Gout/hyperuricemia reduces the risk of Alzheimer's disease: A meta‐analysis based on latest evidence

Wang, Long; Tan, Zheng; Wang, Fu‐Yu; Wu, Wen‐Pei; Wu, Jun‐Cang

doi:10.1002/brb3.3207

Cited by 4 publications

(1 citation statement)

References 56 publications

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“…We read with great interest the recent systematic review and meta‐analysis by Wang et al. ( 2023 ), which explored the association of hyperuricemia and gout with Alzheimer's disease. The authors observed a negative correlation between the two conditions detected by a hazard ratio of 0.69 (95% confidence interval 0.66–0.72).…”

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confidence: 99%

Comment on: “Gout/hyperuricemia reduces the risk of Alzheimer's disease: A meta‐analysis based on latest evidence”

Nadeem,

Nashwan

2024

Brain and Behavior

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We read with great interest the recent systematic review and meta-analysis by Wang et al. (2023), which explored the association of hyperuricemia and gout with Alzheimer's disease. The authors observed a negative correlation between the two conditions detected by a hazard ratio of 0.69 (95% confidence interval 0.66-0.72). The authors concluded that there was a moderate risk of heterogeneity (I 2 = 93%), which they attributed to regional differences.In an otherwise excellent paper, we find two methodological inaccuracies that might have overestimated the effect. First, the authors used a fixed-effect model for their meta-analysis. The fixed-effect model ignores any heterogeneity that may be present and gives a more precise effect estimate, but it may not be generalizable. In cases where considerable heterogeneity is present, the random effects model can be used. This model takes into account the different populations on which the individual studies were conducted (Deeks et al., 2019). Second, the authors used funnel plots, Begg's test, and Egger's test to assess the risk of publication bias. As a rule of thumb, the Cochrane Handbook for Systematic Reviews of Interventions recommends against using tests for funnel plot asymmetry when the number of included studies is less than 10 (Page et al., 2019). Additionally, visual inspection of funnel plot asymmetry is quite subjective and prone to errors (Terrin et al., 2005). The Doi plot and the Luis Furuya-Kanamori index are more sensitive to publication bias with less than 10 included studies (Furuya-Kanamori et al., 2018) and do not suffer from the difficulty in interpretation as do funnel plots.

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confidence: 99%

Comment on: “Gout/hyperuricemia reduces the risk of Alzheimer's disease: A meta‐analysis based on latest evidence”

Nadeem,

Nashwan

2024

Brain and Behavior

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Role of uric acid in neurodegenerative diseases, focusing on Alzheimer and Parkinson disease: A new perspective

Alrouji,

Al‐kuraishy,

Al‐Gareeb

et al. 2024

Neuropsychopharm Rep

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Neurodegenerative diseases (NDs) such as Alzheimer disease (AD) and Parkinson disease (PD) are group of diseases affecting the central nervous system (CNS) characterized by progressive neurodegenerations and cognitive impairment. Findings from different studies highlighted the beneficial and detrimental effects of serum uric acid on the development and progression of NDs. Therefore, this mini‐review aims to discuss the beneficial and detrimental effects of uric on NDs. The neuroprotective effect of uric acid is mainly related to the antioxidant effect of uric acid which alleviates oxidative stress‐induced neurodegeneration in AD and PD. However, long‐term effect of hyperuricemia prompts for the development and progression of cognitive impairment. Hyperuricemia is associated with cognitive impairment and dementia, and gout increases dementia risk. In addition, hyperuricemia can cause cerebral vascular injury which is a risk factor for vascular dementia and cognitive impairment. Taken together, the relationship between uric acid and NDs risk remains conflicting. Hence, preclinical and clinical studies are indicated in this regard.

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The influence of vascular risk factors on cognition among patients over 65 years of age in rural area - preliminary report

Zachara,

Wlaszczuk,

de Carrillo

et al. 2024

Preprint

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Background: Hypertension (HTN) and diabetes mellitus (DM) are associated with cognitive impairment and dementia. Antihypertensive treatment may improve cognitive functioning. Elevated blood glucose levels can increase the risk of dementia even in non-DM. Both HTN and DM may contribute to the development of Alzheimer’s disease. Aims: The aim of this study was to assess the influence of vascular risk factors on cognition. Methods: The study was conducted in the south of Poland among rural population over 65 years of age. 85 patients qualified into the study were divided into groups according to the presence of HTN (n=18), DM (n=7), or both (n=40). Control group was also formed (n=20). Biochemical tests, neurological scales assessment and ultrasound examinations were conducted. Results: The median score for the M-ACE scale was 3 points lower when HTN and DM coexisted, compared to the diagnosis of DM or HTN solely (25 points and 28 points respectively). Considering MMSE scale the results were comparable. The higher number of years of education correlated with better M-ACE result (median value of years of education 11 for the >25 points M-ACE results and 9 for patients with suspected dementia (<22 M-ACE points) Conclusions: The coexistence of DM and HTN caused the most profound decline in cognitive functioning of patients. Moreover, the higher number of years of education was a protective factor against the development of dementia in old age. Cholesterol and uric acid roles in cognitive decline are still debatable.

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Gout/hyperuricemia reduces the risk of Alzheimer's disease: A meta‐analysis based on latest evidence

Cited by 4 publications

References 56 publications

Comment on: “Gout/hyperuricemia reduces the risk of Alzheimer's disease: A meta‐analysis based on latest evidence”

Comment on: “Gout/hyperuricemia reduces the risk of Alzheimer's disease: A meta‐analysis based on latest evidence”

Role of uric acid in neurodegenerative diseases, focusing on Alzheimer and Parkinson disease: A new perspective

The influence of vascular risk factors on cognition among patients over 65 years of age in rural area - preliminary report

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