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Lack of association between proton pump inhibitor use and decline in cognitive performance in the ELSA-Brasil cohort

  • Pharmacoepidemiology and Prescription
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Abstract

Objective

The study aims to investigate the longitudinal association of use and time of use of proton pump inhibitors (PPIs) with decreased performance in three cognitive tests.

Methods

Prospective cohort study included 7115 participants with mean age of 58.9 years at baseline (2008–2010) who participated in the second wave (2012–2014) of ELSA-Brasil (average interval between visits = 3.9 years (range: 1.7 to 6.0 years)). Cognitive performance was assessed by tests of memory, phonemic and semantic verbal fluency, and the trail making test, applied to both waves. Associations with the use and time of use of PPIs at baseline were investigated using linear models with mixed effects after adjusting for confounding factors.

Results

At baseline, 7.4% (529) of the participants used PPIs on a regular basis. After all adjustments, the interaction term use of PPI × age was not statistically significant for the cognitive tests evaluated, indicating that the use of PPI at baseline was not associated with a more accelerated decline in cognitive performance between waves. The interaction term PPI use × age was not statistically significant, in any of the categories of medication use time, any of the cognitive function tests evaluated, indicating that PPI use time is not associated with decrease in cognitive scores as the time interval between visits increases.

Conclusion

In this cohort middle-aged and elderly adults, after average interval of 3.9 years (relatively short time to detect cognitive decline in a young cohort), the use and time of use of PPIs at the beginning of the study were not associated with a decline in cognitive performance in these tests between visits.

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Data availability

The datasets generated during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

The authors thank the staff and participants of the ELSA-Brasil for their important contributions. The study was supported by the Brazilian Ministries of Health (DECIT) and of Science and Technology (FINEP/CNPq).

Funding

The ELSA-Brasil baseline study was supported by the Brazilian Ministry of Health (Science and Technology Department) and the Brazilian Ministry of Science and Technology (Financiadora de Estudos e Projetos and CNPq National Research Council), grants 01 06 0010.00 RS, 01 06 0212.00 BA, 01 06 0300.00 ES, 01 06 0278.00 MG, 01 06 0115.00SP, and 01 06 0071.00 RJ. S.M.Barreto is a CNPq research fellow (grant no. 300159/99-4). S.M.Barreto is also a supported by a research grant (Pesquisador Mineiro) from FAPEMIG, the research agency of the State of Minas Gerais, Brazil.

Author information

Authors and Affiliations

  1. Department of Healh Science, Federal University of São João Del-Rei (UFSJ), Divinópolis, Minas Gerais, Brazil

    Andrêza Soares dos Santos, Sara Teles de Menezes & Roberta Carvalho Figueiredo

  2. Center of Clinical and Epidemiological Research, University Hospital, University of Sao Paulo, Sao Paulo, Brazil

    Isabela M. Bensenor & Alessandra Carvalho Goulart

  3. Medical School and Clinical Hospital, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil

    Sandhi Maria Barreto

Authors
  1. Andrêza Soares dos Santos
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  2. Sara Teles de Menezes
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  3. Isabela M. Bensenor
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  4. Alessandra Carvalho Goulart
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  5. Sandhi Maria Barreto
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  6. Roberta Carvalho Figueiredo
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Contributions

All authors were responsible for the study design, analysis and interpretation of data, the writing of the manuscript, and the decision to submit for publication. All authors had full access to the data.

Corresponding author

Correspondence to Roberta Carvalho Figueiredo.

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Ethical approval and consent to participate

ELSA-Brasil was approved by the Research Ethics Committees of the participating institutions and by the National Committee for Research Ethics (CONEP 976/2006) of the Ministry of Health. All study participants signed an Informed Consent Form.

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The authors declare no competing interests.

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dos Santos, A.S., de Menezes, S.T., Bensenor, I.M. et al. Lack of association between proton pump inhibitor use and decline in cognitive performance in the ELSA-Brasil cohort . Eur J Clin Pharmacol 77, 1725–1735 (2021). https://doi.org/10.1007/s00228-021-03156-3

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