recent studies have produced mixed results—some observe an association with very long-term use, while others do not. Because findings are inconsistent and mechanisms are speculative (vitamin B12 deficiency, microbiome shifts, amyloid pathways), most experts advise individualized, time-limited use of PPIs at the lowest effective dose.
Key Takeaways (Evidence-Based, Not Alarmist)
Association ≠ Causation. These studies can’t prove that a drug causes dementia; they show patterns that warrant caution and shared decision-making.
Dose & Duration Matter. Higher cumulative exposure—especially to strong anticholinergics—carries more risk signal. Keep doses low and durations short when
