A recent study published in Alzheimer’s & Dementia, the journal of the Alzheimer’s Association, investigated the methods by which proton pump inhibitors and dementia are connected.

PPIs and dementia have been tentatively linked, according to “several pharmacoepidemiological studies.” The new study, published on May 8, 2020, has identified a potential biological mechanism that could solidify the link between PPIs and dementia. 

Using an advanced computer simulation referred to as “in silico,” study researchers examined the way PPIs affect the enzyme “choline-acetyltransferase” (ChAT). The in silico analysis was based on the observed in vitro interactions of PPIs and ChAT.

The ChAT enzyme enables neurotransmitters to communicate with one another by breaking down the compound acetylcholine. According to the researchers, it’s acting on one of the body’s oldest signaling systems.

The study’s results demonstrated that the PPIs omeprazole, lansoprazole, pantoprazole, rabeprazole, tenatoprazole, and ilaprazole all contained elements that could impair the ChAT enzyme by forming a coordinate bond with it. 

The interaction was found to demonstrate that PPIs are a “more potent and more selective inhibitors of ChAT than one of the strongest known inhibitors of this enzyme, that is, α‐NETA.” 

However, a patient would need to take a higher and more frequent dose of PPIs to experience the effect. 

Acknowledging study limitations, researchers stated: “studies on biological consequences of inhibition of ChAT are scarce.” This study alone cannot prove PPIs cause dementia in patients.

“The findings warrant specific pharmacoepidemiological studies on PPI use as risk factor (or risk modifier) for ALS and the related motor neurons disorders,” study authors wrote. 

However, it’s significant because it demonstrates a plausible method that may link PPIs and dementia. The relationship may help scientists narrow the focus to find more conclusive answers.