title: Considerations for the use of proton-pump inhibitors in older adults.
abstract: OBJECTIVE
  To investigate current concerns regarding the use of proton-pump inhibitors (PPIs) in older adults.
  
  
  METHODS
  A literature search was conducted in MEDLINE (1948 to April week 3 2011) to identify relevant publications. Key words searched included proton-pump inhibitor, safety, adverse events, elderly, and older adults. Additional data sources were obtained through a bibliographic review of selected articles.
  
  
  METHODS
  Relevant studies conducted in older adults published in English that examined risks associated with the use of PPIs were included in this review.
  
  
  RESULTS
  The older adult population in the United States is growing at an astounding rate. With the increase in age, there are many factors that make the elderly susceptible to acid-related gastrointestinal disorders that require treatment with PPIs. However, PPI use in the elderly has been shown to lead to a number of health concerns. Recent data have shown that PPI use is associated with an increased risk of fractures, Clostridium difficile infection, community-acquired pneumonia, vitamin and mineral deficiencies, and drug interactions. These concerns will be further investigated and weighed against the benefits of PPI use in this population.
  
  
  CONCLUSIONS
  Patient-specific characteristics must be taken into consideration when recommending and/or prescribing PPIs to older adults.
authors.affiliation: Massachusetts College of Pharmacy and Health Sciences, Manchester, NH, USA. Alicia.desilets@mcphs.edu
authors.forename: Alicia R
authors.initials: AR
authors.lastname: Desilets
authors.forename: Nicole J
authors.initials: NJ
authors.lastname: Asal
authors.forename: Kaelen C
authors.initials: KC
authors.lastname: Dunican
mesh_terms: D000368:Aged; D016360:Clostridioides difficile / Q000187:drug effects; D017714:Community-Acquired Infections / Q000139:chemically induced; D004347:Drug Interactions; D050723:Fractures, Bone / Q000139:chemically induced; D006801:Humans; D054328:Proton Pump Inhibitors / Q000009:adverse effects*; D012306:Risk; D014805:Vitamin B 12 / Q000378:metabolism
chemical_list: D054328:Proton Pump Inhibitors; D014805:Vitamin B 12