Banca de DEFESA: ANDRÊZA SOARES DOS SANTOS

Uma banca de DEFESA de DOUTORADO foi cadastrada pelo programa.
STUDENT : ANDRÊZA SOARES DOS SANTOS
DATE: 27/08/2021
TIME: 09:00
LOCAL: Videoconferência
TITLE:

PROTON PUMP INHIBITORS (PBIs) AND CHANGE OF COGNITIVE FUNCTION IN 4 YEARS: LONGITUDINAL STUDY OF ADULT HEALTH (ELSA-Brasil)

KEY WORDS:

Proton pump inhibitors; Cognitive function; Renal function.

PAGES: 101
BIG AREA: Ciências da Saúde
AREA: Saúde Coletiva
SUMMARY:

Objective: To investigate if the use of proton pump inhibitors at baseline is associated with decreased performance in memory, language, executive function tests and renal function after about four years of follow-up in ELSA-Brasil participants. Methods: This present doctoral thesis was developed in the ELSA-Brasil cohort, composed of 15,105 civil servants (active or retired), from higher education or research institutions located in six Brazilian capitals, using baseline data Wave 1 (2008-2010) and Wave 2 follow-up (2012-2014). Use of proton pump inhibitors (PPI) was evaluated at baseline and all participants were instructed to take to the research center all medications (prescribed or not) used in the last two weeks, also reporting the time of use of each medicament. In the assessment of cognitive performance, memory and verbal fluency tests were used in the neuropsychological battery CERAD (Consortium to Establish a Registry for Alzheimer's Disease) adapted to the Brazilian population and the Trail Test (version B) in the Wave 1 and 2. The assessment of reduction renal function was verified using the estimated glomerular filtration rate (eGFR) using the Chronic Kidney Disease Epidemiology Collaboration equation, with levels below 60 ml/min/1.73 m2 being considered as decrease in GFR at Wave 1 and 2. Mixed-effect linear regression models were used to assess longitudinal changes in cognitive performance and decrease in renal function between Wave 1 and 2. The work was divided into two parts, each part corresponding to a scientific article with independent objectives. Results: In the assessment of cognitive performance, after adjustment, the interaction term PPI use × age was not statistically significant for the cognitive tests evaluated, and in none of the categories of length of drug use, indicating that the PPI use at baseline was not associated with a more accelerated decline in cognitive performance between waves. In the assessment of decreased renal function, the regular use of PPI at baseline is not associated with incident chronic kidney disease (CKD) after adjustment for confounding factors, but is associated with a reduction in standardized eGFR assessed between Wave 1 and 2. PPI use of one to three years is associated with the incidence of CKD and PPI use of less than one year and above three years is associated with a reduction in eGFR. Additional analyzes were performed and found an association between PPI use and increased risk of mortality. Conclusion: The results of this thesis regarding the absence of association between the use of PPI and the decline in cognitive function should not be interpreted as the absence of a definite association, as the relatively short interval between visits may have had an impact when analyzing cognitive decline in a young cohort. The results regarding the association of PPI use and length of use in reducing kidney function demonstrate the need to educate healthcare professionals to increase awareness and reduce PPI prescription and overuse. Our results contribute to the post-marketing surveillance of these drugs, as the results are still recent, scarce and conflicting.

BANKING MEMBERS:
Externo à Instituição - SOTERO SERRATE MENGUE - UFRGS
Externo à Instituição - JOSÉ GERALDO MILL - UFES
Externa à Instituição - MARIA DAS GRACAS CARVALHO - UFMG
Externa ao Programa - 1296968 - MARIANA LINHARES PEREIRA
Presidente - 2059540 - ROBERTA CARVALHO DE FIGUEIREDO