{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T23:33:42Z","timestamp":1780616022718,"version":"3.54.1"},"reference-count":38,"publisher":"BMJ","issue":"6","license":[{"start":{"date-parts":[[2021,6,21]],"date-time":"2021-06-21T00:00:00Z","timestamp":1624233600000},"content-version":"unspecified","delay-in-days":20,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"1.3.5 project for disciplines of excellence, West China Hospital, Sichuan University","award":["Project no. ZYGD18015"],"award-info":[{"award-number":["Project no. ZYGD18015"]}]},{"name":"the National Key Research and Development Program of China","award":["Project no.2016YFC0906201"],"award-info":[{"award-number":["Project no.2016YFC0906201"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>Gout, characterised by hyperuricaemia with monosodium urate crystal formation and inflammation, is the most common inflammatory arthritis in adults. Recent studies have found that elevated uric acid levels are related to the occurrence of dementia. We conducted a study to investigate the association between dementia and gout or hyperuricaemia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Systematic review and meta-analysis of cohort studies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Data sources<\/jats:title><jats:p>Studies were screened from inception to 28 June 2019 by searching Medline, Embase and the Cochrane Library databases.<\/jats:p><\/jats:sec><jats:sec><jats:title>Eligibility criteria<\/jats:title><jats:p>Cohort studies comparing the risk of dementia in patients with gout and hyperuricaemia versus non-gout and non-hyperuricaemia controls were enrolled.<\/jats:p><\/jats:sec><jats:sec><jats:title>Data extraction and analysis<\/jats:title><jats:p>Two reviewers separately selected studies and extracted data using the Medical Subject Headings without restriction on languages or countries. The adjusted HRs were pooled using the DerSimonian and Laird random effects model. Sensitivity analyses were conducted to evaluate the stability of the results. Publication bias was evaluated using Egger\u2019s and Begg\u2019s tests. Quality assessment was performed according to the Newcastle-Ottawa Scale.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Four cohort studies that met the inclusion criteria were included in our meta-analysis. We found that gout and hyperuricaemia did not increase the risk of dementia, with a pooled HR of 0.94 (95% CI 0.69 to 1.28), but might decrease the risk of Alzheimer\u2019s disease (AD), with a pooled HR of 0.78 (95% CI 0.64 to 0.95). There was little evidence of publication bias. Quality assessment of the included studies was high (range: 6\u20138 points).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our study shows that gout and hyperuricaemia do not increase the risk of dementia. However, gout and hyperuricaemia might have a protective effect against AD. Due to the limited number of research articles, more investigations are needed to demonstrate the potential relationship between dementia and gout or hyperuricaemia.<\/jats:p><\/jats:sec>","DOI":"10.1136\/bmjopen-2020-041680","type":"journal-article","created":{"date-parts":[[2021,6,22]],"date-time":"2021-06-22T15:56:42Z","timestamp":1624377402000},"page":"e041680","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":24,"title":["Risk of dementia in gout and hyperuricaemia: a meta-analysis of cohort studies"],"prefix":"10.1136","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9057-1143","authenticated-orcid":false,"given":"Shu-Yue","family":"Pan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rui-Juan","family":"Cheng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zi-Jing","family":"Xia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiu-Ping","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2021,6,22]]},"reference":[{"key":"2021062208401239000_11.6.e041680.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2018.01.022."},{"key":"2021062208401239000_11.6.e041680.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jalz.2012.11.007"},{"key":"2021062208401239000_11.6.e041680.3","first-page":"3167","article-title":"Update on the epidemiology, genetics, and therapeutic options of hyperuricemia","volume":"12","author":"Li","year":"2020","journal-title":"Am J Transl Res"},{"key":"2021062208401239000_11.6.e041680.4","doi-asserted-by":"crossref","first-page":"531","DOI":"10.1007\/s40265-019-01081-5","article-title":"Cardiovascular Disease in Gout and the Protective Effect of Treatments Including Urate-Lowering Therapy","volume":"79","author":"Gupta","year":"2019","journal-title":"Drugs"},{"key":"2021062208401239000_11.6.e041680.5","doi-asserted-by":"publisher","DOI":"10.1002\/mds.27492"},{"key":"2021062208401239000_11.6.e041680.6","doi-asserted-by":"publisher","DOI":"10.1002\/gps.3963"},{"key":"2021062208401239000_11.6.e041680.7","doi-asserted-by":"crossref","DOI":"10.1186\/s12883-018-1136-y","article-title":"Hyperuricemia and dementia - a case-control study","volume":"18","author":"Engel","year":"2018","journal-title":"BMC