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The results of a US study presented at EULAR 2018 suggest that gout is associated with a 17-to-20 per cent higher risk of dementia in the elderly.
The study included 1.23 million Medicare beneficiaries, of which 65,325 had incident dementia. In an analysis, which was adjusted for various potential confounding variables, including demographics, comorbidities and commonly-used medications (HR 1.17, 95 per cent CI 1.13-1.21), the results showed that gout is independently associated with a significantly higher risk of dementia. The association was larger in older age groups, females, African-American race and people with higher medical comorbidity.
Subgroup analyses indicated that gout was associated with a significant 20-to-57 per cent (p<0.0001) increase in dementia in patients without key comorbidities: Coronary artery disease (CAD); hyperlipidaemia; cardiovascular disease; diabetes; or hypertension. However, this was not the case in patients with each of these comorbidities, except in patients with CAD.
“Our study found a considerable increased risk of dementia associated with gout in the elderly,” said study author Dr Jasvinder Singh, Professor of Medicine and Epidemiology at the University of Alabama, Birmingham, US. “Further study is needed to explore these relationships and understand the pathogenic pathways involved in this increased risk.”
“We welcome these results, as they contribute to our understanding of the relationship between uric acid and dementia,” said Prof Robert Landewé, Chairperson of the Scientific Programme Committee, EULAR. “Previous studies have shown contradictory results, with some indicating an increased risk of dementia, while others reporting the opposite.”