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High serum urate protects against dementia in women

14 Jun 2019

Elevated serum urate concentrations may be protective against dementia, regardless of subtype, reports a recent study.

Researchers followed 1,447 women (mean age, 47.4±6.2 years) for a mean of 33.1 years and monitored for the development of late-life dementia. Serum urate concentrations were measured through standard routine clinical laboratory testing upon enrolment into the study at 1968–1969.

Mean serum urate concentration at baseline was 233.8±75.0 µmol/L, which rose slightly to 271.3±72.7 µmol/L during the follow-up examination between 1992 and 1994. The mean change in serum urate was 45.3±77.6 µmol/L.

A total of 320 participants developed dementia: 151 had Alzheimer’s disease without cerebrovascular disease, 52 had pure vascular dementia, 91 developed mixed dementia and 26 developed dementia of other types. The mean age at onset was 79.9±7.9 years, while the average time between serum urate measurement and dementia onset was 15.8±10.4 years.

Age-adjusted competing risk Cox proportional hazard analysis showed that higher serum urate was associated with a reduced risk of developing dementia (adjusted hazard ratio [HR] per standard deviation value of 76.5 µmol/L, 0.81, 95 percent CI, 0.72–0.91).

The same remained true for Alzheimer’s disease (adjusted HR, 0.78, 0.66–0.91) and vascular dementia (adjusted HR, 0.66, 0.47–0.94). Adjusting for confounders, such as education, body mass index, alcohol and smoking consumption patterns, and blood biochemistry did not meaningfully alter the findings.

If confirmed in future studies with larger study populations, the present findings may have important implications in treatment decisions for hyperuricaemia in patients with gout, with respect to potential dementia risk, said researchers.

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