Serum uric acid is associated with better executive function in men but not in women: Baseline assessment of the ELSA-Brasil study.

BACKGROUND: Serum uric acid (SUA) may protect against free radical stress damage and was previously linked to cognitive impairment in older adults, but evidence in middle-aged adults is scarce.

PURPOSE: We sought to analyze whether SUA is associated with cognitive performance in apparently healthy middle-aged participants in the ELSA-Brasil cohort study.

METHODS: We excluded participants older than age 65, those taking allopurinol, benzbromarone, or medications that could impair cognitive performance, those with previous stroke, and those with incomplete data on cognitive tests or SUA. The Consortium to Establish a Registry for Alzheimer's Disease Word List Memory Test (CERAD-WLMT), the Semantic Fluency Test (SFT), and the Trail Making Test version B (TMT) were used as dependent variables. Sex-specific linear regression models were used to assess the association between SUA and cognitive tests, adjusted by age, education, hypertension, dyslipidemia, diabetes, smoking, alcohol consumption, body mass index, coronary heart disease, renal function, depression, aspirin use, thyroid function, and menopausal status (in women). We used the Bonferroni procedure to control for the false discovery rate associated with multiple comparisons.

RESULTS: We analyzed cross-sectional data from 6751 women and 5464 men. Mean age and standard deviation (SD) of the sample was 49.6 (SD 7.4) years for men and 49.9 (SD 7.3) years for women. The majority of men (52%) and women (51%) were white. Mean SUA value was 4.75 (SD 1.16) mg/dL in women and 6.44 (SD 1.39) mg/dL in men. Multivariate linear models showed no association in women and a significant inverse association between SUA levels and TMT (β=-3.106, 95% CI=-4.594; -1.618, p=0.0004) in men.

CONCLUSION: In a middle-aged subset population, SUA is associated with better performance on an executive function test in men, but not in women in the ELSA-Brasil cohort study.