title: Cognitive impact after short-term exposure to different proton pump inhibitors: assessment using CANTAB software.
abstract: BACKGROUND
  Studies have shown that proton pump inhibitors (PPIs) increase the brain burden of amyloid-beta (Aβ) and also create vitamin B12 deficiency. However, these two phenomena have deleterious effect on cognition and Alzheimer's disease (AD). Since the use of PPIs has increased tremendously for the last few years, it is of great public health importance to investigate the cognitive impact of PPIs. Hence, the purpose of this study was to investigate the degree of neuropsychological association of each PPI with different cognitive functions.
  
  
  METHODS
  Sixty volunteers of either gender were recruited and divided randomly into six groups: five test groups for five classes of PPIs and one control group. All the groups participated in the five computerized neuropsychological tests (nine subtests) of the Cambridge Neuropsychological Test Automated Battery twice: at the beginning of the study and 7 days thereafter.
  
  
  RESULTS
  We found statistically and clinically significant impairment in visual memory, attention, executive function, and working and planning function. One-way analysis of variance findings showed that all PPIs had a similar negative impact on cognition. However, paired-samples t tests indicated that omeprazole showed significant (p < 0.05) results in seven subtests; lansoprazole and pantoprazole showed significant results in five subtests; and rabeprazole showed significant results in four subtests. Among five classes of PPIs, esomeprazole showed comparatively less impact on cognitive function with significant results in three subtests.
  
  
  CONCLUSIONS
  The present study reveals for the first time that different PPIs have varying degrees of influence on different cognitive domains and have associations with AD. These findings should be considered when balancing the risks and benefits of prescribing these medications. A study done for a longer period of time with a larger sample size might yield better results.
authors.affiliation: Department of Pharmacy, School of Medicine, University of Asia Pacific, House no. 73, Road no. 5A, Dhanmondi, Dhaka, 1209, Bangladesh. sanjida2050@yahoo.com.
authors.forename: Sanjida
authors.initials: S
authors.lastname: Akter
authors.affiliation: Department of Pharmacy, School of Medicine, University of Asia Pacific, House no. 73, Road no. 5A, Dhanmondi, Dhaka, 1209, Bangladesh. rajib@uap-bd.edu.
authors.forename: Md Rajib
authors.initials: MR
authors.lastname: Hassan
authors.affiliation: Department of Pharmacy, School of Medicine, University of Asia Pacific, House no. 73, Road no. 5A, Dhanmondi, Dhaka, 1209, Bangladesh. shahriar@uap-bd.edu.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Shahriar
authors.affiliation: Department of Pharmacy, School of Medicine, University of Asia Pacific, House no. 73, Road no. 5A, Dhanmondi, Dhaka, 1209, Bangladesh. nahia_07@uap-bd.edu.
authors.forename: Nahia
authors.initials: N
authors.lastname: Akter
authors.affiliation: Department of Molecular Neuroscience and Integrative Physiology, Graduate School of Medical Science, Kanazawa University, Kanazawa, Ishikawa, Japan. abbasgolam@yahoo.com.
authors.forename: Md Golam
authors.initials: MG
authors.lastname: Abbas
authors.affiliation: Department of Pharmacy, School of Medicine, University of Asia Pacific, House no. 73, Road no. 5A, Dhanmondi, Dhaka, 1209, Bangladesh. mohiuddin@uap-bd.edu.
authors.forename: Mohiuddin Ahmed
authors.initials: MA
authors.lastname: Bhuiyan
mesh_terms: D053799:2-Pyridinylmethylsulfinylbenzimidazoles / Q000494:pharmacology; D000328:Adult; D000897:Anti-Ulcer Agents / Q000494:pharmacology*; D003071:Cognition / Q000187:drug effects*; D064098:Esomeprazole / Q000494:pharmacology; D005260:Female; D006801:Humans; D064747:Lansoprazole / Q000494:pharmacology; D008297:Male; D009853:Omeprazole / Q000494:pharmacology*; D000077402:Pantoprazole; D054328:Proton Pump Inhibitors / Q000494:pharmacology*; D064750:Rabeprazole / Q000494:pharmacology*; D012984:Software; D055815:Young Adult
chemical_list: D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000897:Anti-Ulcer Agents; D054328:Proton Pump Inhibitors; D064747:Lansoprazole; D064750:Rabeprazole; D000077402:Pantoprazole; D009853:Omeprazole; D064098:Esomeprazole