Aniqa B Alam1, Aozhou Wu2, Melinda C Power3, Nancy A West4, Alvaro Alonso5. 1. Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA. Electronic address: abalam@emory.edu. 2. Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA. 3. Department of Epidemiology and Biostatistics, Milken School of Public Health, George Washington University, Washington D.C., USA. 4. Division of Epidemiology, Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA. 5. Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
Abstract
INTRODUCTION: Elevated serum uric acid (SUA) is associated with cardiovascular risk factors, which often contribute to dementia and dementia-like morbidity, yet several cross-sectional studies have shown protective associations with cognition, which would be consistent with other work showing benefits of elevated SUA through its antioxidant properties. METHODS: We studied 11,169 participants free of dementia and cardiovascular disease from the Atherosclerosis Risk in Communities (ARIC) cohort. SUA was measured in blood samples collected in 1990-92, baseline for this study (age range 47-70 years). Incident dementia was ascertained based on clinical assessments in 2011-13 and 2016-17, surveillance based on dementia screeners conducted over telephone interviews, hospitalization discharge codes, and death certificates. Cognitive function was assessed up to four times between 1990 and 92 and 2016-17. We estimated the association of SUA, categorized into quartiles, with incidence of dementia using Cox regression models adjusting for potential confounders. The association between cognitive decline and SUA was assessed using generalized estimating equations. RESULTS: Over a median follow-up period of 24.1 years, 2005 cases of dementia were identified. High baseline SUA was associated with incident dementia (HR, 1.29; 95% CI, 1.12, 1.47) when adjusted for sociodemographic variables. However, after further adjustment including cardiovascular risk factors, this relationship disappeared (HR, 1.03; 95% CI, 0.88, 1.21). Elevated baseline SUA was associated with faster cognitive decline even after further adjustment (25-year global z-score difference, -0.149; 95% CI, -0.246, -0.052). CONCLUSION: Higher levels of mid-life SUA were associated with faster cognitive decline, but not necessarily with higher risk of dementia.
INTRODUCTION: Elevated serum uric acid (SUA) is associated with cardiovascular risk factors, which often contribute to dementia and dementia-like morbidity, yet several cross-sectional studies have shown protective associations with cognition, which would be consistent with other work showing benefits of elevated SUA through its antioxidant properties. METHODS: We studied 11,169 participants free of dementia and cardiovascular disease from the Atherosclerosis Risk in Communities (ARIC) cohort. SUA was measured in blood samples collected in 1990-92, baseline for this study (age range 47-70 years). Incident dementia was ascertained based on clinical assessments in 2011-13 and 2016-17, surveillance based on dementia screeners conducted over telephone interviews, hospitalization discharge codes, and death certificates. Cognitive function was assessed up to four times between 1990 and 92 and 2016-17. We estimated the association of SUA, categorized into quartiles, with incidence of dementia using Cox regression models adjusting for potential confounders. The association between cognitive decline and SUA was assessed using generalized estimating equations. RESULTS: Over a median follow-up period of 24.1 years, 2005 cases of dementia were identified. High baseline SUA was associated with incident dementia (HR, 1.29; 95% CI, 1.12, 1.47) when adjusted for sociodemographic variables. However, after further adjustment including cardiovascular risk factors, this relationship disappeared (HR, 1.03; 95% CI, 0.88, 1.21). Elevated baseline SUA was associated with faster cognitive decline even after further adjustment (25-year global z-score difference, -0.149; 95% CI, -0.246, -0.052). CONCLUSION: Higher levels of mid-life SUA were associated with faster cognitive decline, but not necessarily with higher risk of dementia.
Authors: Ron Brookmeyer; Denis A Evans; Liesi Hebert; Kenneth M Langa; Steven G Heeringa; Brenda L Plassman; Walter A Kukull Journal: Alzheimers Dement Date: 2011-01 Impact factor: 21.566
Authors: Megha Prasad; Eric L Matteson; Joerg Herrmann; Rajiv Gulati; Charanjit S Rihal; Lilach O Lerman; Amir Lerman Journal: Hypertension Date: 2016-12-19 Impact factor: 10.190
Authors: Nita A Limdi; Virginia J Howard; John Higginbotham; Jason Parton; Monika M Safford; George Howard Journal: J Racial Ethn Health Disparities Date: 2015-11-05
Authors: Danielle L Heidemann; Nicholas A Joseph; Aishwarya Kuchipudi; Denise White Perkins; Sean Drake Journal: Ethn Dis Date: 2016-01-21 Impact factor: 1.847
Authors: Erin L Richard; Linda K McEvoy; Steven Y Cao; Eyal Oren; John E Alcaraz; Andrea Z LaCroix; Rany M Salem Journal: J Neurol Sci Date: 2021-09-14 Impact factor: 4.553