs on the risk of dementia in an Asian population with upper gastrointestinal disease (UGID).<h4>Methods</h4>We conducted a population-based retrospective cohort study with a 10-year follow-up using data from 2000 to 2015 derived from Taiwan's Longitudinal Health Insurance Database. We included 6711 patients with UGID receiving gastric acid-suppressive agents, 6711 patients with UGID not receiving agents, and 6711 patients without UGID or treatment thereof, all at least 20 years of age. Groups were matched for age, sex, and index date. The association between gastric acid-suppressive agent use and dementia was analyzed using a Cox proportional hazards regression model adjusted for potential confounders.<h4>Results</h4>The adjusted hazard ratio (aHR) of dementia for patients with UGID receiving gastric acid-suppressive agents compared with patients with UGID without gastric acid-suppressive agents was 1.470 (95% confidence interval [CI] 1.267-1.705, p < 0.001). Both PPIs and H2RAs increase the risk of dementia (PPIs: aHR 1.886 [95% CI 1.377-2.582], p < 0.001; H2RAs: aHR 1.357 [95% CI 1.098-1.678], p < 0.01), with PPIs exhibiting significantly greater risk (aHR 1.456 [95% CI 1.022-2.075], p < 0.05).<h4>Conclusions</h4>Our results demonstrate an increased risk of dementia in patients with UGID receiving gastric acid-suppressive agents, including PPIs and H2RAs, and the use of PPIs was associated with a significantly greater risk than H2RA use.Hsiu-Chen LinKuan-Tzu HuangHsiu-Li LinYow-Sheng UangYi HoJoseph Jordan KellerLi-Hsuan WangPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 3, p e0249050 (2021)
institution DOAJ
collection DOAJ
language EN
topic Medicine
R
Science
Q
spellingShingle Medicine
R
Science
Q
Hsiu-Chen Lin
Kuan-Tzu Huang
Hsiu-Li Lin
Yow-Sheng Uang
Yi Ho
Joseph Jordan Keller
Li-Hsuan Wang
Use of gastric acid-suppressive agents increases the risk of dementia in patients with upper gastrointestinal disease: A population-based retrospective cohort study.
description <h4>Background</h4>Prescriptions for gastric acid-suppressive agents, including proton-pump inhibitors (PPIs) and histamine type-2 receptor antagonists (H2RAs), are rising. However, little data exist regarding their association with dementia in the Asian population. The objective of this study was thus to investigate the impact of the use of PPIs and H2RAs on the risk of dementia in an Asian population with upper gastrointestinal disease (UGID).<h4>Methods</h4>We conducted a population-based retrospective cohort study with a 10-year follow-up using data from 2000 to 2015 derived from Taiwan's Longitudinal Health Insurance Database. We included 6711 patients with UGID receiving gastric acid-suppressive agents, 6711 patients with UGID not receiving agents, and 6711 patients without UGID or treatment thereof, all at least 20 years of age. Groups were matched for age, sex, and index date. The association between gastric acid-suppressive agent use and dementia was analyzed using a Cox proportional hazards regression model adjusted for potential confounders.<h4>Results</h4>The adjusted hazard ratio (aHR) of dementia for patients with UGID receiving gastric acid-suppressive agents compared with patients with UGID without gastric acid-suppressive agents was 1.470 (95% confidence interval [CI] 1.267-1.705, p < 0.001). Both PPIs and H2RAs increase the risk of dementia (PPIs: aHR 1.886 [95% CI 1.377-2.582], p < 0.001; H2RAs: aHR 1.357 [95% CI 1.098-1.678], p < 0.01), with PPIs exhibiting significantly greater risk (aHR 1.456 [95% CI 1.022-2.075], p < 0.05).<h4>Conclusions</h4>Our results demonstrate an increased risk of dementia in patients with UGID receiving gastric acid-suppressive agents, including PPIs and H2RAs, and the use of PPIs was associated with a significantly greater risk than H2RA use.
format article
author Hsiu-Chen Lin
Kuan-Tzu Huang
Hsiu-Li Lin
Yow-Sheng Uang
Yi Ho
Joseph Jordan Keller
Li-Hsuan Wang
author_facet Hsiu-Chen Lin
Kuan-Tzu Huang
Hsiu-Li Lin
Yow-Sheng Uang
Yi Ho
Joseph Jordan Keller
Li-Hsuan Wang
author_sort Hsiu-Chen Lin
title Use of gastric acid-suppressive agents increases the risk of dementia in patients with upper gastrointestinal disease: A population-based retrospective cohort study.
title_short Use of gastric acid-suppressive agents increases the risk of dementia in patients with upper gastrointestinal disease: A population-based retrospective cohort study.
title_full Use of gastric acid-suppressive agents increases the risk of dementia in patients with upper gastrointestinal disease: A population-based retrospective cohort study.
title_fullStr Use of gastric acid-suppressive agents increases the risk of dementia in patients with upper gastrointestinal disease: A population-based retrospective cohort study.
title_full_unstemmed Use of gastric acid-suppressive agents increases the risk of dementia in patients with upper gastrointestinal disease: A population-based retrospective cohort study.
title_sort use of gastric acid-suppressive agents increases the risk of dementia in patients with upper gastrointestinal disease: a population-based retrospective cohort study.
publisher Public Library of Science (PLoS)
publishDate 2021
url https://doaj.org/article/74d5bf0fabcf46dcac18911b398d24e1
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