Good News for Your Gout Patients

Chronic tophaceous gout. Courtesy Angela Potter, MD

With all the discomfort and comorbidities associated with gout, here’s one piece of good news: a large population study shows gout patients may have a reduced risk of dementia -– including Alzheimer’s disease.

Data from a large population database in Taiwan, comparing dementia occurrence among 28,769 gout patients and 114,742 healthy controls, shows those with gout have a more than 75% lower risk of developing vascular and non-vascular dementia.

The randomly sampled patients with no history of dementia, most of them men with an average age of 64, were followed from 2002 to 2008.

Those with gout had a higher frequency of hypertension, elevated cholesterol, diabetes, coronary artery disease, stroke history, and chronic kidney disease –- all risk factors for dementia – - compared with the healthy controls.

What the gout patients didn’t have was a greater likelihood of dementia: 9.5% (n=1,214) of the gout patients developed dementia during more than 4 years of follow-up vs almost 12% (n=5,634) of those who did not have gout.

Regression analysis shows the gout patients had a reduced risk of dementia -–specifically a hazard ratio of 0.77 for non-vascular dementia and 0.76 for vascular dementia (a reduced risk of 77% and 76%, respectively).

Older gout patients and those with comorbid heart disease, diabetes, chronic kidney disease, and Parkinson’s did have a higher risk of developing dementia, but the risk was still lower than that of the healthy controls.

This is a significant finding and may support theories that uric acid has antioxidant properties and possible neuroprotective effects.

Indeed, some recent studies show patients with Alzheimer's tend to have lower central nervous system uric acid levels. And higher serum urate level is also associated with a lesser rate of cognitive decline in mild cognitive impairment, the researchers note.

The study is limited in that all of the patients were non-Caucasian, so the data may not apply to other ethnic populations. Also, no information was collected on lifestyle factors, including smoking.

References:

Hong JY, Lan TY, Tang GJ, et al, Gout and the risk of dementia: a nationwide population-based cohort study. Arthritis Research & Therapy. Volume 17. Open Access.