Higher Serum Urate Associated With Lower Risk for Dementia

Prospective population-based study explores relationship between serum urate concentration and risk for dementia.

Higher levels of serum urate are associated with a lower risk for Alzheimer disease and vascular dementia in women, according to a study recently published in Alzheimer’s & Dementia.

This study included 1462 women from the Prospective Population Study of Women, which took place in Sweden between 1968 and 1969 with a 33.1-year mean follow up. The women were between 38 and 60 years at study initiation. Serum urate was measured in the 1968-1969 period and again in 1992-1994 following overnight fasts, while neuropsychiatric examinations were performed multiple times throughout the follow-up period and as late as 2010. The third edition of the Diagnostic and Statistical Manual of Mental Disorders was used to classify dementia. Participants were stratified by 3 serum urate categories: higher (≥271 μmol/L), middle (211-270 μmol/L), and lower (≤210 μmol/L). The correlation between serum urate and incidence of dementia was examined with a competing risk Cox proportional hazard model.

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Greater serum urate per 76.5-μmol/L standard deviation correlated with lower dementia risk (adjusted hazard ratio [aHR] 0.81; 95% CI, 0.72-0.91) among 320 women, lower Alzheimer disease (aHR 0.78; 95% CI, 0.66-0.91) among 152 women, and lower vascular dementia (aHR 0.66; 95% CI, 0.47-0.94) among 52 women. These results did not change significantly when adjusting for smoking status, alcohol consumption, triglycerides, cholesterol, hypertension, socioeconomic status, body mass index, education level, or estimated glomerular filtration rate. In fully adjusted and age-adjusted models, greater serum urate levels showed a borderline association with lower risk for vascular and mixed dementia (aHR 0.85; 95% CI, 0.71-1.01).

Limitations to this study include potential misclassification among dementia diagnoses, loss to follow up among the study population, and the exclusive inclusion of Swedish women.

The study researchers conclude that “higher [serum urate] concentration was related to a lower risk for dementia, both [Alzheimer disease] and [vascular dementia], in a prospective population-based cohort study in women. Our findings support the hypothesis that [serum urate] has a protective role in the development of dementia. Clearly, more prospective studies with large sample sizes and long follow up, also including men, are required, as well as studies examining the underlying mechanisms of this association.”

Authors LEJM Scheepers and LTH Jacobsson report associations with pharmaceutical companies.


Scheepers LEJM, Jacobsson LTH, Kern S, Johansson L, Dehlin M, Skoog I. Urate and risk of Alzheimer’s disease and vascular dementia: a population-based study [published online May 2, 2019]. Alzheimers Dement. doi: 10.1016/j.jalz.2019.01.014.