- What is the issue being addressed?
When food is swallowed it enters oesophagus – carrying food from the mouth to the stomach for further digestion. Contractions called peristalsis push the food down the oesophagus through a muscular valve called the lower oesophageal sphincter (LES) and into the stomach. The digestive juices secreted by the stomach are highly acidic. When the stomach contracts to move the food into the intestine the LES closes tightly in order to prevent these acidic juices from moving back into the oesophagus where they can cause damage. The diaphragm separates the chest from the abdomen, to reach the stomach the oesophagus passes through the diaphragm at a point called the hiatal ring. If the patient has reflux disease …show more content…
While dementia does shorten the lives of those affected, its greatest impact is upon quality of life, both for individuals living with dementia, and for their family and carers. The global costs of dementia have increased from
US$ 604 billion in 2010 to US$ 818 billion in 2015, an increase of 35.4%.
A study conducted by German researchers that was recently published in the journal of JAMA Neurology suggested that the regular use of the PPI’s increased the risk of dementia by 44% than those not taking the drugs. In 2013–14, there were over 19 million prescriptions for PPIs in Australia Most prescriptions for PPIs are for managing GORD. PPI use has increased by more than 1000% in Australia,2 with over 19 million prescriptions in the 2013–14 financial year.1 Over the last decade, at least two PPIs have featured in the top 10 most prescribed PBS-subsidised medicines every year. There are also financial implications of overuse, with extensive costs to both individuals and government. In the 2013–14 financial years, there were close to 7 million PBS-subsidised prescriptions for esomeprazole in Australia, at a cost of over $200 million to the …show more content…
• What did they find?
• What ae the issues that remain?
Only provides a statistical link, the biological cause needs to be further explored. Heavy users of PPIs usually have poorer health anyway having a higher risk of diabetes and heart disease. Further research is needed for cause and effect. It arises a questionable association – does not directly indicate that the drug causes increased risk of dementia.
Older people take many drugs, and these drugs are taken for a number of conditions. Polypharmacy – taking many drugs was also noted to be a risk factor. People who take lots of drugs for several medical conditions (that may themselves increase dementia risk) go to the doctor more, hence may tend to be diagnosed with dementia more.
The two groups used weren’t very similar. Those taking PPIs have poorer health more likely to be taking more medication. It was a cohort study – measuring changes overtime and can highlight associations. Cohort studies cannot prove cause and effect, as they include no randomisation of blinding. Other factors such as a person’s diet and lifestyle can influence the specific link of interest – bias and
When food is swallowed it enters oesophagus – carrying food from the mouth to the stomach for further digestion. Contractions called peristalsis push the food down the oesophagus through a muscular valve called the lower oesophageal sphincter (LES) and into the stomach. The digestive juices secreted by the stomach are highly acidic. When the stomach contracts to move the food into the intestine the LES closes tightly in order to prevent these acidic juices from moving back into the oesophagus where they can cause damage. The diaphragm separates the chest from the abdomen, to reach the stomach the oesophagus passes through the diaphragm at a point called the hiatal ring. If the patient has reflux disease …show more content…
While dementia does shorten the lives of those affected, its greatest impact is upon quality of life, both for individuals living with dementia, and for their family and carers. The global costs of dementia have increased from
US$ 604 billion in 2010 to US$ 818 billion in 2015, an increase of 35.4%.
A study conducted by German researchers that was recently published in the journal of JAMA Neurology suggested that the regular use of the PPI’s increased the risk of dementia by 44% than those not taking the drugs. In 2013–14, there were over 19 million prescriptions for PPIs in Australia Most prescriptions for PPIs are for managing GORD. PPI use has increased by more than 1000% in Australia,2 with over 19 million prescriptions in the 2013–14 financial year.1 Over the last decade, at least two PPIs have featured in the top 10 most prescribed PBS-subsidised medicines every year. There are also financial implications of overuse, with extensive costs to both individuals and government. In the 2013–14 financial years, there were close to 7 million PBS-subsidised prescriptions for esomeprazole in Australia, at a cost of over $200 million to the …show more content…
• What did they find?
• What ae the issues that remain?
Only provides a statistical link, the biological cause needs to be further explored. Heavy users of PPIs usually have poorer health anyway having a higher risk of diabetes and heart disease. Further research is needed for cause and effect. It arises a questionable association – does not directly indicate that the drug causes increased risk of dementia.
Older people take many drugs, and these drugs are taken for a number of conditions. Polypharmacy – taking many drugs was also noted to be a risk factor. People who take lots of drugs for several medical conditions (that may themselves increase dementia risk) go to the doctor more, hence may tend to be diagnosed with dementia more.
The two groups used weren’t very similar. Those taking PPIs have poorer health more likely to be taking more medication. It was a cohort study – measuring changes overtime and can highlight associations. Cohort studies cannot prove cause and effect, as they include no randomisation of blinding. Other factors such as a person’s diet and lifestyle can influence the specific link of interest – bias and