I often write about the pitfalls of taking stomach acid-reducing or blocking drugs, and here’s one more reason not to take them: Popping acid-reducers such as Tagamet or Zantac for an extended period can increase the risk of mental decline in older people. Think twice before reaching for these drugs, especially if you are getting on in years.
MORE DRUGS LEAD TO MORE COGNITIVE IMPAIRMENT
Physicians have long observed that older patients tend to become disoriented and confused after regularly taking acid-reducing drugs known as H2-receptor blockers (histamine-2 receptor antagonists). Available both over-the-counter and by prescription, these drugs are taken to reduce the production of stomach acid. Popular OTC brands include Axid AR (nizatidine), Pepcid AC (famotidine), Tagamet HB (cimetidine) and Zantac 75 (ranitidine).
At the Indiana University Center for Aging Research, gerontologist Malaz A. Boustani, MD, MPH, set out to determine whether long-term use of H2-receptor blockers contributes to a higher risk of cognitive impairment. He and his colleagues conducted a study of 1,558 Americans 65 and over. They found that participants who took these medications on a continuous basis for two or more years substantially increased their risk of cognitive impairment (including Alzheimer’s Disease) — by nearly 2½ times.
The results of the study were published in the August 2007 issue of the Journal of the American Geriatrics Society. Dr. Boustani cautions that this is not the final word on H2-receptor blockers, and further research is needed to determine how acid reducers contribute to mental decline. According to Dr. Boustani, one theory is that H2-receptor blockers might be blocking the cholinergic system in the brain (the system of nerve cells that uses acetylcholine as its neurotransmitter and is damaged in the brains of people with dementia). Another theory is that they might interfere with the absorption of vitamins such as B-12, which might in turn interfere with cognitive processes.
STAYING SAFE
Even though doctors don’t know why, the results seem to stand for themselves. While some people need to take acid-reducing drugs for a period of time when they have stomach ulcers (most ulcers heal with medication in six to eight weeks, but recurrence is common), many mistakenly rely on them afterward for heartburn. They may help soothe symptoms in the short term, but they can lead to far worse long-term problems. Better is to limit use of acid-reducing or acid-suppressing medications and find more healthful ways to manage gastric distress. (For more on how acid-reducing drugs interfere with digestion and health. And since there is no treatment that cures or reverses dementia at present, it is particularly important for older people to take every possible step they can to prevent its development.

Source(s): ??Malaz A. Boustani, MD, MPH, director of research operations, Indianapolis Discovery Network for Dementia, research scientist, Regenstrief Institute, Inc., scientist, Indiana University Center for Aging Research.