Interesting. I thought I had read about dementia concerns with long term use of PPIs (like omeprazole) several years ago. In fact, it was worrying me quite a lot. You question caused me to do a new internet search and I am not finding as much concern about dementia as I thought existed. One conclusion from this review is that it is hard to study long term side effects of PPIs.

FYI - I originally had links to these articles in this post, and attachments. By Mayo Connect is not letting me post with links.

One article from Cleveland Clinic: "“The biggest controversy has been around whether PPIs increase the risk of dementia,” he says, “but recent data do not support that association, although none of the research was from randomized, controlled trials so we can’t say this issue has been laid to rest.”

Another review article from the American Gastroenterology Assoc. (2017) concluded "Residual confounding related to study design and the over-extrapolation of quantitatively small estimates of effect size have probably led to much of the current controversy about PPI safety." There is a good chart in this article about % risks. (I tried attaching a graphic and a chart from this article but Mayo says I am too new a member.)

An article from US Pharmacist does not mention dementia as a concern. It mentions, among other things, loss of magnesium and osteoporosis concerns.

My conclusion, personally, is to try to get off omeprazole if I can, to reduce possible long term repercussions. (increased chance of getting C-Dificile is one of the risks and that is a dangerous and unpleasant infection.) I am doing as many other people in this Forum have suggested, I am going to read the Dr. Jonathan Aviv book Acid Watcher Diet. I am going to try to be ask strict as I can in following the recommendations, and see if I can get by on 20 mg famotidine twice a day. I have also learned there is a prescription 40 mg famotidine twice a day.... Of course - who knows what the long term side effects of famotidine are? (For years I took Ranitidine and then it was pulled from the marketing for having NDMA. Who knows what that did?)

Hard to balance pros and cons, especially when we really don't know them all. Best wishes to all! -RSE