The Cognitive Effect of Uric Acid in Idiopathic Parkinson’s Patients

  • Osman Korucu Kecioren Training and Research Hospital. Unıversity of Health Sciences. Neurology Department


Objective:High serum uric acid level (sUA) has been associated with decreased Parkinson's disease risk, slow disease progression, good cognitive performance and low dementia risk. In this study, the relation of dementia and uric acid levels was investigated in idiopathic Parkinson's patients that are known to be associated with low sUA. Methods:Patients files of patients, who were diagnosed with idiopathic Parkinson's disease and have applied between dates 01.01.2009-31.01.2019, have been scanned retrospectively. Their age, gender, marital status, uric acid level and the presence of dementia were recorded. A total of 126 patients between ages 18-90 with creatinine levels below 1.25 mg/dl and no diagnosis of gout have been included in the study. Results:Among 126 patients included in the study, 68 (54%) were male, 93 (73.81%) were married, and 37 (29.37%) patients were diagnosed with dementia. There was a statistically significant difference between groups with or without dementia diagnosis with regard to age (p:0.006) and marital status (p:0.007). Mean uric acid level was determined to be 4.6 mg/dl for the patients. There was no statistically significant difference between the two groups when this value was taken as reference (p:0.328). However, the number of patients diagnosed with dementia was relatively lower in the group with higher uric acid level. Conclusion:The fact that median uric acid levels of our patients were within the interval recognized to be normal and the patients had relatively higher sUA levels in non-dementia group suggests that high sUA levels within normal interval may be protective.


- de Lau LM, Breteler MM. Epidemiology of Parkinson’s disease. Lancet Neurol. 2006;5(6):525-35.

- Alzheimer’s Association. 2016 Alzheimer’s disease facts and figures. Alzheimers Dement. 2016;12(4):459-509.

- Jiang T, Sun Q, Chen S. Oxidative stress: a major pathogenesis and potential therapeutic target of antioxidative agents in Parkinson’s disease and Alzheimer’s disease. Progr Neurobiol 2016;147: 1–9.

- Jesús S, Pérez I, Cáceres-Redondo MT, Carrillo F, Carballo M, Gómez-Garre P, et al. Low serum uric acid concentration in Parkinson’s disease in southern Spain. Eur J Neurol. 2013; 20(1):208-10.

- Ascherio A, LeWitt PA, Xu K, Eberly S, Watts A, Matson WR, et al. Urate as a predictor of the rate of clinical decline in Parkinson disease. Arch Neurol. 2009;66:1460–8.

- Moher D, Liberati A, Tetzlaff J, Altman DG; PRISMA Group, et al. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009 Jul 21;6(7):e1000097. doi: 10.1371/journal.pmed.1000097. Epub 2009 Jul 21.

- Zhou Q, Caı C, Qıu J, Kong L. Clinical study of the protective effect of uric acid on Parkinson’s disease. J Med Theory Pract. 2016;11:1401–2,1405.

- Shen C, Guo Y, Luo W, Lin C, Ding M. Serum urate and the risk of Parkinson’s disease: Results from a meta-analysis. Can J Neurol Sci. 2013;40(1):73-9.

- Gao X, O’Reilly EJ, Schwarzschild MA, Ascherio A. Prospective study of plasma urate and risk of Parkinson disease in men and women. Neurology. 2016;9; 86(6): 520–6.

- Dalbeth N, Merriman TR, Stamp LK. Gout. Lancet. 2016 Oct 22;388(10055):2039-52.

- Wang N, Jin X, Guo D, Tong G, Zhu X. Iron chelation nanoparticles with delayed saturation as an effective therapy for Parkinson Disease. Biomacromolecules 2017;18(2):461–74

- Dusek P, Schneider SA, Aaseth J. Iron chelation in the treatment of neurodegenerative diseases. J Trace Elem Med Biol 2016;38:81–92.

- Sian-Hülsmann J, Mandel S, Youdim MB, Riederer P. The relevance of iron in the pathogenesis of Parkinson’s disease. J Neurochem. 2011;118(6):939-57.

- Berg D, Hochstrasser H. Iron metabolism in Parkinsonian syndromes. Mov Disord. 2006;21(9):1299-310.

- Hong JY, Lan TY, Tang GJ, Tang CH, Chen TJ, Lin HY. Gout and the risk of dementia: a nationwide population-based cohort study. Arthritis Res Ther. 2015 May 28;17:139. doi: 10.1186/s13075-015-0642-1.

