A popular class of heartburn medications might raise a senior's risk of dementia, a new study suggests. 
 
 Called proton pump inhibitors (PPIs), this group of drugs includes Prilosec, Nexium and Prevacid. They work by lowering the amount of acid produced by the stomach. 
 
 But German researchers found that people 75 or older who regularly take the medications had a 44 percent increased risk of dementia, compared with seniors not using the drugs. The study only found an association, however, and not a cause-and-effect link. 
 
 "To evaluate cause-and-effect relationships between long-term PPI use and possible effects on cognition in the elderly, randomized, prospective clinical trials are needed," said corresponding author Britta Haenisch, from the German Center for Neurodegenerative Diseases in Bonn. 
 
 In the meantime, "Clinicians should follow guidelines for PPI prescription, to avoid overprescribing PPIs and inappropriate use," Haenisch said. 
 
 The report was published Feb. 15 in the journal JAMA Neurology. 
 
 The results are surprising enough that at least one leading expert on aging, Dr. Malaz Boustani, plans to share the findings with older patients who are using PPIs. 
 
 Boustani said earlier studies have linked another type of antacid, H2 blockers, with an increased risk of dementia. Up to now, he's recommended that patients use PPIs to treat acid reflux and steer clear of H2 blockers like Tagamet, Pepcid and Zantac. 
 
 "I'm going to disclose the finding to my patients and then let them decide whether they will take the risk or not," said Boustani, a professor of medicine with the Indiana University Center for Aging Research and a spokesman for the American Federation for Aging Research. "On Monday I have clinic, and if I have patients taking a PPI or an H2 blocker I will tell them exactly what I'm telling you, and then they can decide." 
 
 More than 15 million Americans used prescription PPIs in 2013, at a total cost of more than $10 billion, according to a report by the IMS Institute for Healthcare Informatics. Several popular PPIs -- Prilosec, Prevacid and Zegerid -- also are available over-the counter, further boosting their use. 
 
 Concern has been increasing that Americans might be overusing PPIs to treat minor cases of heartburn or acid reflux. 
 
 As many as 70 percent of PPI prescriptions in the United States have been inappropriately handed out by doctors, and 25 percent of long-term users could stop taking the medication without suffering increased heartburn or acid reflux, according to a study published in January in the journal JAMA Internal Medicine. 
 
 Overuse of PPIs could have drastic effects on health, that study found. For example, the medications have been linked to a 20 percent to 50 percent higher risk of chronic kidney disease. 
 
 And now the German researchers report there also is some evidence that PPI use might affect a person's ability to reason. 
 
 PPIs appear to effect levels of amyloid beta and tau, which are proteins associated with Alzheimer's disease, the German authors said. PPI use can also lead to vitamin B12 deficiency, which has been associated with cognitive decline. 
 
 To test the possible association between PPIs and dementia, the German researchers collected data from a large German health insurance firm on almost 74,000 seniors aged 75 or older. The data ran from 2004 to 2011, and included diagnoses and drug prescriptions. 
 
 About 2,950 patients regularly used PPIs, which for this study was defined as at least one PPI prescription in each quarter of an 18-month interval. 
 
 Regular users of PPIs had a 44 percent increased risk of dementia compared with those not receiving PPI medications. 
 
 However, the study doesn't make clear whether PPIs are also available over the counter in Germany, as they are in the United States, said Dr. Arun Swaminath, director of the inflammatory bowel disease program at Lenox Hill Hospital in New York City. 
 
 If over-the-counter PPIs are available, then more people might have been taking them and the dementia risk described in this paper could be overestimated, Swaminath said. 
 
 "However, I think the point here is that for some patients, weaning off PPIs is reasonable and they should make this decision with their doctors," he said. 
 
 People who want to ease off PPIs can take a number of steps to reduce excess acid or prevent acid reflux, Boustani said. They can eat smaller meals, lay off chocolate and caffeine, and stay upright for a few hours following each meal. 
 
 Boustani added that his group has received federal funding to design clinical trials in which people would be weaned off PPIs, to see how it affects their ability to remember and think. 
 
 Dr. Gisele Wolf-Klein, director of geriatric education at North Shore-LIJ Health System in New Hyde Park, N.Y., added that even the researchers aren't sure why PPIs would affect the aging brain. 
 
 "We don't know what is causing the brain to deteriorate. Until we know this, there's no reason for people who are taking PPIs to be too concerned about that and stop taking those agents if they are needed," Wolf-Klein said. 
 
