Gout or Hyperuricemia and Dementia Risk: A Meta-Analysis of Observational Studies.

ABSTRACT

Background: As a natural antioxidant, uric acid has neuroprotective effects. The association between uric acid levels and dementia risk was reported by previous studies. However, recently published studies showed that the relationship between uric acid and dementia risk might be heterogeneous in dementia subtypes. Objective: This study aimed to clarify the relationship between hyperuricemia (or gout) and dementia. Methods: The PubMed and Web of Science databases were systematically searched up to April 2024 to identify relevant studies. A meta-analysis was conducted using hazard ratios (HR) or odds ratios (OR) and 95% confidence interval (CI) as pooled indicators. Heterogeneity between the studies was examined using Cochran's Q statistic and I2 statistic. Subgroup analyses were conducted for gender and age. Stratification analysis, sensitivity analyses and meta-regression were conducted to explore possible explanations for heterogeneity. Publication bias was assessed by funnel plot and Egger's test. Results: A total of 11 studies met the inclusion criteria including 2,928,152 participants were abstracted. Hyperuricemia (or gout) did not reduce the overall risk of dementia (OR/HR = 0.92, 95% CI 0.81-1.05) and vascular dementia (OR/HR = 0.74, 95% CI 0.53-1.05), but may have a protective effect against Alzheimer's disease (OR/HR = 0.82, 95% CI 0.70-0.96). Subgroup analysis showed that a lower risk of dementia was observed in men (OR/HR = 0.83, 95% CI 0.77-0.90) and patients whose age under 65 (OR/HR = 0.83, 95% CI 0.72-0.95). Conclusions: Patients with gout or hyperuricemia have a low risk of Alzheimer's disease.