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Alzheimer's, Dementia & Mental Health
Mild Cognitive Impairment in Senior Citizens Linked
to Higher Uric Acid
Clinical studies may probe reducing uric acid
(urate) with
drugs to help older people avoid mild cognitive deficits
January 2, 2007 - A simple blood test to measure
uric acid, a measure of kidney function, might reveal a risk factor for
cognitive problems in old age, according to researchers at the Johns
Hopkins and Yale university medical schools. Of 96 community-dwelling
adults aged 60 to 92 years, those with uric-acid (or urate) levels at the high end
of the normal range had the lowest scores on tests of mental processing
speed, verbal memory and working memory.
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High-normal uric acid levels, defined in this study
as 5.8 to 7.6 mg/dL for men and 4.8 to 7.1 mg/dL for women, were more
likely to be associated with cognitive problems even when the
researchers controlled for age, sex, weight, race, education, diabetes,
hypertension, smoking and alcohol abuse.
These findings suggest that older people with serum
(blood) uric-acid levels in the high end of the normal range are more
likely to process information slowly and experience failures of verbal
and working memory, as measured by the Wechsler Adult Intelligence Scale
and other well-established neuropsychological tests.
“It might be useful for primary-care physicians to
ask elderly adults with high normal serum uric acid about any problems
they might be having with their thinking, and perhaps refer those who
express concern, or whose family members express concern, for
neuropsychological screening,” says lead author David Schretlen, PhD.
The link between high-normal uric acid and
cognitive problems is also sufficiently intriguing for the authors to
propose clinical studies of whether medicines that reduce uric acid,
such as allopurinol, can help older people with high-normal uric acid
avoid developing the mild cognitive deficits that often precede
dementia.
For reasons that are not entirely clear, uric acid
levels increase with age, says Dr. Schretlen. Higher levels of uric acid
are linked with known risk factors for dementia, including high blood
pressure, atherosclerosis, Type 2 diabetes and the “metabolic syndrome”
of abdominal obesity and insulin resistance.
Dr. Schretlen also says there is mounting evidence
that end-stage renal (kidney) disease increases the risk of cognitive
dysfunction and dementia in elderly adults. Given this web of
connections, uric acid could potentially become a valuable biological
marker for very early cognitive problems in old age.
The researchers say that it’s unclear why mild
cognitive problems appear with high-normal uric acid because,
paradoxically, uric acid also has anti-oxidant properties that are
thought to be protective in other situations. The authors are also
researching links between uric acid and vascular damage in the brain and
attempting to dissect which aspects of uric acid and its production help
or hurt the nervous system.
Editor's Notes:
The findings appear in the January issue of
Neuropsychology, which is published by the American Psychological
Association (APA).
Article: “Serum Uric Acid and Cognitive Function
in Community-Dwelling Older Adults,” David J. Schretlen, PhD, Anjeli B.
Inscore, PsyD, H. A. Jinnah, MD, PhD, Vani Rao, MD, and Barry Gordon,
MD, PhD, Johns Hopkins University School of Medicine, Godfrey D.
Pearlson, MD, Johns Hopkins School of Medicine, Hartford
Hospital/Institute of Living, and Yale University School of Medicine;
Neuropsychology, Vol 21, No. 1
The American Psychological Association (APA), in
Washington, DC, is the largest scientific and professional organization
representing psychology in the United States and is the world’s largest
association of psychologists. APA’s membership includes more than
150,000 researchers, educators, clinicians, consultants and students.
Through its divisions in 54 subfields of psychology and affiliations
with 60 state, territorial and Canadian provincial associations, APA
works to advance psychology as a science, as a profession and as a means
of promoting human welfare.
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