Gout not a risk factor for dementia

Gout does not contribute to an increased risk of overall dementia and may even be protective against Alzheimer's disease (AD) and cognitive impairment, according to the results of a systematic review and meta-analysis.

Researchers searched multiple online databases for studies, wherein the risk of dementia was evaluated in relation to gout. Data were extracted and synthesized according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses. The Newcastle-Ottawa Scale was used to assess the risk of bias.

Five observational studies published between 2015 and 2022 met the inclusion criteria and were included in the meta-analysis. The pooled population comprised 227,419 men and women with gout. A standard protocol was used to identify gout and dementia across the studies. The Newcastle-Ottawa Scale scores ranged from 8 to 9, with a mean of 8.2.

In the pooled analysis, gout showed no association with the overall risk of dementia (risk ratio [RR], 0.80, 95 percent confidence interval [CI], 0.58–1.10; p=0.17), with no significant heterogeneity across studies (I²=99.26, p<0.001).

However, gout was associated with a 30-percent lower risk of Alzheimer’s disease (RR, 0.70, 95 percent CI, 0.62–0.78; p<0.001; I²=59.40, p=0.06) and a 32-percent reduction in the risk of developing cognitive impairment (RR, 0.68, 95 percent CI, 0.48–0.95; p=0.02; I²=91.33, p<0.001).

In subgroup analyses, gout showed an inverse association with dementia in Asian (RR, 0.71, 95 percent CI, 0.60–0.84; p<0.001) but not in Western cohorts (RR, 0.94, 95 percent CI, 0.62–1.41; p=0.76).

Additional prospective studies and randomized trials are needed to validate the findings, as well as clarify causality and underlying mechanisms.