A report from The Huffington Post explores the possible role of sleep apnea in dementia.
The recent study in JAMA Neurology entitled “Association of Proton Pump Inhibitors With Risk of Dementia” by Willy Gomm, PhD and associates explored the potential relationship by reviewing a health insurance database within Germany (1). A total of 73,679 subjects aged 75 years and older were identified and about 3 in 4 were women. Though initially free of dementia, after following these people from 2004 to 2011, cognitive changes were noted among those who took proton pump inhibitor medications. These medicines are both over-the-counter and prescription drugs used to treat heartburn and gastro-esophageal reflux disease (GERD), including: omeprazole (Prilosec), pantoprazole (Protonix), lansoprazole (Prevacid), esomeprazole (Nexium), and rabeprazole (AcipHex). Regular use of the drugs was associated with a 44% increased risk of developing dementia.
This result made headlines for two reasons: these drugs are some of the most widely used of all medicines – and people really don’t want to get dementia. There are few things more fear-inducing than the prospect that something you are doing is increasing your risk of developing a condition that steadily robs you of your independence, your personality, and your memory. Why might such an association exist with a seemingly unrelated stomach medication?
The jury is still out on a potential explanation. The accompanying editorial explored some of the possible contributions: medication crossing the blood-brain barrier and increasing amyloid levels and plaques or reduced vitamin B12 levels, known risk factors for dementia (2). The population was older and perhaps sicker, with comorbid diseases that may increase the risk of both heartburn and dementia. One condition that was curiously left off the list as a possible cause of both the symptom instigating the use of a medication – and dementia – was sleep apnea. It wasn’t the first time.