Gout and the risk of dementia: a nationwide population-based cohort study

INTRODUCTION Uric acid was proposed to have anti-oxidant property and possible neuroprotective effects. We examined the association between gout and dementia with population database. METHODS The study utilized the claims data from the nationwide representative sample of Taiwan National Health Insurance Research Database (NHIRD). We ascertained patients with gout and dementia covering vascular and non-vascular (including Alzheimer's) subtypes using International Classification of Diseases Ninth Revision, Clinical Modification (ICD9-CM) codes. A control group matched on sex, age, and index date of gout patients was randomly sampled with a ratio of 1:4 from the same database for comparison. RESULTS From 2002 to 2008, 28,769 gout patients who were older than 50 years old were identified, and 114,742 control patients was matched into the study. During follow-up, 7,119 patients developed dementia (1,214 with gout, and 5,905 without gout). After adjusting for age, sex, and relevant comorbidities, a Cox regression analysis showed that gout patients had a lower risk of developing non-vascular dementia (hazard ratio (HR): 0.77; 95% confidence interval (CI): 0.72-0.83; p < 0.001) and vascular dementia (HR: 0.76; 95% CI: 0.65-0.88; p < 0.001). CONCLUSIONS Patients with gout have a lower risk of developing dementia. This phenomenon exists for both non-vascular and vascular types of dementia.