Cognitive problems of breast cancer survivors on proton pump inhibitors
Proton pump inhibitors (PPIs) are used in cancer patients to manage treatment-related gastrointestinal symptoms and to prevent damage to the gastric mucosal lining during treatment. However, PPI use may contribute to cognitive problems. To compare PPI-users and non-users, breast cancer survivors reported cognitive problems in three studies.
In Study 1, breast cancer survivors (N = 209; n = 173 non-users, n = 36 PPI-users; stages 0-IIIC) rated their cognitive function on the Kohli scale prior to cancer treatment, as well as one and two years later. In Study 2, women (N = 200; n = 169 non-users, n = 31 PPI-users, stages 0-IIIa, M = 11 months post-treatment) rated their cognitive function on the Kohli scale and BCPT checklist at three visits over a six-month period. In Study 3, participants (N = 142; n = 121 non-users, n = 21 PPI-users; stages I-IIIa, M = 4 years post-treatment) rated their cognitive function on the Kohli scale, BCPT checklist, and Functional Assessment of Cancer Therapy cognitive scale (FACT-cog).
In Study 1, PPI-users reported more severe concentration problems (p = 0.039) but not memory problems (p = 0.17) than non-users. In Study 2, PPI-users reported more severe concentration problems (p = 0.022) than non-users, but not memory problems or symptoms on the BCPT (ps = 0.11). Study 3’s PPI-users reported more severe memory problems (p = 0.002), poorer overall cognitive function (p = 0.006), lower quality of life related to cognitive problems (p = 0.005), greater perceived cognitive impairment (p = 0.013), and poorer cognitive abilities (p = 0.046), but not more severe concentration problems (p = 0.16), compared to non-users.
PPI use may impair breast cancer survivors’ memory, concentration, and quality of life.
KeywordsProton pump inhibitors Breast cancer survivors Cognitive symptoms, concentration, memory
Proton Pump Inhibitor
Breast Cancer Prevention Trial
Functional Assessment of Cancer Therapy cognitive scale
This study was supported in part by NIH grants: R01 CA186251, R01 CA126857, R01 CA131029, R01 CA186720, K05 CA172296, UL1RR025755, and T32 DE014320.
Compliance with ethical standards
Conflict of interest
The authors had no conflicts of interest.
- 28.Von Ah D, Tallman EF. Perceived cognitive function in breast cancer survivors: evaluating relationships with objective cognitive performance and other symptoms using the functional assessment of cancer therapy—cognitive function instrument. J Pain Symptom Manag. 2015;49:697–706.Google Scholar
- 30.Park S, Nam JH, Lee H, Chung H, Lee E, Shin J. Beyond uncertainty: negative findings for the association between the use of proton pump inhibitors and risk of dementia. J Gastroenterol Hepatol. 2019.Google Scholar
- 31.Hussain S, Singh A, Zameer S, Jamali MC, Baxi H, Rahman SO, et al. No association between proton pump inhibitors use and risk of dementia: evidence from a meta-analysis. J Gastroenterol Hepatol. 2019.Google Scholar
- 33.Kwa M, Plottel CS, Blaser MJ, Adams S. The intestinal microbiome and estrogen receptor–positive female breast cancer. JNCI J Natl Cancer Inst. 2016;108.Google Scholar
- 36.Al-Qaisi M, Kahn A, Crowell M, Burdick G, Vela M, Ramirez F. Do recent reports about the adverse effects of proton pump inhibitors change providers’ prescription practice? Dis esophagus. 2018;Google Scholar