New research has delivered unsettling news for millions of people who rely on proton pump inhibitors (PPIs) to manage chronic acid reflux. According to a recent study, taking these medications over long periods may raise the risk of developing dementia by as much as 33%. While the findings highlight a potential link rather than definitive proof, they add to a growing list of concerns surrounding the extended use of PPIs — drugs already tied to increased risks of kidney disease, infections, and even stroke.

For many, these medications offer essential relief. But experts warn that ignoring possible long-term effects could be a mistake.

Acid reflux is more common than most people realize. The condition occurs when stomach acid flows back into the esophagus, often after eating or while lying down. Heartburn is the most recognizable symptom, but chronic reflux can lead to far more serious problems, including ulcers and gastroesophageal reflux disease (GERD). The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) reports that nearly one in five Americans live with GERD. Across the UK, more than 40% of people report ongoing heartburn. When left untreated, GERD can increase the risk of esophageal cancer and other long-term complications.

To control these symptoms, many turn to PPIs such as omeprazole, lansoprazole, and esomeprazole. These medications work by reducing acid production at the source: they block an enzyme in the stomach lining responsible for generating acid. With fewer acid attacks, the esophagus has a chance to heal, making PPIs one of the most widely used treatments for reflux worldwide.

However, long-term reliance on these drugs has raised red flags over the years. The U.S. Food and Drug Administration (FDA) has issued multiple warnings about extended PPI use, citing connections to kidney disease, bone fractures, and infections like Clostridium difficile. A 2019 study in the BMJ even found a higher risk of premature death among long-term PPI users compared to those who never used the drugs. While PPIs can be highly effective, medical professionals have increasingly urged caution.

The latest study, published in the journal Neurology and conducted by researchers at the University of Minnesota, adds dementia concerns to the list. The research team examined whether prolonged PPI use might contribute to cognitive decline. Although the study found an association, researchers stressed that it does not confirm a direct cause-and-effect relationship. People who take PPIs regularly may already have underlying conditions that increase their dementia risk.

Study author Professor Kamakshi Lakshminarayan explained, “Proton pump inhibitors are a useful tool to help control acid reflux. However, long-term use has been linked in previous studies to a higher risk of stroke, bone fractures, and chronic kidney disease.” She and other specialists emphasize that the findings shouldn’t inspire panic but should encourage discussions with healthcare providers, especially for those who rely on PPIs without viable alternatives.

The study analyzed data from more than 5,700 adults aged 45 and older, none of whom had dementia at the start. Participants — whose average age was 75 — were monitored over roughly 5.5 years through regular visits and annual phone interviews. Researchers divided them into four groups based on how long they used PPIs: no use, up to 2.8 years, 2.8 to 4.4 years, and more than 4.4 years.

The differences between the groups were striking. For those who never took PPIs, 19 out of every 1,000 person-years developed dementia. But among those who used the medications for more than 4.4 years, the number rose to 24 per 1,000 person-years. After adjusting for factors like age, sex, race, high blood pressure, and diabetes, the team concluded that long-term PPI users had a 33% higher risk of dementia. Notably, short-term use did not show the same association.

Even with these findings, stopping PPIs abruptly is not recommended — doing so can trigger severe rebound acid production. Instead, experts encourage patients to work with their doctors to review treatment plans and consider alternative strategies when appropriate.

For many people, lifestyle changes can help reduce dependence on PPIs. Losing excess weight, avoiding large meals before bedtime, reducing alcohol and caffeine intake, and elevating the head of the bed during sleep can all ease acid reflux symptoms. Over-the-counter antacids may help in mild cases. For anyone worried about dementia risk, discussing a personalized approach with a healthcare provider is essential.

As the conversation around long-term PPI use continues to evolve, one message remains clear: treatment decisions should balance relief with long-term safety, guided by expert advice and a full understanding of potential risks.