Uric acid and cognitive decline: a double-edge sword?

Latourte, Augustin; Bardin, Thomas; Richette, Pascal

doi:10.1097/bor.0000000000000472

Cited by 39 publications

(35 citation statements)

References 41 publications

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“…PRH is associated with low sUA levels, nephrolithiasis, and exercise-induced acute failure (EIARF). Several authors have found an association between some neurological alterations of the posterior reversible encephalopathy syndrome and EIARF, supporting the hypothesis of a relation between changes of sUA levels and altered cognitive function [ 65 , 66 , 67 ].…”

Section: Mechanisms Underlying the Relation Between Ua And Cognitimentioning

confidence: 68%

Uric Acid and Cognitive Function in Older Individuals

et al. 2018

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Hyperuricemia has been recognized as an independent cardiovascular risk factor in epidemiological studies. However, uric acid can also exert beneficial functions due to its antioxidant properties, which may be particularly relevant in the context of neurodegenerative diseases. In this paper, we critically revise the evidence on the relationship between serum uric acid levels and cognitive function in older individuals, focusing on the etiology of cognitive impairment (Alzheimer’s disease, Parkinson’s dementia, and vascular dementia) and on the interactive connections between uric acid, dementia, and diet. Despite high heterogeneity in the existing studies, due to different characteristics of studied populations and methods of cognitive dysfunction assessment, we conclude that serum uric acid may modulate cognitive function in a different way according to the etiology of dementia. Current studies indeed demonstrate that uric acid may exert neuroprotective actions in Alzheimer’s disease and Parkinson’s dementia, with hypouricemia representing a risk factor for a quicker disease progression and a possible marker of malnutrition. Conversely, high serum uric acid may negatively influence the disease course in vascular dementia. Further studies are needed to clarify the physio-pathological role of uric acid in different dementia types, and its clinical-prognostic significance.

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Section: Mechanisms Underlying the Relation Between Ua And Cognitimentioning

confidence: 68%

Uric Acid and Cognitive Function in Older Individuals

et al. 2018

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“…Serum urate has antioxidant properties, eliminating reactive oxygen specimens and peroxynitrite and preventing iron‐mediated ascorbate oxidation . However, some studies showed that serum urate may be prooxidant depending on the microenvironment, and there is extensive evidence that hyperuricemia induces vasculopathy . Therefore, serum urate may play complex and different roles in the central nervous system depending on its concentration, microenvironment, and other factors.…”

Section: Discussionmentioning

confidence: 99%

Cause‐Specific Mortality in Gout: Novel Findings of Elevated Risk of Non–Cardiovascular‐Related Deaths

Vargas-Santos

Neogi

Pinheiro

et al. 2019

Arthritis & Rheumatology

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Objective To examine cause‐specific mortality beyond cardiovascular diseases (CVDs) in patients with gout compared to the general population. Methods We included all residents of Skåne (Sweden) age ≥18 years in the year 2002. Using the Skåne Healthcare Register, we identified subjects with a new diagnosis of gout (2003–2013) and matched each person with gout with 10 comparators free of gout, by age and sex. We used information on the underlying cause of death from the Swedish Cause of Death Register (through December 31, 2014) to estimate hazard ratios (HRs, with 95% confidence intervals [95% CIs]) of mortality for specific causes of death in a multi‐state Cox model, with adjustment for potential confounders. Results Among 832,258 persons, 19,497 had a new diagnosis of gout (32% women) and were matched with 194,947 comparators. Subjects with gout had higher prevalence of chronic kidney disease, metabolic disease, and CVD. Gout was associated with 17% increased hazard of all‐cause mortality overall (HR 1.17 [95% CI 1.14–1.21]), 23% in women (HR 1.23 [95% CI 1.17–1.30]), and 15% in men (HR 1.15 [95% CI 1.10–1.19]). In terms of cause‐specific mortality, the strongest associations were seen in the relationship of gout to the risk of death due to renal disease (HR 1.78 [95% CI 1.34–2.35]), diseases of the digestive system (HR 1.56 [95% 1.34–1.83]), CVD (HR 1.27 [95% CI 1.22–1.33]), infections (HR 1.20 [95% CI 1.06–1.35]), and dementia (HR 0.83 [95% CI 0.72–0.97]). Conclusion Several non‐CV causes of mortality are increased in persons with gout, emphasizing the need for improved management of comorbidities.

