Use of proton pump inhibitors and mortality among institutionalized older people.

E vidence is accumulating in relation to adverse events associated with proton pump inhibitors (PPIs). Reports in the Archives have demonstrated an association with fractures, Clostridium difficile infections, and community-acquired pneumonia. Proton pump inhibitors may also attenuate the antiplatelet benefits of clopidogrel. Because frail older people often use PPIs and may be especially vulnerable, we investigated the association between PPIs and all-cause mortality in 2 cohorts of institutionalized people.