Proton Pump Inhibitors and the Risk of Severe Cognitive Impairment: The Role of Posttraumatic Stress Disorder

Details

• Personal Author:
  Bromet EJ ; Clouston SAP ; Kotov R ; Lei L ; Luft BJ ; Shapira O ; Waszczuk M
• Description:
  Introduction: Proton pump inhibitors (PPIs), a common treatment for gastroesophageal reflux disease (GERD), were recently associated with increased risk of dementia. However, severe or chronic stress including, for example, posttraumatic stress disorder (PTSD) was not accounted for. This study examined whether PPI use was associated with severe cognitive impairment (SCI) and whether PTSD explained this association in a cohort of World Trade Center (WTC) responders. Method: A prospective cohort study of 3779 WTC responders attending a university-based monitoring and treatment program. Prescriptions for PPIs and SCI determined using the Montreal Cognitive Assessment were the focus of the analysis. Results: Overall, 1451 (38.4%) responders were dispensed PPIs, and 83 (2.2%) had SCI. Bivariable analyses revealed significant associations between being-dispensed PPIs in relation to SCI. After adjusting for PTSD, major depressive disorder, WTC exposures, age, and sex, being-dispensed PPIs were significantly associated with odds of SCI (adjusted odds ratio = 1.67 95% confidence interval = 1.054-2.643). Conclusions: Being-dispensed PPIs were associated with SCI in this analysis of WTC responders. Results suggest that clinicians treating GERD seek to both understand patients' mental health history and monitor cognitive functioning when designing treatment routines. Overall, results confirmed that this is an important area of investigation with potential direct clinical implications. [Description provided by NIOSH]
• Subjects:
  Cohort Studies Emergency Responders Mental Health Nervous System Occupational Health Safety September 11 Terrorist Attacks
• Keywords:
  Author Keywords: Cognitive Impairment Cognitive Function Cohort Studies Gastroesophageal Reflux Disease GERD Mental Health Post-traumatic Stress Disorder Posttraumatic Stress Disorder Proton Pump Inhibitors PTSD Rescue Workers World Trade Center WTC

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• ISSN:
  2352-8737
• Document Type:
  Text
• Funding:
  Contract
• Genre:
  Journal Article
• Place as Subject:
  New York ; OSHA Region 2
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  3
• Issue:
  4
• NIOSHTIC Number:
  nn:20068997
• Citation:
  Alzheimers Dement Transl Res Clin Interv 2017 Nov; 3(4):579-583
• Contact Point Address:
  Sean A. P. Clouston, Department of Family, Population, and Preventive Medicine and Program in Public Health, Stony Brook University, Stony Brook, NY
• Email:
  sean.clouston@stonybrookmedicine.edu
• Federal Fiscal Year:
  2018
• Peer Reviewed:
  True
• Source Full Name:
  Alzheimer's & Dementia: Translational Research & Clinical Interventions
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:75cdcaa08f6e64871a183ed171649af7a86e709ec32ab9636722549701ee19689b1e9357217ad07f1f97e1d58081b12b4da8c7cfc23630157bf5396c9c28d320
• Download URL:
  https://stacks.cdc.gov/view/cdc/207553/cdc_207553_DS1.pdf
• File Type:
  [PDF - 234.26 KB ]