Study results published in the Journal of the American Geriatrics Society (May 2014) showed a significant correlation between the use of proton pump inhibitors (PPIs) and functional decline in older adults (avg age 79.2) discharged from acute care hospitals. Measurement of function was activities of daily living (ADL) and loss of one or more ADLs was the outcome defining functional decline. Follow-up was at least 12 months post acute care discharge. The results showed a significant correlation between PPI use and functional decline (odds ratio 1.75, 95% CI). Considering the prevalence of use of PPIs and the fact they are evidenced to not be as innocuous as once believed, I am not surprised by the findings. Adverse effects from PPIs that might be responsible for functional decline are: vitamin B-12 malabsorption; hypomagnesemia, hyponatremia, acute interstitial nephritis, aspirational pneumonia, Clostridium difficile, drug-drug interactions.
The wide-spread use of PPIs is hardly justified and is leading to a public health concern as newer, more serious adverse events are now appearing in large population-based studies. Limiting use to a specific duration is the best course, if the PPI is even needed in the first place.