 Another expert agreed. 
 
 While the study is intriguing, it's not enough for doctors to warn patients off PPI use, said Keith Fargo, director of scientific programs and outreach for the Alzheimer's Association. 
 
 "It does not tell us anything that should change medical practice right now," Fargo said. "I don't think there's going to be an uprising among doctors telling patients not to take their PPIs. This doesn't rise anywhere near the level of evidence you would need for that." 
 
 One of the paper's main flaws is that researchers could not control for diet and body weight as risk factors, Fargo said. 
 
 "Both of those things, we know, are risk factors for developing cognitive decline and dementia in later life, and both of those are reasons why a person might need to take a proton pump inhibitor," Fargo explained. ||||| WASHINGTON, Feb. 15 (UPI) -- The number of potential side effects from the use of proton-pump inhibiting drugs to control heartburn continues to grow, with new research in Germany linking them to the development of dementia. 
 
 A new study links the widely used PPIs -- which include Nexium, Prevacid and Prilosec -- to an increased risk for cognitive decline, though researchers caution the study has limitations, and does not show a definite cause. 
 
 PPIs have recently been linked to kidney disease, heart disease, and deficiencies of B12 and other vitamins. While patients have reported side effects of the drugs, not taking them often results in stomach pains and worse heartburn as the drug leaves their systems. 
 
 "It does not tell us anything that should change medical practice right now," Keith Fargo, director of scientific programs and outreach for the Alzheimer's Association, told CBS News. "I don't think there's going to be an uprising among doctors telling patients not to take their PPIs. This doesn't rise anywhere near the level of evidence you would need for that." 
 
 For the study, published in JAMA Neurology, researchers analyzed patient data collected from 2004 to 2011 by the German health insurer Allgemeine Ortskrankenkassen for 73,679 of its customers. 
 
 The patients, who were 75 years or older and did not have dementia, on PPI drugs showed a 44 percent increased risk of dementia compared with those who did not use them. Researchers said in the study the data is supported by recent studies with mice that found rodents on PPIs had increased levels of amyloid plaques in their brains, the buildup of which contributed to dementia. 
 
 Researchers and doctors note that these studies have not accounted for lifestyle or diet, both of which affect the risk for dementia, or other diseases for which PPIs may increase risk. 
 
 "The teaching for many years was that these drugs were quite safe," John Clarke, a gastroenterologist at Johns Hopkins Hospital, told NPR. "But there is data that's emerging that suggests PPIs may not be as safe as we think they are." ||||| Popular Heartburn Pills Can Be Hard To Stop, And May Be Risky 
 
 Enlarge this image Katherine Streeter for NPR Katherine Streeter for NPR 
 
 When Marcella Lafayette started having really bad heartburn, she went to her doctor to see if there was anything that might help. 
 
 "I was experiencing a lot of chest pain, back pain caused from heartburn," says Lafayette, 62, of Portland, Ore. 
 
 Her doctor diagnosed her with gastroesophageal reflux disease, or GERD, and prescribed a drug called a proton pump inhibitor, or PPI. The drug worked, but Lafayette soon started having other problems, such as muscle weakness and severe leg cramping. 
 
 Lafayette discovered she was suffering from a magnesium deficiency, a side effect of the drug. She also learned that PPIs can cause not just deficiencies of nutrients but other side effects, such as an increased risk for infections. 
 
 So Lafayette decided to try to stop using her PPI. But whenever she did, her heartburn returned. And the symptoms were much worse. 
 
 "I can't seem to get off the drug, because when I do, I experience severe stomach pain. I can't eat anything without experiencing stomach pain," Lafayette says. "It just feels like you've got a knife in your gut. It's just really painful." 
 
 Lafayette is not alone. Many people have trouble discontinuing PPIs because the amount of acid in their digestive system surges when they stop taking the drug. 
 
 Experiences like Lafayette's, and rising evidence that the drugs may be associated with a variety of increased risks, are making doctors increasingly worried about their wide use. 
 
 "The teaching for many years was that these drugs were quite safe," says John Clarke, a gastroenterologist at Johns Hopkins Hospital in Baltimore. "But there is data that's emerging that suggests PPIs may not be as safe as we think they are." 
 
 An estimated 15 million Americans use PPIs, which are sold by prescription and over the counter under a variety of brand names, including Nexium, Prilosec and Prevacid. 
 
