中年痛风与晚年认知障碍的关联 - 新加坡华人健康研究。

Association between gout at midlife and cognitive impairment at late life - The Singapore Chinese Health Study.

机构信息

Healthy Ageing Programme, Alexandra Hospital, National University Health System, Singapore.

Healthy Longevity Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.

出版信息

Arch Gerontol Geriatr. 2023 Aug;111:104996. doi: 10.1016/j.archger.2023.104996. Epub 2023 Mar 11.

DOI:10.1016/j.archger.2023.104996

PMID:36958148

Abstract

OBJECTIVES

The association between gout and risk of cognitive impairment or dementia is not well established. We examined the relationship between having gout at midlife and the risk of developing cognitive impairment later on.

METHODS

We used data of 16,948 participants from the population-based Singapore Chinese Health Study cohort. Participants were recruited from 1993 to 1998 at mean age of 53 years and re-contacted for three follow-up interviews: 1999 to 2004 for follow-up 1, 2006 to 2010 for follow-up 2, and 2014 to 2016 for follow-up 3. History of physician-diagnosed gout was self-reported at follow-up 1 and follow-up 2, while cognitive function was assessed with the Singapore modified Mini-Mental State Examination during follow-up 3, when participants had a mean age of 73.2 years.

RESULTS

Gout was reported by 1281 (7.6%) participants at either follow-up 1 or 2, and 2243 (14.4%) had cognitive impairment at follow-up 3. A history of gout was associated with reduced risk of cognitive impairment (OR 0.78, 95% CI 0.65-0.93). This risk was reduced in a stepwise manner with either increased duration of gout or lower age at first diagnosis of gout (P <0.001). Compared to those without gout, those with gout for ≥20 years (OR 0.56, 95% CI 0.39-0.80) and those with age of onset of gout <50 years old (OR 0.59, 95% CI 0.37-0.94) had a lower risk of developing cognitive impairment.

CONCLUSION

A young age of onset or a long history of gout was associated with reduced risk of cognitive impairment in late life.

摘要

目的

痛风与认知障碍或痴呆风险之间的关联尚未得到充分证实。本研究旨在探讨中年时期患有痛风与之后发生认知障碍的风险之间的关系。

方法

我们利用来自基于人群的新加坡华人健康研究队列的 16948 名参与者的数据。参与者于 1993 年至 1998 年以平均 53 岁的年龄入组，并在随访期间进行了三次访谈：1999 年至 2004 年进行随访 1，2006 年至 2010 年进行随访 2，2014 年至 2016 年进行随访 3。在随访 1 和随访 2 时报告了医生诊断的痛风病史，而在随访 3 时使用新加坡改良的简易精神状态检查评估认知功能，参与者的平均年龄为 73.2 岁。

结果

在随访 1 或 2 时，有 1281 名（7.6%）参与者报告有痛风，而在随访 3 时，有 2243 名（14.4%）患有认知障碍。痛风病史与认知障碍风险降低相关（OR 0.78，95%CI 0.65-0.93）。这种风险呈阶梯式下降，痛风持续时间增加或首次诊断痛风的年龄降低（P<0.001）。与没有痛风的参与者相比，痛风持续时间≥20 年（OR 0.56，95%CI 0.39-0.80）和发病年龄<50 岁的参与者（OR 0.59，95%CI 0.37-0.94）发生认知障碍的风险较低。