The Association Between Serum Uric Acid and Cognitive Function Among Middle-Aged and Older Adults Without Hyperuricemia: The Mediating Role of Depressive Symptoms.
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Abstract
Background: The association between serum uric acid (SUA) and cognitive function remains unclear, especially among individuals without hyperuricemia. We examined the cross-sectional and longitudinal bidirectional associations between SUA and cognition, as well as the mediating effect of depressive symptoms among Chinese adults.
Methods: Data were obtained from the China Health and Retirement Longitudinal Study (CHARLS). SUA (continuous) and cognitive function (based on mental intactness and episodic memory) were measured at Wave 1 and Wave 3. Depressive symptoms (Center for Epidemiologic Studies Depression scale) were assessed at Wave 1. Bivariate latent change score models and mediation analysis were used to investigate these possible associations.
Results: A total of 6 236 participants free of hyperuricemia (aged 58.3 ± 8.5 years) were included. After controlling for potential confounders, the SUA level was associated with cognition at baseline (standardized r = 0.042; p = .001). Higher baseline SUA level was associated with slower subsequent cognitive decline (standardized β = 0.026; p = .027), whereas baseline cognition was not significantly associated with subsequent change in SUA (standardized β = 0.003; p = .817). In mediation analysis, baseline SUA was indirectly associated with subsequent cognition via baseline depressive symptoms (mediation effect 13.3%; p < .001).
Conclusions: Higher baseline SUA level is associated with better baseline cognition and less subsequent cognitive decline among Chinese adults without hyperuricemia. Baseline depressive symptoms may partially mediate the association between baseline SUA and later cognition. Continued research is warranted to verify these findings and elucidate the causality and underlying mechanisms.
背景：血清尿酸（SUA）与认知功能之间的关系尚不明确，尤其是在无高尿酸血症的人群中。我们研究了中国成年人血清尿酸与认知功能之间的横向和纵向双向关系，以及抑郁症状的中介效应：方法：数据来自中国健康与退休纵向研究（CHARLS）。方法：数据来自中国健康与退休纵向研究（CHARLS），在第一波和第三波测量了SUA（连续性）和认知功能（基于精神完好性和外显记忆）。在第 1 波时对抑郁症状（流行病学研究中心抑郁量表）进行了评估。采用双变量潜在变化评分模型和中介分析来研究这些可能的关联：共纳入 6 236 名无高尿酸血症的参与者（年龄为 58.3 ± 8.5 岁）。在控制了潜在的混杂因素后，基线 SUA 水平与认知能力相关（标准化 r = 0.042; p = .001）。基线 SUA 水平越高，随后的认知能力下降速度越慢（标准化 β = 0.026；p = .027），而基线认知能力与随后的 SUA 变化无显著相关性（标准化 β = 0.003；p = .817）。在中介分析中，基线 SUA 通过基线抑郁症状与随后的认知间接相关（中介效应为 13.3%；p 结论：基线 SUA 水平越高，认知能力越强：在无高尿酸血症的中国成年人中，较高的基线 SUA 水平与较好的基线认知能力和较少的后续认知能力下降有关。基线抑郁症状可能会部分调节基线 SUA 与日后认知能力之间的关系。要验证这些发现并阐明其因果关系和内在机制，还需要继续开展研究。
期刊介绍：
Publishes articles representing the full range of medical sciences pertaining to aging. Appropriate areas include, but are not limited to, basic medical science, clinical epidemiology, clinical research, and health services research for professions such as medicine, dentistry, allied health sciences, and nursing. It publishes articles on research pertinent to human biology and disease.
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