International Journal of Pharma Insight Studies

Association Between Chronic Proton Pump Inhibitor Use and Frailty in Geriatric Patients in Primary Care

Juliana Fontes Beltran Paschoal1, Fernanda Gomes Picciani2, ⁠José A N Neto3, Jonhata N da Conceição4, Raquel Perez Carvalho5, Thamara Vitória Pereira6, ⁠Camila Santos da Costa7, Clarice Alencar de Medeiros8, Maria Beatriz Mendonça Ventura9, Rubens R Tutela10, Carlos Henrique B Figueiredo de Mendonça11, Joel Eloi Belo Junior12, Bianca Lopes Corrêa Proost13, Pedro Henrique Félix Tadei14, Júlia L S de Arruda15, Bruna Lima Pellicciotti16, Regilane da S Batista17, Roselene de O Carvalho18, Silvia Alves da Silva Carvalho19, Filipe J L Garcia20, Leonardo Tomé da Silva21, Maria Eduarda Kartabil Machado de Souza22, Rogerio Leite dos Santos23, Marcos Vinícius Brizola Rafael Botelho24, Marcia Cristina Guimarães Siqueira25, Giovana Casarini Yamashiro26, Vitória Belchior Ahmad27, Ana Laura Nogueira Ervilha28, Tânia Alves da Silva dos Santos29, Mateus Soares Santos Araújo30, Tatiana da Silva Francelino31, Thiago Augusto Rochetti Bezerra32

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Version of record

This is an author-deposited copy. The version of record was originally published elsewhere: Originally published in International Journal of Pharma Insight Studies. eISSN 3107-393X. Volume 3 Issue 4. Pages 01-16. Published 2026-01-01. DOI 10.54660/IJPIS.2026.3.4.01-16 . Source: https://www.pharmainsightjournal.com/article/173/association-between-chronic-proton-pump-inhibitor-use-and-frailty-in-geriatric-patients-in-primary

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.

Keywords: Pharma Insight, Pharmaceutical Sciences, Clinical Research, Drug Development, Healthcare Innovation, Pharmaceutical Studies, Medical Research

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