title: Serum uric acid level and association with cognitive impairment and dementia: systematic review and meta-analysis.
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.
authors.affiliation: School of Medicine, University of Glasgow, Glasgow, UK.
authors.forename: Aamir A
authors.initials: AA
authors.lastname: Khan
authors.affiliation: Institute of Cardiovascular and Medical Sciences, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK.
authors.forename: Terence J
authors.initials: TJ
authors.lastname: Quinn
authors.affiliation: Department of Geriatric Medicine, Institute of Primary Care and Public Health, Cardiff University, Cardiff, UK.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Hewitt
authors.affiliation: 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.
authors.forename: Yuhua
authors.initials: Y
authors.lastname: Fan
authors.affiliation: Institute of Cardiovascular and Medical Sciences, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK. jesse.dawson@glasgow.ac.uk.
authors.forename: Jesse
authors.initials: J
authors.lastname: Dawson
mesh_terms: D000375:Aging / Q000097:blood*; D003071:Cognition / Q000502:physiology*; D060825:Cognitive Dysfunction / Q000097:blood* / Q000503:physiopathology; D003704:Dementia / Q000097:blood* / Q000503:physiopathology; D018450:Disease Progression; D006801:Humans; D009483:Neuropsychological Tests; D014527:Uric Acid / Q000097:blood*
chemical_list: D014527:Uric Acid
keywords: Cognition; Dementia; Meta-analysis; Systematic review; Uric acid
references.citation: J Neural Transm Park Dis Dement Sect. 1993;6(2):119-26
references.pmid: 8117408
references.citation: Am J Nephrol. 2011;34(1):49-54
references.pmid: 21659739
references.citation: N Engl J Med. 2004 Mar 11;350(11):1093-103
references.pmid: 15014182
references.citation: J Am Geriatr Soc. 1993 May;41(5):501-6
references.pmid: 8486882
references.citation: Parkinsonism Relat Disord. 2014 Jul;20(7):772-5
references.pmid: 24725754
references.citation: Eur J Neurol. 2005 Jul;12(7):531-5
references.pmid: 15958093
references.citation: Geriatr Gerontol Int. 2013 Jul;13(3):672-7
references.pmid: 23170844
references.citation: Exp Gerontol. 2010 May;45(5):331-5
references.pmid: 20080169
references.citation: Nephrol Dial Transplant. 2007 Feb;22(2):440-4
references.pmid: 17023495
references.citation: Acta Neurol Scand. 1981 Jul;64(1):1-11
references.pmid: 7324870
references.citation: J Alzheimers Dis. 2011;27(1):119-26
references.pmid: 21765209
references.citation: Br J Clin Pharmacol. 2006 Dec;62(6):633-44
references.pmid: 21894646
references.citation: J Neurol Sci. 2008 Mar 15;266(1-2):57-62
references.pmid: 17888453
references.citation: J Psychiatr Res. 1975 Nov;12(3):189-98
references.pmid: 1202204
references.citation: Curr Med Chem. 2006;13(9):1075-83
references.pmid: 16611085
references.citation: Parkinsonism Relat Disord. 2011 Jun;17(5):333-7
references.pmid: 21320793
references.citation: Clin Biochem. 2009 Jun;42(9):783-90
references.pmid: 19232336
references.citation: Eur Neurol. 2013;69(6):377-80
references.pmid: 23751563
references.citation: Parkinsonism Relat Disord. 2008 Nov;14(7):576-8
references.pmid: 18321759
references.citation: Neuroimmunomodulation. 2013;20(1):19-28
references.pmid: 23154271
references.citation: Arch Neurol. 2009 Dec;66(12):1460-8
references.pmid: 19822770
references.citation: QJM. 1999 Jan;92(1):39-45
references.pmid: 10209671
references.citation: Dement Geriatr Cogn Disord. 2004;18(3-4):265-70
references.pmid: 15286458
references.citation: Curr Alzheimer Res. 2013 May 1;10(4):365-72
references.pmid: 22950912
references.citation: J Neurosci Res. 1998 Sep 1;53(5):613-25
references.pmid: 9726432
references.citation: J Alzheimers Dis. 2008 Sep;15(1):117-28
references.pmid: 18780972
references.citation: Neuroepidemiology. 2013;41(1):29-34
references.pmid: 23548762
references.citation: Neurodegener Dis. 2009;6(1-2):23-8
references.pmid: 19066433
references.citation: Clin Biochem. 2012 Jan;45(1-2):49-53
references.pmid: 22040815
references.citation: Stroke. 2008 Dec;39(12):3418-20
references.pmid: 18772442
references.citation: Cardiovasc Drugs Ther. 2003 Sep-Nov;17(5-6):397-414
references.pmid: 15107595
references.citation: Zhonghua Yi Xue Za Zhi. 2009 Jun 16;89(23):1633-5
references.pmid: 19957513
references.citation: Neurology. 2007 Oct 2;69(14):1418-23
references.pmid: 17909154
references.citation: Mov Disord. 1995 Sep;10(5):566-73
references.pmid: 8552107
references.citation: J Alzheimers Dis. 2013;33(4):1051-8
references.pmid: 23109556
references.citation: BMJ. 2013 Feb 05;346:e5595
references.pmid: 23386360
references.citation: Intern Emerg Med. 2015 Feb;10(1):25-31
references.pmid: 24986078
references.citation: Brain. 2009 Feb;132(Pt 2):377-82
references.pmid: 19036766
references.citation: J Clin Epidemiol. 2008 Apr;61(4):344-9
references.pmid: 18313558
references.citation: J Alzheimers Dis. 2010;21(4):1383-92
references.pmid: 21504117
references.citation: Nihon Ronen Igakkai Zasshi. 1988 Nov;25(6):576-80
references.pmid: 3241443
references.citation: Int J Geriatr Psychiatry. 2006 Apr;21(4):344-8
references.pmid: 16534775
references.citation: JAMA. 2000 Apr 19;283(15):2008-12
references.pmid: 10789670
references.citation: Neuroepidemiology. 1989;8(5):254-61
references.pmid: 2812184
references.citation: Dement Geriatr Cogn Disord. 2009;27(4):382-9
references.pmid: 19339776
references.citation: Parkinsonism Relat Disord. 2014 Jun;20(6):637-9
references.pmid: 24637121
references.citation: Neurobiol Aging. 2003 Nov;24(7):915-9
references.pmid: 12928050
references.citation: J Alzheimers Dis. 2010;19(4):1331-6
references.pmid: 20061611
references.citation: J Alzheimers Dis. 2002 Dec;4(6):517-22
references.pmid: 12629261