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Serum uric acid level and association with cognitive impairment and dementia: systematic review and meta-analysis

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Abstract

Serum uric acid (sUA) level may be associated with cognitive impairment/dementia. It is possible this relationship varies with dementia subtype, particularly between vascular dementias (VaD) and Alzheimer’s (AD) or Parkinson’s disease (PDD)-related dementia. We aimed to present a synthesis of all published data on sUA and relationship with dementia/cognition through systematic review and meta-analysis. We included studies that assessed the association between sUA and any measure of cognitive function or a clinical diagnosis of dementia. We pre-defined subgroup analyses for patients with AD, VaD, PDD, mild cognitive impairment (MCI), and mixed or undifferentiated. We assessed risk of bias/generalizability, and where data allowed, we performed meta-analysis to describe pooled measures of association across studies. From 4811 titles, 46 papers (n = 16,688 participants) met our selection criteria. Compared to controls, sUA was lower in dementia (SDM −0.33 (95%CI)). There were differences in association by dementia type with apparent association for AD (SDM −0.33 (95%CI)) and PDD (SDM −0.67 (95%CI)) but not in cases of mixed dementia (SDM 0.19 (95%CI)) or VaD (SDM −0.05 (95%CI)). There was no correlation between scores on Mini-Mental State Examination and sUA level (summary r 0.08, p = 0.27), except in patients with PDD (r 0.16, p = 0.003). Our conclusions are limited by clinical heterogeneity and risk of bias in studies. Accepting this caveat, the relationship between sUA and dementia/cognitive impairment is not consistent across all dementia groups and in particular may differ in patients with VaD compared to other dementia subtypes.

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Acknowledgments

Dr. J Dawson has access to all relevant project data and takes full responsibility for the data, the analyses and interpretation, and the conduct of the research. There are no conflicts of interest to note.

Dr. Quinn is supported by a joint Stroke Association/Chief Scientist Office Senior Clinical Lectureship.

This project was supported by a Scottish Society of Physicians Research Grant.

Author contributions

Dr Khan—study design, data acquisition, analysis, interpretation, critical revision

Dr. Quinn—study design, data acquisition, analysis, interpretation, critical revision

Dr. Hewitt—study design, interpretation, critical revision

Dr. Fan—data acquisition, interpretation, and critical revision

Dr. Dawson—study design, data acquisition, analysis, interpretation, critical revision, and study supervision

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Authors and Affiliations

  1. School of Medicine, University of Glasgow, Glasgow, UK

    Aamir A. Khan

  2. Institute of Cardiovascular and Medical Sciences, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK

    Terence J. Quinn & Jesse Dawson

  3. Department of Geriatric Medicine, Institute of Primary Care and Public Health, Cardiff University, Cardiff, UK

    Jonathan Hewitt

  4. Department of Neurology, Guangdong Key Laboratory for Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department, National Key Discipline, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China

    Yuhua Fan

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  1. Aamir A. Khan
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Correspondence to Jesse Dawson.

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Dr Khan reports no disclosures.

Dr Quinn reports no disclosures.

Dr Hewitt reports no disclosures.

Dr Fan reports no disclosures.

Dr Dawson reports no disclosures.

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Khan, A.A., Quinn, T.J., Hewitt, J. et al. Serum uric acid level and association with cognitive impairment and dementia: systematic review and meta-analysis. AGE 38, 16 (2016). https://doi.org/10.1007/s11357-016-9871-8

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