Proton pump inhibitors and functional decline in older adults discharged from acute care hospitals.

OBJECTIVES: To investigate the relationship between use of proton pump inhibitors (PPIs) and incident dependency in older adults discharged from acute care hospitals.

DESIGN: Prospective observational study.

SETTING: Eleven geriatric and internal medicine acute care wards located throughout Italy.

PARTICIPANTS: Individuals (mean age 79.2 ± 5.5) who were not completely dependent at the time of discharge from participating wards (N = 401).

MEASUREMENTS: The outcome of interest was the loss of at least one basic activity of daily living (ADL) from discharge to the end of follow-up (12 months). The relationship between PPI use and functional decline was investigated using logistic regression analysis before and after propensity score matching.

RESULTS: Use of PPIs was significantly associated with functional decline before (odds ratio (OR) = 1.75, 95% confidence interval (CI) = 1.17-2.60) and after propensity score matching (OR = 2.44; 95% CI = 1.36-4.41). Other predictors of functional decline were hypoalbuminemia (OR = 3.10, 95% CI = 1.36-7.10 before matching, OR = 2.81, 95% CI = 1.09-7.77 after matching) and cognitive impairment (OR = 4.08, 95% CI = 1.63-10.2 before matching, OR = 6.35, 95% CI = 1.70-24.0 after matching).

CONCLUSION: Use of PPIs is associated with functional decline during 12 months of follow-up in older adults discharged from acute care hospitals.