Proton pump inhibitors and vitamin B12 deficiency in older adults: a systematic review of clinical studies

Au, Minnie, Power, Jacinta, and Gilmore, David (2015) Proton pump inhibitors and vitamin B12 deficiency in older adults: a systematic review of clinical studies. Annals of the Australasian College of Tropical Medicine, 17 (1). p. 17.

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Abstract

Background/Aims: Proton pump inhibitors (PPIs) are commonly prescribed in the clinical setting worldwide. Current evidence shows an association between PPI use and fractures, pneumonia and enteric infections, with inconclusive findings on PPI use leading to vitamin B12 deficiency. This is particularly relevant in older adults as the physiological changes that occur with ageing predispose to illness and the occurrence of additional co-morbidities places them at a greater risk of vitamin B12 deficiency. The aim of this study is to determine whether the long term use of PPIs in the older adult population is related to vitamin B12 deficiency.

Methods: A systematic review was conducted using Pubmed, Embase and the Cochrane library for records from 1988 up to 2015. Search terms used included: "proton pump inhibitors", "vitamin B12 deficiency", "cobalamin", "clinical studies", "elderly" and "older adults".

Results: A total of seven studies were analysed, including one non-randomised-control- trial, one retrospective-cohort study, two retrospective-case-control studies, one cross-sectional study and two case reports. Four studies found an association between long term PPI use and vitamin B12 deficiency, a retrospective case-control study showed no association. Both the case reports show an association between long term PPI use and vitamin B12 deficiency. One case report demonstrated clinical manifestations of vitamin B12 deficiency.

Conclusion: Small scale clinical studies suggest that vitamin B12 absorption is impaired in individuals on PPI therapy. This is supported by observational studies showing a reduction in vitamin B12 levels associated with long term PPI therapy in participants over 60 years, whether this association has a significant clinical impact remains unanswered.

Item ID: 40572
Item Type: Article (Abstract)
Keywords: proton pump inhibitors; vitamin B12 deficiency; cobalamin deficiency; older adults
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ISSN: 1448-4706
Date Deposited: 17 Nov 2015 02:41
FoR Codes: 11 MEDICAL AND HEALTH SCIENCES > 1111 Nutrition and Dietetics > 111199 Nutrition and Dietetics not elsewhere classified @ 35%
11 MEDICAL AND HEALTH SCIENCES > 1115 Pharmacology and Pharmaceutical Sciences > 111502 Clinical Pharmacology and Therapeutics @ 35%
11 MEDICAL AND HEALTH SCIENCES > 1103 Clinical Sciences > 110308 Geriatrics and Gerontology @ 30%
SEO Codes: 92 HEALTH > 9204 Public Health (excl. Specific Population Health) > 920411 Nutrition @ 50%
92 HEALTH > 9201 Clinical Health (Organs, Diseases and Abnormal Conditions) > 920199 Clinical Health (Organs, Diseases and Abnormal Conditions) not elsewhere classified @ 50%
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