P4‐431: PROTON PUMP INHIBITORS USE AND RISK OF DEMENTIA: A META‐ANALYSIS USING REAL WORLD EVIDENCE
Bibliographic record
Abstract
Dementia is one of the major causes of disability and dependency in the elderly. A growing body of literature suggests both the protective as well as the detrimental effects of proton pump inhibitors (PPIs) use on dementia risk. However there are published epidemiological studies which found no association between PPI use and dementia risk. Therefore, this study is aimed to investigate the association between PPI use and dementia risk. An extensive literature search was performed in PubMed, Embase, and Cochrane central from inception to January 2019. All the studies assessing the association between PPI use and dementia risk was eligible for inclusion except cross-sectional studies, letter to the editor, review and others. Articles were selected based on the screening of title and abstract, data were extracted and risk of bias was assessed using Newcastle-Ottawa Scale. Primary outcome of this study was pooled dementia risk among PPI user as compared to non-PPI user. Secondary outcomes include dementia risk based on subgroup like study design, sex, and others. Statistical analysis was performed using Review manager software. Nine studies (six cohort and three case-control) with a total of 6,36,030 participants of which 2,45,281 were PPI user. The mean age of the PPI user was 76.91 ± 6.91 years (60.53% female). Majority of the studies were of high quality. Dementia was diagnosed based on ICD-9 or ICD-10 code in majority of the included studies. PPI use was not associated with the dementia risk, with a pooled relative risk (RR) of 1.05 (95%CI: 0.94 – 1.17), p = 0.42 (Fig.1). Subgroup analysis based on study design [Cohort: RR 1.12 (95%CI: 0.87 – 1.45), p = 0.36; Case control: RR 0.94 (95% CI: 0.87 – 1.03), p = 0.20], sex [RR 1.25 (95% CI: 0.97 – 1.60), p = 0.08)], H2RAs (p = 0.99) and dementia subtypes [Alzheimer's disease: RR 0.96 (95% CI: 0.84 – 1.09), p = 0.53)] revealed no significant association between PPI use and dementia risk.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.018 | 0.036 |
| Meta-epidemiology (narrow) | 0.003 | 0.002 |
| Meta-epidemiology (broad) | 0.019 | 0.065 |
| Bibliometrics | 0.008 | 0.008 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.006 | 0.003 |
| Open science | 0.003 | 0.002 |
| Research integrity | 0.003 | 0.003 |
| Insufficient payload (model declined to judge) | 0.007 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".