The Association between Serum Uric Acid Level and Dementia in Geriatric Population – A Case–Control Study

  • Sangeetha Kandasamy Government Sivagangai Medical College and Hospital, Sivagangai, Tamil Nadu, India
  • Shivkumar Gopalakrishnan Government Villupuram Medical College and Hospital, Villupuram, Tamil Nadu, India,
  • M Kavitha Government Sivagangai Medical College and Hospital, Sivagangai, Tamil Nadu, India
  • G Harissh Government Villupuram Medical College and Hospital, Villupuram, Tamil Nadu, India
  • P Cerline Government Villupuram Medical College and Hospital, Villupuram, Tamil Nadu, India
Keywords: Dementia, Serum Uric acid level, Hypouricemia

Abstract

Importance: The increasing prevalence of dementia worldwide has reduced the quality of life in geriatric patients, thereby increasing the burden on the caregivers. As dementia evolves gradually, diagnosis of the disease is often delayed. Thus, the need for a sensitive biomarker for early diagnosis is instrumental.
Objective: The objective of the study was to study the association between serum uric acid levels and dementia in geriatric patients.
Design: This is a case–control study comparing the age-matched geriatric patients with and without dementia (cases – 50 and controls – 50).
Setting and Participants: A total of 100 geriatric patients from Government Villupuram Medical College and Hospital were included in this study for a study period of 4 months. Out of this, 50 were cases (with dementia) and 50 were controls (without dementia). Mini-mental state examination test was done to categorize the cases into mild, moderate, and severe subgroups (24–30 out of 30 as normal; 20–23 out of 30 as mild; 10–19 out of 30 as moderate; and score lesser than 10 out of 30 as severe). Serum uric acid levels were measured in the study population and compared between the cases and controls.
Results: The correlation of serum uric acid levels with cases and controls revealed 16% of the cases had hypouricemia, whereas none in the control group had hypouricemia. When serum uric acid levels were compared, it was found that 44% of the control group had normal serum uric acid levels and 82% of the cases had normal serum uric acid levels. Based on mini-mental state examination score, 10% of mild group and 21% of moderate group had hypouricemia and 4% of moderate group had hyperuricemia while the others had normal serum uric acid levels. All the data were statistically significant with “P” < 0.001.
Conclusion: The study identified the prevalence of hypouricemia in the study population. This study can pave the path for further multicentric research to delineate the role of uric acid level as potential biomarker for dementia.
Relevance: The information gained from this study will enable us to diagnose dementia in the early stages and improve the quality of life of the patients.

Author Biographies

Sangeetha Kandasamy, Government Sivagangai Medical College and Hospital, Sivagangai, Tamil Nadu, India

Professor, Department of Biochemistry

Shivkumar Gopalakrishnan, Government Villupuram Medical College and Hospital, Villupuram, Tamil Nadu, India,

Professor, Department of Internal Medicine, Government Villupuram Medical College and Hospital,

M Kavitha, Government Sivagangai Medical College and Hospital, Sivagangai, Tamil Nadu, India

Assistant Professor, Department of Biochemistry

G Harissh, Government Villupuram Medical College and Hospital, Villupuram, Tamil Nadu, India

III MBBS Trainee

P Cerline, Government Villupuram Medical College and Hospital, Villupuram, Tamil Nadu, India

II MBBS Trainee

References

1. Dementia Fact Sheet N°362; 2012. Available from: http://www.who.int.
[Last accessed on 2014 Nov 28].
2. Gaki GS, Papavassiliou AG. Oxidative stress-induced signaling pathways
implicated in the pathogenesis of Parkinson’s disease. Neuromol Med
2014;16:217-30.
3. GBD 2015 Disease and Injury Incidence and Prevalence, Collaborators.
Global, regional, and national incidence, prevalence, and years lived with
disability for 310 diseases and injuries, 1990-2015: A systematic analysis
for the global burden of disease study 2015. Lancet 2015;388:1545-602.
4. Alzheimer’s Association. 2014 Alzheimer’s disease facts and figures.
Alzheimers Dement 2014;10:e47-92.
5. Burns A, Iliffe S. Dementia. BMJ 2009;338:b75.
6. Harvey RJ, Skelton-Robinson M, Rossor MN. The prevalence and causes
of dementia in people under the age of 65 years. J Neurol Neurosurg
Psychiatry 2003;74:1206-9.
7. Wu XW, Muzny DM, Lee CC, Caskey CT. Two independent mutational
events in the loss of urate oxidase during hominoid evolution. J Mol Evol
1992;34:78-84.
8. Baldeiras I, Santana I, Proenc MT, Garrucho MH, Pascoal R, Rodrigues A,
et al. Peripheral oxidative damage in mild cognitive impairment and mild
Alzheimer’s disease. J Alzheimer’s Dis 2008;15:117-28.
9. Greilberger J, Koidl C, Greilberger M, Lamprecht M, Schroecksnadel K,
Leblhuber F, et al. Malondialdehyde, carbonyl proteins and albumindisulphide
as useful oxidative markers inmild cognitive impairment and
Alzheimer’s disease. Free Radic Res 2008;42:633-8.
10. Euser SM, Hofman A, Westendorp RG, Breteler MM. Serum uric acid and
cognitive function and dementia. Brain 2009;132:377-82.
11. Cherubini A, Rinaldi P, Polidori MC, Metastasio A, Mariani E, Mattioli P,
et al. Plasma antioxidants are similarly depleted in mild cognitive
impairment and in Alzheimer’s disease. Neurobiol Aging 2003;24:915-9.
12. NICE. Dementia: Supporting People with Dementia and Their Carers in
Health and Social Care. Israel: NICE Clinical Guideline; 2006.
13. Tana C, Ticinesi A, Prati B, Nouvenne A, Meschi T. Uric acid and cognitive
function in older individuals. Nutrients 2018;10:975.
14. Cervellati C, Cremonini E, Bosi C, Magon S, Zurlo A, Bergamini CM, et al.
Systemic oxidative stress in older patients with mild cognitive impairment
or late onset Alzheimer’s disease. Curr Alzheimer Res 2013;10:365-72.
15. Schrag M, Mueller C, Zabel M, Crofton A, Kirsch WM, Ghribi O, et al.
Oxidative stress in blood in Alzheimer’s disease and mild cognitive
impairment: A meta-analysis. Neurobiol Dis 2013;59:100-10.
16. Chen X, Guo X, Huang R, Chen Y, Zheng Z, Shang H. Serum uric acid
levels in patients with Alzheimer’s disease: A meta-analysis. PLoS One
2014;9:e94084.
17. Greg R. Utility of mini-mental state exam scores in predicting functional
impairment among white and African American dementia patients. J
Gerontol Seri A 1996;51A:M185-8.
Published
2021-09-28