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“…A significant portion of studies researching the correlation between serum UA concentrations in patients with AD and healthy controls have reported the UA values are lower in patients with AD (5,7,8,9,10,11,14,34,35). Additionally, there are studies reporting no significant relationship between AD and UA concentrations (12,13,36). Xue et al (37) reported in their 2017 study including 58 patients with MCI and 57 healthy participants that low UA concentrations posed a risk for MCI.…”

Section: Discussionmentioning

confidence: 99%

Assessment of Serum Uric Acid Levels According to Sex and Stage for Patients with Alzheimer-type Dementia

Yazar¹,

Yazar²

2019

tnd

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Objective:The aim of this study was to identify serum uric acid (UA) concentrations according to disease stage in patients with Alzheimer-type dementia (AD), and to collect data related to the hypothesis that oxidative stress is effective on the etiopathogenesis and progression of disease stage. Materials and Methods:The study was conducted with 180 patients who were categorized into disease stages in accordance with the Clinical Dementia Rating Scale (CDR) and 150 healthy individuals of the same age group. In our retrospective study, patients who showed more than one cognitive deficit and diagnosed with possible AD according to the diagnostic criteria of National Institute of Neurological and Communicative Disorders and Stroke-Alzheimer's Disease and Related Disorders Association were administered the CDR, Mini-Mental Test (MMSE), Geriatric Depression Rating Scale (GDRS), and individuals in the control group were administered the MMSE and GDRS. Venous blood samples for biochemical studies were collected after 12-14 hours of fasting in the patient and control groups. Results: In patients diagnosed as having AD, it was found that there was a statistically significant increase in age and duration of disease parallel with the progression of disease stages, and a decrease in UA and albumin concentrations in both males and females (p<0.05). Conclusion: Our study supports the hypothesis that the decrease detected in serum UA concentrations in parallel with the progression of disease stages is directly related to the pathogenesis of AD. For the identification of chronic progressive diseases such as AD and to take precautions, the identification of variations in easily accessible and low-cost parameters such as serum albumin and UA concentrations in the early stages becomes important. In future years, when neuroprotective and neuro-restorative treatment options are available, identification of serum UA values as a marker of disease progression and knowledge of the association between serum UA concentrations and disease stage in our data will guide and support research into disease etiology.Amaç: Alzheimer tipi demans (AH) tanılı hastalarda hastalık evresine göre serum ürik asit (ÜA) seviyelerinin tespiti ile oksidatif stresin hastalık etiyolojisindeki rolüne ve hastalık evresinin ilerlemesi üzerindeki olası etkilerine yönelik veriler toplanması amaçlanmıştır. Gereç ve Yöntem: Çalışma, Clinical Dementia Rating Scale (CDR) kriterlerine göre evrelere ayrılan 180 hasta ve hastalarla aynı yaş aralığında sağlıklı 150 birey ile gerçekleştirilmiştir. Retrospektif olarak yapılan çalışmamızda, birden fazla bilişsel alanda bozukluk gösteren ve National Institute of Neurological and Communicative Disorders and Stroke-Alzheimer's Disease and Related Disorders Association tanı kriterlerine göre olası AH tanısı konulmuş hastalara CDR, Mini-Mental Test (MMSE), Geriatrik Depresyon Rating Scale (GDRS), kontrol grubundaki bireylere MMSE ve GDRS uygulanmıştır. Hasta ve kontrol gruplarında 12-14 saat açlıktan sonra biyokimyasal çalışmalar iç...

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Uric acid and cognitive decline: a double-edge sword?

Abstract: We lack strong evidence for an association between low SUA level and cognitive decline over time. Conversely, high SUA level might increase the cerebrovascular burden and the risk of vascular dementia; physicians should continue to treat hyperuricemia when appropriate.

Cited by 39 publications

References 41 publications

Uric Acid and Cognitive Function in Older Individuals

Uric Acid and Cognitive Function in Older Individuals

Cause‐Specific Mortality in Gout: Novel Findings of Elevated Risk of Non–Cardiovascular‐Related Deaths

Assessment of Serum Uric Acid Levels According to Sex and Stage for Patients with Alzheimer-type Dementia

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