The results of a study presented today at the Annual European Congress of Rheumatology (EULAR 2018) suggest that gout is associated with a 17-20% higher risk of dementia in the elderly.1
Gout is a very common condition. It is caused by deposits of crystals of a substance called uric acid (also known as urate) in the joints, which leads to inflammation. Periods of time when patients are experiencing gout symptoms are called flares. Flares can be unpredictable and debilitating, developing over a few hours and causing severe pain in the joints. Guidelines for the treatment of gout recommend lowering uric acid levels, although maintaining too low levels is a concern because uric acid is thought to protect the brain.2,3
"We welcome these results as they contribute to our understanding of the relationship between uric acid and dementia," said Professor Robert Landewé, Chairperson of the Scientific Programme Committee, EULAR. "Previous studies have shown contradictory results with some indicating an increased risk of dementia, while others reporting the opposite."
"Our study found a considerable increased risk of dementia associated with gout in the elderly," said Dr. Jasvinder Singh, Professor of Medicine and Epidemiology at the University of Alabama at Birmingham, USA (study author). "Further study is needed to explore these relationships and understand the pathogenic pathways involved in this increased risk."
The study included 1.23 million Medicare beneficiaries, of which 65,325 had incident dementia. In an analysis which was adjusted for various potential confounding variables including demographics, comorbidities and commonly used medications (HR 1.17, 95% CI 1.13-1.21), the results showed that gout is independently associated with a significantly higher risk of dementia.1 The association was larger in older age groups, females, black race, and people with higher medical comorbidity.1
Subgroup analyses indicated that gout was associated with a significant 20-57% (p<0.0001) increase in dementia in patients without key comorbidities; coronary artery disease (CAD), hyperlipidemia, cardiovascular disease, diabetes, or hypertension. However, this was not the case in patients with each of these comorbidities, except in patients with CAD.1
Abstract number: OP0182
NOTES TO EDITORS
For further information on this study, or to request an interview with the study lead, please do not hesitate to contact the EULAR Press Office:
About Rheumatic and Musculoskeletal Diseases
Rheumatic and musculoskeletal diseases (RMDs) are a diverse group of diseases that commonly affect the joints but can affect any organ of the body. There are more than 200 different RMDs, affecting both children and adults. They are usually caused by problems of the immune system, inflammation, infections or gradual deterioration of joints, muscle and bones. Many of these diseases are long term and worsen over time. They are typically painful and Iimit function. In severe cases, RMDs can result in significant disability, having a major impact on both quality of life and life expectancy.4
About 'Don't Delay, Connect Today!'
'Don't Delay, Connect Today!' is a EULAR initiative that unites the voices of its three pillars; patient (PARE) organisations, scientific member societies and health professional associations - as well as its international network - with the goal of highlighting the importance of early diagnosis and access to treatment. In the European Union alone, over 120 million people are currently living with a rheumatic disease (RMD), with many cases undetected.5 The 'Don't Delay, Connect Today!' campaign aims to highlight that early diagnosis of RMDs and access to treatment can prevent further damage, and also reduce the burden on individual life and society as a whole.
The European League against Rheumatism (EULAR) is the European umbrella organisation representing scientific societies, health professional associations and organisations for people with RMDs. EULAR aims to reduce the burden of RMDs on individuals and society and to improve the treatment, prevention and rehabilitation of RMDs. To this end, EULAR fosters excellence in education and research in the field of rheumatology. It promotes the translation of research advances into daily care and fights for the recognition of the needs of people with RMDs by the EU institutions through advocacy action.
To find out more about the activities of EULAR, visit: http://www.eular.org.
1 Singh JA, Cleveland JD. Gout and dementia in the elderly: A medicare claims study. EULAR 2018; Amsterdam: Abstract OP0182.
2 Khanna D, Fitzgerald JD, Khanna PP, et al. 2012 American College of Rheumatology guidelines for management of gout. Part 1: systematic nonpharmacologic and pharmacologic therapeutic approaches to hyperuricemia. Arthritis Care Res. 2012;64:1431-46.
3 Richette P, Doherty M, Pascual E, et al. 2016 updated EULAR evidence-based recommendations for the management of gout. Ann Rheum Dis. 2017;76:29-42.
4 van der Heijde D, et al. Common language description of the term rheumatic and musculoskeletal diseases (RMDs) for use in communication with the lay public, healthcare providers and other stakeholders endorsed by the European League Against Rheumatism (EULAR) and the American College of Rheumatology (ACR). Annals of the Rheumatic Diseases. 2018;doi:10.1136/annrheumdis-2017-212565. [Epub ahead of print].
5 EULAR. 10 things you should know about rheumatic diseases fact sheet. Available at: https://www.eular.org/myUploadData/files/10%20things%20on%20RD.pdf [Last accessed April 2018].
Annals of the Rheumatic Diseases