ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 229

Uric Acid and Incident Dementia over 10 Years

Pascal Richette1, Aicha Soumare2, Stéphanie Debette2, Thomas Bardin3,4 and Christophe Tzourio2, 1Université Paris Diderot, UFR médicale, Paris, France; APHP Hôpital Lariboisière, Fédération de Rhumatologie and Inserm U1132, Hôpital Lariboisière, Paris, France, 2INSERM Research Center for Epidemiology and Biostatistics (U897) Team Neuroepidemiology, Bordeaux, France, 3Service de Rhumatologie, Hôpital Lariboisière, Paris, France, 4Rhumatology Departement, Hôpital Lariboisière, Paris, France

Meeting: 2015 ACR/ARHP Annual Meeting

Date of first publication: September 29, 2015

Keywords:

Session Information

Date: Sunday, November 8, 2015

Title: Metabolic and Crystal Arthropathies Poster I

Session Type: ACR Poster Session A

Session Time: 9:00AM-11:00AM

Background/Purpose: In patients with gout, maintaining the serum uric acid (SUA) levels too low with ULT is a matter of concern because UA is thought to be neuroprotective. However, the relation between UA and both dementia and cognitive function, in which both vascular mechanisms and oxidative stress are thought to play a role, has been poorly explored.

Methods: We assessed the longitudinal association between SUA levels and the risk of incident dementia (DSM-IV criteria) over 10 years of follow-up in a large cohort of elderly individuals (3C cohort). Additionally, we investigated the relation between SUA levels and change in cognitive function (minimental state examination, Benton and Isaac tests, Trail making tests) and change in brain MRI patterns (total brain volume, white matter lesions volume and infarct-like brain lesions). 

Results: The study sample comprised 1,769 individuals (mean age 72.4, male 39.6 %). During the 10,608 person-years of follow-up (median duration: 9.6 years), 134 participants developed dementia (crude incidence rate: 9.2/1000 person-years) with 94 (70.1%) classified as Alzheimer’s disease and 9 (6.7%) as vascular dementia. Dementia was associated with older age, depressive symptoms, and APOE-ε4 genotype. Increasing age and BMI, current smoking, renal impairment, hypertension, history of cardiovascular disease, low HDL cholesterol, hypertriglyceridemia, high CRP and IL-6 levels, as well as the use diuretics, or aspirin were associated with hyperuricemia (all P values <0.001). The multivariate HR of dementia among individuals in the highest tertile of SUA levels as compared with those in the lowest tertile was 1.67 (95% CI 1.04 to 2.71); P for trend=0.05). The association was stronger for vascular dementia (HR 6.37 (95% 0.61 to 66.98)) than for Alzheimer’s disease HR 1.71 (95% 0.97-3.03). There was no clear association between SUA levels and change in cognitive performance, nor with change in white matter lesions volume or brain structure as assessed with MRI.

Conclusion: These findings suggest that higher SUA levels are associated with an increase risk of dementia, mainly from vascular cause.

Disclosure: P. Richette, None; A. Soumare, None; S. Debette, None; T. Bardin, Novartis , Gilead Sciences , ViiV Healthcare , Bristol Myers-Squibb, Merck, Romark, Abbvie, 2,Gilead Sciences, ViiV Healthcare, tol Myers-Squibb, Merck, Eli Lilly, 5,Eli Lilly, 8; C. Tzourio, None.

To cite this abstract in AMA style:

Richette P, Soumare A, Debette S, Bardin T, Tzourio C. Uric Acid and Incident Dementia over 10 Years [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/uric-acid-and-incident-dementia-over-10-years/. Accessed .

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