Association Between Chronic Proton Pump Inhibitor Use and Frailty in Geriatric Patients in Primary Care
Abstract
Introduction: Proton pump inhibitors (PPIs) are among the most frequently prescribed medications for acid-related disorders and are widely used by the geriatric population. However, emerging evidence suggests that long-term use may be associated with the development of conditions related to geriatric frailty.
Methods: A systematic literature review was conducted in accordance with the PRISMA 2020 guidelines. The following databases were searched: PubMed/MEDLINE, Scopus, Web of Science, Embase, Cochrane Library, LILACS, and the Virtual Health Library (BVS), including studies published between 2021 and 2026. Evidence regarding the impacts of PPIs on frailty, micronutrient deficiency, bone health, cognitive decline, cardiovascular events, polypharmacy, and deprescribing strategies was selected.
Results: Studies demonstrated an association between long-term PPI use and deficiencies in vitamin B12, magnesium, calcium, and iron, as well as an increased risk of osteoporosis, fractures, cognitive decline, dementia, cardiovascular events, and polypharmacy. These alterations showed the potential to reduce functional capacity and increase clinical vulnerability in the geriatric population. Deprescribing strategies demonstrated benefits in reducing unnecessary medication exposure and promoting therapeutic safety.
Conclusion: Chronic PPI use may contribute to the development or exacerbation of geriatric frailty through multiple pathophysiological mechanisms. Periodic assessment of therapeutic necessity and the implementation of deprescribing strategies are essential measures for promoting healthy aging and enhancing the quality of care in primary health care settings.
How to Cite This Article
Juliana Fontes Beltran Paschoal, Fernanda Gomes Picciani, José A N Neto, Jonhata N da Conceição, Raquel Perez Carvalho, Thamara Vitória Pereira, Camila Santos da Costa, Clarice Alencar de Medeiros, Maria Beatriz Mendonça Ventura, Rubens R Tutela, Carlos Henrique B Figueiredo de Mendonça, Joel Eloi Belo Junior, Bianca Lopes Corrêa Proost, Pedro Henrique Félix Tadei, Júlia L S de Arruda, Bruna Lima Pellicciotti, Regilane da S Batista, Roselene de O Carvalho, Silvia Alves da Silva Carvalho, Filipe J L Garcia, Leonardo Tomé da Silva, Maria Eduarda Kartabil Machado de Souza, Rogerio Leite dos Santos, Marcos Vinícius Brizola Rafael Botelho, Marcia Cristina Guimarães Siqueira, Giovana Casarini Yamashiro, Vitória Belchior Ahmad, Ana Laura Nogueira Ervilha, Tânia Alves da Silva dos Santos, Mateus Soares Santos Araújo, Tatiana da Silva Francelino, Thiago Augusto Rochetti Bezerra (2026). Association Between Chronic Proton Pump Inhibitor Use and Frailty in Geriatric Patients in Primary Care . International Journal of Pharma Insight Studies (IJPIS), 3(4), 01-16. DOI: https://doi.org/10.54660/IJPIS.2026.3.4.01-16