Int J Med Sci 2021; 18(9):2042-2050. doi:10.7150/ijms.55496 This issue

Research Paper

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

Natalia Mikhailichenko1,2, Yu-Hsun Wang3, James Cheng-Chung Wei1,4✉, Te-Jen Lai1,5✉

1. Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan.
2. NEVRON International Medical Center, Vladivostok, 690078, Russia; nevron.vl@gmail.com.
3. Department of Medical Research, Chung Shan Medical University Hospital, Taichung, Taiwan.
4. Department of Allergy, Immunology & Rheumatology, Chung Shan Medical University Hospital, Taichung, Taiwan.
5. Department of Psychiatry, Chung Shan Medical University Hospital, Taichung, Taiwan.

This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/). See http://ivyspring.com/terms for full terms and conditions.
Citation:
Mikhailichenko N, Wang YH, Wei JCC, Lai TJ. Association between Anti-inflammatory Drug and Dementia in Patients with Gout: A Nationwide, Population-Based Nested Case-Control Study. Int J Med Sci 2021; 18(9):2042-2050. doi:10.7150/ijms.55496. Available from https://www.medsci.org/v18p2042.htm

File import instruction

Abstract

Graphic abstract

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.

Keywords: anti-inflammatory drugs, dementia, gout, old age.