Saturday, May 14, 2011

Uric Acid And Dementia

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Elevated Uric Acid Level May Forewarn Dementia Risks

Normal values for uric acid fall between 3.0 and 7.0 mg/dL.(1)

A high uric acid (UA) level may not cause problems. However, some people develop gout, kidney stones or kidney failure due to high uric acid levels. A high uric acid level may appear prior to the development of high blood pressure, heart disease or chronic kidney disease. But it's often unclear whether a high uric acid level is a direct cause or merely an early warning sign of these conditions.

A recent study (2) of 1,061 persons over 60 years of age (593 women and 468 men) suggests a positive association between high circulating levels of UA and dementia syndome which, at least in part, is independent of most cardiovascular, cerebrovascular and metabolic risk factors.

The authors, from the Institute of Gerontology and Geriatrics, University of Perugia, Italy defined hyperuricemia as UA level of greater than 7.5 mg/dl in men and greater than 6.2 mg/dl in women. For statistical analysis, UA was divided into tertiles (3) according to the following cut-points: 4.6 and 5.6 mg/dl.

Persons with circulating UA levels in the highest tertile showed a threefold higher probability of being affected by a dementia syndrome. The probability of having dementia remained significantly higher independent of several confounders such as age, sex, education, BMI, smoking habit, total energy and alcohol consumption, vitamin E and cholesterol plasma levels, hypertension, renal function, cardiovascular and cerebrovascular diseases.

Persons with UA levels within the middle UA tertile showed a clear tendency to be affected by a dementia syndrome with about twofold higher probability.

The authors suggest that it would be worthwhile to perform clinical trials aimed at determining whether the pharmacological reduction in UA levels prevents the onset or delays the progression of dementia.

(1) Normal uric acid values may vary slightly from laboratory to laboratory. Click here for more on uric acid.

(2) Ruggiero C, Antonio Cherubini A, Lauretani F,Stefania Bandinelli S, Maggio M, Di Iorio A, Zuliani G, Dragonas C, Senin U, Ferruccih L. Uric Acid and Dementia in Community-Dwelling Older Persons. Dementia and Geriatric Cognitive Disorders. 2009 April; 27(4): 382–389. doi: 10.1159/000210040. Click here for the complete paper.

(3) A tertile is any of the two points that divide an ordered distribution into three parts, each containing a third of the values. Normal values for uric acid falling between 3.0 and 7.0 mg/dL., thus the cut-points of 4.6 and 5.6 mg/dl.

Why wait, you should take steps to reduce you UA level if it is on the high side.

Here’s What You Can Do To Control Your Uric Acid Levels.

Maintain a healthy, balanced diet.

Adjust your diet to prevent the onset of hyperuricemia. Avoid large amounts of foods containing a moderate concentration of purine, since they increase the amount of uric acid in the body and may trigger a gout attack. Low fructose intake is important as well. Click here for more on dieting.

Exercise regularly.

Develop a regular exercise routine. Try moderate-intensity exercise for at least 30 minutes most days of the week. Types of suggested exercise include:

  • Walking briskly
  • Mowing the lawn
  • Dancing
  • Swimming
  • Bicycling on level terrain

Be careful about strenuous exercise, since it may raise uric acid levels.

Work with your physician to develop an appropriate exercise program tailored to your body, lifestyle and needs. Always check with your physician before starting an exercise program.

Maintain a healthy body weight.

Increasing the intensity or the amount of time you are physically active is also beneficial to prevent weight gain. Obesity contributes to many chronic conditions, including hyperuricemia. Excess weight affects how the body metabolizes nutrients and waste products. Avoid rapid-weight loss diets and low-carbohydrate diets high in protein and fat, both of which can elevate uric acid levels.

Obesity is defined as a body mass index (BMI) of 30 or higher. Click here to calculate your BMI.

Stay hydrated.

Water is vital for transporting nutrients throughout the body and eliminating waste. Water also helps regulate body temperature and cushion joints and tissues. Many dietitians recommend consuming at least 2 liters of water daily, and more if you exercise, to avoid dehydration. Research also suggests that drinking adequate water might guard against excessive crystallization of uric acid and constipation. Some experts also believe that drinking water can help remove uric acid from the bloodstream.

Drink less alcohol, especially beer.

Consumption of alcohol, especially beer which is high in purines, can increase the amount of uric acid in your body. For men, who are most at risk for gout, it is suggested to limit consumption to no more than two drinks per day. Women over age 65 should limit their intake to one drink per day.

Furthermore, alcohol is diuretic. This means it encourages the body to lose more water than it takes on by halting the production of the body's anti-diuretic hormone. This speeds up the loss of fluid from your body, leading to dehydration.

The above is modified from resources of the Gout & Uric Acid Education Society

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