Association between Anti-inflammatory Drug and Dementia in Patients with Gout: A Nationwide, Population-Based Nested Case-Control Study.

Introduction

The interaction between hyperuricemia and the cognitive system is still under debate, with studies presenting somewhat conflicting results.

Objectives

This study aimed to investigate the risk of dementia in patients with gout who are administered anti-inflammatory drug treatment.

Methods

Gouty arthritis patients aged 50 years and older, who received at least one of the background therapy drugs (colchicine, corticosteroids, or nonsteroidal anti-inflammatory drugs for 6 months), were divided into the following groups and compared: patients who had dementia over a period of 5 years (n = 2,292) and matched patients without dementia (n = 2,292).

Results

We found that the most significant risk factors for dementia were stroke (OR, 2.66; 95% C.I., 2.33-3.03; AOR, 2.39; 95% C.I., 2.08-2.75) and depression (OR, 3.72; 95% C.I., 3.01-4.6; AOR, 3.25; 95% C.I., 2.60-4.05). The results of anti-gout drug administration, which impacted the dementia risk among patients of all ages (but especially in 50-64-year-old patients), demonstrated a higher risk ratio after 90 days of corticosteroid use (OR, 3.39; 95% C.I., 1.15-9.99), which was further increased after 180 days (OR, 3.61; 95% C.I., 1.31-9.94). We revealed that female patients experienced a significant increase in dementia risk after 90 days of corticosteroid administration, whereas male patients experienced a significant increase only after 180 days (OR, 1.52; 95% C.I., 1.06-2.17).

Conclusion

We had identified that > 90-day corticosteroid administration is a significant dementia risk factor in both female and male patients of all ages, especially in the 50-60-year-old group.