Association Between Urate-lowering Therapies and Cognitive Decline in Community-dwelling Older Adults: a Post-hoc Analysis of the MAPT Study.

Abstract IntroductionLong-term use of urate-lowering therapies (ULT) may reduce inflammaging and thus prevent cognitive decline during aging. This article examined the association between long-term use of ULT and cognitive decline among community-dwelling older adults with spontaneous memory complaints.Material and methodsWe performed a secondary observational analysis using data of 1,673 participants ≥70 years old from the Multidomain Alzheimer Preventive Trial (MAPT Study), a randomized controlled trial assessing the effect of a multidomain intervention, the administration of polyunsaturated fatty acids (PUFA), both, or placebo on cognitive decline. We compared cognitive decline during the 5-year follow-up between three groups according to ULT use: participants treated with ULT during at least 75% of the study period (PT≥75; n=51), less than 75% (PT<75; n=31), and non-treated participants (PNT; n=1,591). Cognitive function (measured by a composite score) was assessed at baseline, 6 months and every year for 5 years. Linear mixed models were performed and adjusted for age, sex, body mass index (BMI), diagnosis of arterial hypertension or diabetes, baseline composite cognitive score, and MAPT intervention groups. ResultsAfter the 5-year follow-up, only non-treated participants presented a significant decline in the cognitive composite score (mean change -0.173, 95%CI -0.212 to -0.135; p<0.0001). However, there were no differences in change of the composite cognitive score between groups (adjusted between-group difference for PNT vs. PT<75: 0.089, 95%CI -0.160 to 0.338, p= 0.484; PNT vs. PT≥75: 0.174, 95%CI -0.042 to 0.391, p= 0.115).ConclusionUse of ULT was not associated with reduced cognitive decline over a 5-year follow-up among community-dwelling older adults at risk of dementia.