Gout and the risk of dementia: a nationwide population-based cohort study

Abstract

IntroductionUric acid was proposed to have anti-oxidant property and possible neuroprotective effects. We examined the association between gout and dementia with population database.MethodsThe study utilized the claims data from the nationwide representative sample of Taiwan National Health Insurance Research Database (NHIRD). We ascertained patients with gout and dementia covering vascular and non-vascular (including Alzheimer’s) subtypes using International Classification of Diseases Ninth Revision, Clinical Modification (ICD9-CM) codes. A control group matched on sex, age, and index date of gout patients was randomly sampled with a ratio of 1:4 from the same database for comparison.ResultsFrom 2002 to 2008, 28,769 gout patients who were older than 50 years old were identified, and 114,742 control patients was matched into the study. During follow-up, 7,119 patients developed dementia (1,214 with gout, and 5,905 without gout). After adjusting for age, sex, and relevant comorbidities, a Cox regression analysis showed that gout patients had a lower risk of developing non-vascular dementia (hazard ratio (HR): 0.77; 95% confidence interval (CI): 0.72 - 0.83; p < 0.001) and vascular dementia (HR: 0.76; 95% CI: 0.65 - 0.88; p < 0.001).ConclusionsPatients with gout have a lower risk of developing dementia. This phenomenon exists for both non-vascular and vascular types of dementia.

Are Chronic Periodontitis and Gingivitis Associated with Dementia? A Nationwide, Retrospective, Matched-Cohort Study in Taiwan

“…The types of dementia were coded as follows: Alzheimer-type dementia (ICD-9-CM 290.0, 290.10-290.13, 290.20-290.21, or 290.3, plus the codes of 331.0), vascular dementia (ICD-9-CM 290.41-290.43), and other non-vascular dementias (ICD-9-CM 290.8-290.9) [55,56,57,58]. …”

A profile of health status and demographics of aged care facility residents with gout

“…Further, unrecognised causes of pain can exacerbate behavioural problems in people with dementia, which may lead to the use of antipsychotic medications, and introduce unnecessary polypharmacy leading to higher risks of medication interactions. Studies have shown that gout is inversely associated with the development of dementia and Alzheimer's disease, purportedly due to neuroprotective properties of uric acid . Osteoporosis in this data set is lower than that of other studies and could indicate under‐reporting of osteoporosis in this cohort .…”

Use of urate-lowering therapies is not associated with an increased risk of incident dementia in older adults

“…In this study, there are some issues to comment. First, the results reported by Singh et al differ from those of a previous prospective population-based cohort study, which demonstrated that patients with gout undergoing uric acid-lowering treatment have a lower risk of developing dementia 2. In addition, another population-based study found that gout is inversely related to the risk of developing Alzheimer’s disease (AD) regardless of whether ULTs are used, supporting the purported potential neuroprotective role of gout or uric acid on the development of AD 3.…”