Associations between serum uric acid levels and risk of dementia in community-dwelling older adults

INTRODUCTION: Evidence on the association between serum uric acid (SUA) and dementia risk is inconsistent, and prospective data in older adults are limited. This study examined associations of SUA levels and trajectories with incident dementia. METHODS: This study included 11,411 community-dwelling adults aged ≥70 years without dementia at baseline. Incident dementia was diagnosed using Diagnostic and Statistical Manual of Mental Disorders – Fourth Revision (DSM-IV) criteria. Sex-stratified Cox proportional hazards models assessed associations of baseline SUA and 3-year SUA changes with dementia risk. RESULTS: Over a median 9-year follow-up, 1000 (8.8%) participants developed dementia. Low SUA levels were associated with higher dementia risk among females (age-adjusted hazard ratio [HR]: 1.31, 95% confidence interval [CI]: 1.07–1.61; fully adjusted HR: 1.24, 95% CI: 1.01–1.53), but not males. A decline in SUA over time was associated with higher dementia risk among males only (age-adjusted HR: 1.30, 95% CI: 1.03–1.63; fully adjusted HR: 1.29, 95% CI: 1.02–1.62). DISCUSSION: Associations between SUA and dementia risk varied by sex and SUA trajectory, suggesting potential sex-specific biological mechanisms.