Gout weakly associated with Alzheimer's disease and vascular dementia

Dementia is one of the most common diseases with high morbidity, mortality, and reduced quality of life, especially in the elderly population taking a toll on global mortality rate. The number of dementia patients or related cognitive impairment is expected to increase to 115 million by 2050.

The association between gout and dementia, Alzheimer's disease (AD), or vascular dementia (VD) is not fully understood. Xuanlin Li and team, aimed to evaluate the risk of all-cause dementia, AD, and VD in gout patients with or without medication.

The meta analysis published in Frontiers in Aging Neuroscience suggests that the risk of all-cause dementia, AD, and VD was found to be decreased in gout patients, but still there is lack of evidence to validate the same.

Researchers included data sources were PubMed, Embase, the Cochrane Library, and reference lists of included studies. The current meta-analysis included cohort studies assessing whether the risk of all-cause dementia, AD, and VD was associated with gout. The risk of bias was assessed using the Newcastle-Ottawa Quality Assessment Scale (NOS). The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system was used to access the overall certainty of evidence. Risk ratios (RR) with 95% confidence intervals (CI) were pooled using a random-effects model, and publication bias was assessed with funnel plots and Egger's test.

The key findings of the study are

• A total of six cohort studies involving 2,349,605 individuals were included in this meta-analysis, which were published between 2015 and 2022.

• The pooling analysis shows that the risk of all-cause dementia was decreased in gout patients [RR = 0.67, 95% CI (0.51, 0.89), I2 = 99%, P = 0.005, very low quality], especially in gout patients with medication [RR = 0.50, 95% CI (0.31, 0.79), I2 = 93%, P = 0.003, low quality].

• The risk of AD [RR = 0.70, 95% CI (0.63, 0.79), I2 = 57.2%, P = 0.000, very low quality] and VD [RR = 0.68, 95% CI (0.49, 0.95), I2 = 91.2%, P = 0.025, very low quality] was also decreased in gout patients.

• Despite the large heterogeneity, the sensitivity analysis indicated that the results were robust, and there was little evidence of publication bias.

Researchers concluded that the risk of all-cause dementia, AD, and VD is decreased in gout patients, but the quality of evidence is generally low. More studies are still needed to validate and explore the mechanisms of this association.

Reference: Li X, Huang L, Tang Y, Hu X, Wen C. Gout and risk of dementia, Alzheimer's disease or vascular dementia: a meta-epidemiology study. Front Aging Neurosci. 2023;15:1051809. Published 2023 Apr 26. doi:10.3389/fnagi.2023.1051809.