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Associations between PPI use, regardless of dosing pattern, and physical function were analyzed using Welch's\n                      <jats:italic>t<\/jats:italic>\n                      \u2010test, chi\u2010square test, and linear and logistic regression models. Models were initially\u00a0run as crude, then adjusted for age, sex, and body mass index (Multivariable Model 1), and further adjusted for the Charlson Comorbidity Index (CCI) (Multivariable Model 2).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 616 participants (63.1% females), PPI users had lower mean handgrip strength (27.6\u2009kg vs. 30.1\u2009kg,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.019), slower median 4\u2010m walking performance (3.7\u2009s vs. 3.5\u2009s,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.017), and lower success in the armchair push\u2013pull test (86.9% vs. 95.4%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002) compared with non\u2010users. Crude regression analyses showed poorer performance across all outcomes among PPI users (all\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05); however, this persisted only for the armchair push\u2013pull test through Multivariable Model 2 (odds ratio 0.40, 95% confidence interval 0.19\u20130.85,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.02). In the sensitivity analysis, replacing the CCI with non\u2010vitamin medication burden attenuated this association as well (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&gt;\u20090.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>PPI use in older adults is significantly associated with lower muscle strength and poorer physical performance in less adjusted models, with these associations attenuating and disappearing with stepwise adjustment. These findings underscore the need to consider residual confounding in studies linking PPI use to adverse outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/1751-2980.70068","type":"journal-article","created":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T02:45:31Z","timestamp":1788317131000},"page":"287-292","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Association Between Proton\u2010Pump Inhibitors and Muscle Strength in Older Adults: A Population\u2010Based Analysis"],"prefix":"10.1111","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-7182-9464","authenticated-orcid":false,"given":"Jaakko","family":"Ollila","sequence":"first","affiliation":[{"name":"Abdominal Center \u2013 Department of Gastroenterology Turku University Hospital and University of Turku  Turku 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