Neurol"},{"key":"2021062208401239000_11.6.e041680.8","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2014-206917"},{"key":"2021062208401239000_11.6.e041680.9","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2016-210767"},{"key":"2021062208401239000_11.6.e041680.10","doi-asserted-by":"publisher","DOI":"10.1186\/s13075-015-0642-1"},{"key":"2021062208401239000_11.6.e041680.11","doi-asserted-by":"publisher","DOI":"10.1037\/0894-4105.21.1.136"},{"key":"2021062208401239000_11.6.e041680.12","doi-asserted-by":"publisher","DOI":"10.1002\/sim.1186"},{"key":"2021062208401239000_11.6.e041680.13","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.327.7414.557"},{"key":"2021062208401239000_11.6.e041680.14","doi-asserted-by":"crossref","DOI":"10.1186\/s12877-018-0975-0","article-title":"Gout and dementia in the elderly: a cohort study of Medicare claims","volume":"18","author":"Singh","year":"2018","journal-title":"BMC Geriatr"},{"key":"2021062208401239000_11.6.e041680.15","doi-asserted-by":"crossref","first-page":"669","DOI":"10.3233\/JAD-2012-111736","article-title":"Midlife rheumatoid arthritis increases the risk of cognitive impairment two decades later: a population-based study","volume":"31","author":"Wallin","year":"2012","journal-title":"J Alzheimers Dis"},{"key":"2021062208401239000_11.6.e041680.16","doi-asserted-by":"crossref","first-page":"1039","DOI":"10.3233\/JAD-150171","article-title":"Are Inflammation and Related Therapy Associated with All-Cause Dementia in a Primary Care Population?","volume":"46","author":"Dregan","year":"2015","journal-title":"J Alzheimer Dis"},{"key":"2021062208401239000_11.6.e041680.17","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1111\/imr.12833","article-title":"Urate-induced immune programming: consequences for gouty arthritis and hyperuricemia","volume":"294","author":"Cab\u0103u","year":"2020","journal-title":"Immunol Rev"},{"key":"2021062208401239000_11.6.e041680.18","doi-asserted-by":"publisher","DOI":"10.1038\/sj.mp.4000225"},{"key":"2021062208401239000_11.6.e041680.19","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.2007.01158.x"},{"key":"2021062208401239000_11.6.e041680.20","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.2007.01159.x"},{"key":"2021062208401239000_11.6.e041680.21","doi-asserted-by":"publisher","DOI":"10.1523\/JNEUROSCI.21-12-04183.2001"},{"key":"2021062208401239000_11.6.e041680.22","doi-asserted-by":"publisher","DOI":"10.1038\/nature05292"},{"key":"2021062208401239000_11.6.e041680.23","doi-asserted-by":"publisher","DOI":"10.1038\/nature01323"},{"key":"2021062208401239000_11.6.e041680.24","doi-asserted-by":"crossref","first-page":"S353","DOI":"10.3233\/JAD-141629","article-title":"Cardiovascular risk profile in women and dementia","volume":"42","author":"Dufouil","year":"2014","journal-title":"J Alzheimer Dis"},{"key":"2021062208401239000_11.6.e041680.25","doi-asserted-by":"publisher","DOI":"10.1126\/science.7901908"},{"key":"2021062208401239000_11.6.e041680.26","doi-asserted-by":"publisher","DOI":"10.1016\/j.semnephrol.2004.09.007"},{"key":"2021062208401239000_11.6.e041680.27","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-4547(19980901)53:5<613::AID-JNR11>3.0.CO;2-1"},{"key":"2021062208401239000_11.6.e041680.28","doi-asserted-by":"publisher","DOI":"10.1006\/abbi.2000.1721"},{"key":"2021062208401239000_11.6.e041680.29","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.78.11.6858"},{"key":"2021062208401239000_11.6.e041680.30","doi-asserted-by":"publisher","DOI":"10.1042\/bj2350747"},{"key":"2021062208401239000_11.6.e041680.31","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.95.2.675"},{"key":"2021062208401239000_11.6.e041680.32","doi-asserted-by":"publisher","DOI":"10.1097\/00005344-200109000-00005"},{"key":"2021062208401239000_11.6.e041680.33","doi-asserted-by":"publisher","DOI":"10.1016\/j.freeradbiomed.2004.06.017"},{"key":"2021062208401239000_11.6.e041680.34","doi-asserted-by":"publisher","DOI":"10.1080\/10715760310001604134"},{"key":"2021062208401239000_11.6.e041680.35","doi-asserted-by":"crossref","first-page":"754","DOI":"10.1016\/j.jalz.2019.01.014","article-title":"Urate and risk of Alzheimer's disease and vascular dementia: a population-based study","volume":"15","author":"Scheepers","year":"2019","journal-title":"Alzheimers Dement"},{"key":"2021062208401239000_11.6.e041680.36","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awn316"},{"key":"2021062208401239000_11.6.e041680.37","doi-asserted-by":"crossref","first-page":"1125","DOI":"10.3233\/JAD-191111","article-title":"Uric acid and high-density lipoprotein cholesterol are differently associated with Alzheimer's disease and vascular dementia","volume":"73","author":"Liu","year":"2020","journal-title":"J Alzheimers Dis"},{"key":"2021062208401239000_11.6.e041680.38","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0084582","article-title":"Structure-activity relationships of benzbromarone metabolites and derivatives as EYA inhibitory anti-angiogenic agents","volume":"8","author":"Pandey","year":"2013","journal-title":"PLoS One"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2020-041680","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,6,22]],"date-time":"2021-06-22T15:56:54Z","timestamp":1624377414000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2020-041680"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,6]]},"references-count":38,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2021,6,22]]},"published-print":{"date-parts":[[2021,6]]}},"alternative-id":["10.1136\/bmjopen-2020-041680"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2020-041680","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,6]]}}}