Newly Discovered Mechanism Can Explain Increased Risk of Dementia

The results of a study published in Alzheimer's & Dementia specify a mechanism that explains how long-term use of acid suppressants called proton pump inhibitors (PPIs) could increase the risk of dementia, reports ScienceDaily . "Proton pump inhibitors affect the synthesis of the neurotransmitter acetylcholine, which plays a significant part in conditions such as Alzheimer's disease," said the Karolinska Institutet's Taher Darreh-Shori. "Since there's no effective treatment for the disease, it's important to avoid risk factors. We therefore want to draw attention to this so that the drugs aren't used needlessly for a long time." PPIs based on the active substances omeprazole, esomeprazole, tenatoprazole, and rabeprazole were the strongest inhibitors of the enzyme controlling acetylcholine synthesis, while the variants pantoprazole and lansoprazole had the least suppressive effect. "Special care should be taken with the more elderly patients and those already diagnosed with dementia," said Darreh-Shori. "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."