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. 2025 Oct 9;87(12):8434–8442. doi: 10.1097/MS9.0000000000004022

Figure 3.

Figure 3.

Biological mechanisms and study insights on proton pump inhibitor (PPI) use and dementia risk. (A) Pie chart illustrating the proposed biological mechanisms linking PPI use to dementia risk, with proportions attributed to amyloid-β deposition (40%), vitamin B12 deficiency (35%), and endothelial dysfunction (25%). (B) Donut chart showing the proportion of studies reporting a significant (41.7%) versus nonsignificant (58.3%) association between PPI use and dementia. (C) Stacked bar chart depicting the relative emphasis on biological mechanisms in key studies (Baddour et al, 2013; Lam et al, 2013; Yepuri et al, 2016; Ortis-Guerrero et al, 2016), normalized to 1.0, with contributions from amyloid-β deposition, vitamin B12 deficiency, and endothelial dysfunction. (D) Violin plot illustrating the distribution of hazard ratios (HRs) for PPI use and dementia risk by region (Asia, Europe, N. America), with the dashed line representing no effect (HR = 1).