 They work by blocking production of stomach acid. And that could be the root of the problem, according to Clarke. Stomach acid helps digest food and also has a "barrier function against different pathogens which are ingested," he says. 
 
 So when there's less stomach acid, it leaves people vulnerable to nutritional deficiencies and infections, including food poisoning like salmonella, a serious, sometimes life-threatening digestive system infection called Clostridium difficile, and perhaps pneumonia. 
 
 Stomach acid also helps digest food. So if you don't have any of that acid, it can make it hard to get the vitamins, minerals and other nutrients you need from your food — including nutrients that keep bones strong and prevent fractures. 
 
 In addition, one recent study suggested people who take PPIs may be at greater risk of heart disease; another suggested the drugs could increase the risk for chronic kidney disease. 
 
 Updated Feb. 15, 11 a.m. ET: The latest concern is that PPIs might increase the risk for dementia. Britta Haenisch and colleagues at the German Center for Neurodegenerative Diseases in Bonn studied 73,679 people ages 75 and older. The researchers found regular PPI users had at least a 44 percent increased risk of dementia compared with those not using the drugs. 
 
 The researchers caution that the risk could only be considered an "association," until more research could be conducted to produce more conclusive evidence. But the findings indicate "the avoidance of PPI medication may contribute to the prevention of dementia." 
 
 How PPIs might increase the risk for dementia is unclear. But other researchers recently reported that, in the brains of mice, PPIs seem to increase levels of a damaging protein that accumulates in the brains of dementia patients, known as beta-amyloid. 
 
 In an editorial accompanying the study in the journal JAMA Neurology, Lewis Kuller of the University of Pittsburgh wrote that the findings "provided an important and interesting challenge to evaluate the possible association," which is a "very important issue given" how commonly the drugs are used by the elderly, who are already at increased risk for dementia. 
 
 Our original post continues: As this evidence has emerged, Clarke says, "I think it's imperative that people who take these drugs really make sure that they are looking at the risks versus benefit and people don't use these drugs lightly." 
 
 Many people take PPIs when they don't really need them, Clarke says. They could get rid of their heartburn by making lifestyle changes, such as losing weight and cutting back on alcohol, caffeine and spicy and fatty foods. And many people stay on them a lot longer than they need them, he says. PPIs are usually supposed to be taken for two to eight weeks, although doctors may recommend more. 
 
 The companies that make PPIs say they're safe for most people if they use them the way they're supposed to. And doctors say many people really need to take a PPI for severe heartburn. 
 
 "Proton pump inhibitors do have some very positive benefits to patients," says Kenneth DeVault, a gastroenterologist at the Mayo Clinic who is president of the American College of Gastroenterology. "They relieve symptoms better than any other medication that has ever been developed." 
 
 The most important "positive effect of proton pump inhibitors is restoration of a quality of life," DeVault says. "This is probably the big one." 
 
 PPIs may also reduce the risk for esophageal cancer for some people, he says. 
 
 DeVault says if someone really needs a PPI, they should take one. But they should try everything else first, keep an eye out for any side effects, and talk to their doctor about how long they should stay on it.
– Certain heartburn drugs have already been linked to heath woes including heart disease and kidney disease. Now a study in JAMA Neurology says those drugs—proton-pump inhibitors like Prilosec, Prevacid, and Nexium—may also boost the chance of dementia, UPI reports. Analyzing a German health insurer's data on nearly 74,000 customers aged 75 and up from 2004 to 2011, researchers found a 44% higher dementia risk among "PPI" users. The finding also coincides with research showing that mice on PPIs had higher amyloid plaque levels in their brains, which has been linked to dementia. So what to do, when roughly 15 million Americans use prescription PPIs and other patients take over-the-counter versions? For now, nothing. More clinical trials are needed to analyze the possible PPI-dementia link, senior study author Britta Haenisch tells CBS News. For one thing, the JAMA Neurology study didn't account for lifestyle and diet, which can influence dementia risk. But, she adds, "clinicians should follow guidelines for PPI prescription, to avoid overprescribing PPIs and inappropriate use." Up to 70% of PPI prescriptions may be needless reactions to minor cases of acid reflux or heartburn, per a recent study. Big picture: PPIs are being seen in a whole new light. "The teaching for many years was that these drugs were quite safe," a gastroenterologist tells NPR. "But there is data that's emerging that suggests PPIs may not be as safe as we think they are." (Turns out vegetable oils may cause dementia when heated.)