Table 2.
Crude and adjusted odd ratios of proton pump inhibitor (ref: non-user) for AD
| Characteristics | N of AD | N of control | Odd ratios for AD (95% confidence interval) | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| exposure/total (%) | exposure/total (%) | Crude† | P-value | Model 1†‡ | P-value | Model 2†§ | P-value | Model 3†§ ⁋ | P-value | ||
| Exposure to PPI | |||||||||||
| Current | 1264/17,225 (7.3%) | 3588/68,900 (5.2%) | 1.46 (1.37–1.57) | < 0.001* | 1.46 (1.37–1.56) | < 0.001* | 1.39 (1.30–1.49) | < 0.001* | 1.36 (1.26–1.46) | < 0.001* | |
| Past | 1652/17,225 (9.6%) | 5873/68,900 (8.5%) | 1.17 (1.10–1.24) | < 0.001* | 1.18 (1.11–1.25) | < 0.001* | 1.14 (1.08–1.21) | < 0.001* | 1.11 (1.04–1.18) | 0.001* | |
| Duration of PPI use | |||||||||||
| < 30 days | 1867/17,225 (10.8%) | 6663/68,900 (9.7%) | 1.18 (1.11–1.24) | < 0.001* | 1.18 (1.12–1.25) | < 0.001* | 1.17 (1.11–1.24) | < 0.001* | 1.13 (1.07–1.19) | < 0.001* | |
| 30–90 days | 1162/17,225 (6.7%) | 3885/68,900 (5.6%) | 1.26 (1.17–1.35) | < 0.001* | 1.26 (1.18–1.35) | < 0.001* | 1.23 (1.15–1.32) | < 0.001* | 1.18 (1.10–1.27) | < 0.001* | |
| > 90 days | 1116/17,225 (6.5%) | 3437/68,900 (5.0%) | 1.36 (1.27–1.46) | < 0.001* | 1.37 (1.27–1.47) | < 0.001* | 1.28 (1.20–1.38) | < 0.001* | 1.26 (1.16–1.36) | < 0.001* | |
| Duration of PPI use (1st-generation) | |||||||||||
| < 30 days | 1325/17,225 (7.7%) | 4406/68,900 (6.4%) | 1.25 (1.17–1.33) | < 0.001* | 1.25 (1.17–1.33) | < 0.001* | 1.20 (1.12–1.28) | < 0.001* | 1.14 (1.07–1.22) | < 0.001* | |
| 30–90 days | 772/17,225 (4.5%) | 2434/68,900 (3.5%) | 1.31 (1.21–1.43) | < 0.001* | 1.32 (1.22–1.44) | < 0.001* | 1.26 (1.15–1.37) | < 0.001* | 1.19 (1.09–1.30) | < 0.001* | |
| > 90 days | 591/17,225 (3.4%) | 1848/68,900 (2.7%) | 1.33 (1.21–1.46) | < 0.001* | 1.33 (1.21–1.46) | < 0.001* | 1.22 (1.11–1.34) | < 0.001* | 1.18 (1.07–1.30) | 0.001* | |
| Duration of PPI use (2nd-generation) | |||||||||||
| < 30 days | 972/17,225 (5.6%) | 3479/68,900 (5.1%) | 1.14 (1.06–1.23) | < 0.001* | 1.15 (1.06–1.23) | < 0.001* | 1.18 (1.09–1.27) | < 0.001* | 1.13 (1.05–1.22) | 0.001* | |
| 30–90 days | 530/17,225 (3.1%) | 1795/68,900 (2.6%) | 1.20 (1.09–1.33) | < 0.001* | 1.21 (1.10–1.34) | < 0.001* | 1.22 (1.11–1.35) | < 0.001* | 1.17 (1.05–1.29) | 0.003* | |
| > 90 days | 468/17,225 (2.7%) | 1412/68,900 (2.1%) | 1.35 (1.22–1.50) | < 0.001* | 1.35 (1.22–1.50) | < 0.001* | 1.31 (1.18–1.46) | < 0.001* | 1.27 (1.14–1.43) | < 0.001* | |
Abbreviations: AD Alzheimer’s disease, PPI proton pump inhibitor
*Conditional logistic regression analysis, Significance at P < 0.05
†Stratified model for age, sex, income, and region of residence
‡Model 1 was adjusted for systolic blood pressure, diastolic blood pressure, fasting blood glucose, and total cholesterol
§Model 2 was adjusted for model 1 plus obesity, smoking, alcohol consumption, and Charlson Comorbidity Index (CCI) scores
⁋Model 3 was adjusted for model 2 plus gastroesophageal reflux disease (GERD) and H2-blocker
The H2-blocker use was included in the analyses because PPI users may take with or without concomitant use of H2-blockers