- Alonso A, Rodríguez LA, Logroscino G, Hernán MA. Gout and risk of Parkinson disease: a prospective study. Neurology. 2007;23;69(17):1696-700.

- De Vera M, Rahman MM, Rankin J, Kopec J, Gao X, Choi H. Gout and the risk of Parkinson’s disease: a cohort study. Arthritis Rheum. 2008;15;59(11):1549-54.

- Schernhammer E, Qiu J, Wermuth L, Lassen CF., Friis S, Ritz B. Gout and the risk of Parkinson’s disease in Denmark. Eur J Epidemiol. 2013; 28(4): 359–360.

- Ungprasert P, Srivali N, Thongprayoon C. Gout is not associated with a lower risk of Parkinson’s disease: A systematic review and meta-analysis. Parkinsonism Relat Disord. 2015;21(10):1238-42.

- Parkinson Study Group SURE-PD Investigators, Schwarzschild MA, Ascherio A, Beal MF, Cudkowicz ME, Curhan GC, et al. Inosine to increase serum and cerebrospinal fluid urate in Parkinson disease: a randomized clinical trial. JAMA Neurol. 2014;71(2):141-50.

- Devore EE, Grodstein F, van Rooij FJ, Hofman A, Stampfer MJ, Witteman JC, et al. Dietary antioxidants and long-term risk of dementia. Arch Neurol. 2010;67(7):819-25.

- Khan AA, Quinn TJ, Hewitt J, Fan Y, Dawson J. Serum uric acid level and association with cognitive impairment and dementia: Systematic review and meta-analysis. Age (Dordr). 2016 Feb;38(1):16. doi: 10.1007/s11357-016-9871-8. Epub 2016 Jan 28.

- González-Aramburu I, Sánchez-Juan P, Sierra M, Fernández-Juan E, Sánchez-Quintana C, Berciano J, et al. Serum uric acid and risk of dementia in Parkinson’s disease. Parkinsonism Relat Disord. 2014;20(6):637-9.

- Lee HR, Park JH, Han SW, Baik JS. Cognition, Olfaction and Uric Acid in Early de novo Parkinson’s disease. J Mov Disord. 2018;11(3):139–144.

- Euser SM, Hofman A, Westendorp RG, Breteler MM. Serum uric acid and cognitive function and dementia. Brain. 2009;132(Pt 2):377-82.

- Du N, Xu D, Hou X, Song X, Liu C, Chen Y, et al. Inverse Association Between Serum Uric Acid Levels and Alzheimer’s Disease Risk. Mol. Neurobiol. 2016;53(4): 2594–9

- Liu M, Wang J, Zeng J, He Y. Relationship between serum uric acid level and mild cognitive impairment in Chinese community elderly. BMC Neurol. 2017 Aug 1;17(1):146. doi: 10.1186/s12883-017-0929-8.

- Engel B, Gomm W, Broich K, Maier W, Weckbecker K, Haenisch B. Hyperuricemia and dementia– a case-control study. BMC Neurol. 2018 Aug 31;18(1):131. doi: 10.1186/s12883-018-1136-y.

- Wen M, Zhou B, Chen YH, Ma ZL, Gou Y, Zhang CL, et al. Serum uric acid levels in patients with Parkinson’s disease: A meta-analysis. PLoS One. 2017 Mar 20;12(3):e0173731. doi: 10.1371/journal.pone.0173731. eCollection 2017.

- Yesavage JA, O'Hara R, Kraemer H, Noda A, Taylor JL, Ferris S, et al. Modeling the prevalence and incidence of Alzheimer's disease and mild cognitive impairment. J Psychiatr Res. 2002;36(5):281-6.

- Poddar K, Kant S, Singh A, Singh TB. An epidemiological study of dementia among the habitants of eastern Uttar Pradesh, India. Ann İndian Acad Neurol. 2011;14(3):164-8.

- Richards M, Brayne C. What do we mean by Alzheimer’s disease? BMJ. 2010 Oct 12;341:c4670. doi: 10.1136/bmj.c4670.

- Skoog I. Vascular aspects in Alzheimer’s disease. J Neural Transm Suppl. 2000;59:37-43.

- Annanmaki T, Pohja M, Parviainen T, Hakkinen P, Murros K. Uric acid and cognition in Parkinson’s disease:A follow-up study. Parkinsonism Relat Disord. 2011; 17(5): 333-7.

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