A Prospective Study on the Association between Uric Acid and Cognitive Function among Middle-Aged and Older Chinese

Abstract

Background: Uric acid (UA) is a powerful antioxidant that may have neuroprotective properties, yet it is also a risk factor of vascular disease that predisposes individuals to cognitive impairment. Results from longitudinal studies on UA and cognitive decline remain controversial.

Objective: We examined the associations of baseline plasma UA level with follow-up cognitive function as well as cognitive decline over time among a large sample of middle-aged and older Chinese.

Methods: Data from China Health and Retirement Longitudinal Study (CHARLS) were used. Cognitive function, including episodic memory, mental intactness, and global cognition, were tested twice with 2-year interval. Plasma UA was measured at baseline. Basic demographics, life habits, and health status were considered as potential confounders. Multiple linear regression models and mixed-effects regression models were fitted.

Results: A total of 12,798 individuals aged above 45 years were eligible with the follow-up time ranging from 1.33 to 2.42 years. Both global cognitive function and mental intactness declined, while episodic memory remained stable over time. In multiple linear regression models, compared with the lowest baseline UA level, 3rd baseline UA quartile was associated with better follow-up global cognitive function (b = 0.425, p = 0.041) and episodic memory (b = 0.413, p = 0.004), and highest baseline UA quartile was associated with better follow-up mental intactness (b = 0.253, p = 0.041) in males; highest baseline UA level was associated with better follow-up cognition for each measure (b = 0.281∼0.768, p≤0.046) in females. Mixed-effects regression models suggested no significant baseline UA-by-time interactions on any cognitive measure.

Conclusion: Higher baseline UA level was associated with better cognition in later life but not with rates of cognitive decline among middle-aged and older Chinese.

Keywords: Aged; cognition; episodic memory; mental intactness; uric acid.