title: Gout and the risk of dementia: a nationwide population-based cohort study.
abstract: BACKGROUND
  Uric acid was proposed to have anti-oxidant property and possible neuroprotective effects. We examined the association between gout and dementia with population database.
  
  
  METHODS
  The study utilized the claims data from the nationwide representative sample of Taiwan National Health Insurance Research Database (NHIRD). We ascertained patients with gout and dementia covering vascular and non-vascular (including Alzheimer's) subtypes using International Classification of Diseases Ninth Revision, Clinical Modification (ICD9-CM) codes. A control group matched on sex, age, and index date of gout patients was randomly sampled with a ratio of 1:4 from the same database for comparison.
  
  
  RESULTS
  From 2002 to 2008, 28,769 gout patients who were older than 50 years old were identified, and 114,742 control patients was matched into the study. During follow-up, 7,119 patients developed dementia (1,214 with gout, and 5,905 without gout). After adjusting for age, sex, and relevant comorbidities, a Cox regression analysis showed that gout patients had a lower risk of developing non-vascular dementia (hazard ratio (HR): 0.77; 95% confidence interval (CI): 0.72-0.83; p < 0.001) and vascular dementia (HR: 0.76; 95% CI: 0.65-0.88; p < 0.001).
  
  
  CONCLUSIONS
  Patients with gout have a lower risk of developing dementia. This phenomenon exists for both non-vascular and vascular types of dementia.
authors.affiliation: Division of Allergy-Immunology-Rheumatology, Veterans General Hospital-Taipei, No.201, Sec. 2, Shipai Rd, Beitou District, Taipei, 11217, Taiwan. pcman.tw@gmail.com.
authors.forename: Jen-Yee
authors.initials: JY
authors.lastname: Hong
authors.affiliation: Institute of Hospital and Health Care Administration, National Yang-Ming University, Taipei, Taiwan. tylan@ym.edu.tw.
authors.forename: Tzuo-Yun
authors.initials: TY
authors.lastname: Lan
authors.affiliation: Institute of Hospital and Health Care Administration, National Yang-Ming University, Taipei, Taiwan. gaujuntang02@gmail.com.
authors.forename: Gau-Jun
authors.initials: GJ
authors.lastname: Tang
authors.affiliation: School of Health Care Administration, College of Medicine, Taipei Medical University, Taipei, Taiwan. chtang@tmu.edu.tw.
authors.forename: Chao-Hsiun
authors.initials: CH
authors.lastname: Tang
authors.affiliation: Division of Family Medicine, Veterans General Hospital-Taipei, Taipei, Taiwan. tjchen@vghtpe.gov.tw.
authors.forename: Tzeng-Ji
authors.initials: TJ
authors.lastname: Chen
authors.affiliation: Division of Allergy-Immunology-Rheumatology, Veterans General Hospital-Taipei, No.201, Sec. 2, Shipai Rd, Beitou District, Taipei, 11217, Taiwan. hylin@vghtpe.gov.tw.|National Yang-Ming University School of Medicine, Taipei, Taiwan. hylin@vghtpe.gov.tw.
authors.forename: Hsiao-Yi
authors.initials: HY
authors.lastname: Lin
mesh_terms: D015331:Cohort Studies; D003704:Dementia / Q000453:epidemiology*; D005260:Female; D006073:Gout / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012307:Risk Factors