THE EFFECTS OF THIAZIDE AND THIAZIDE-LIKE DIURETICS ON THE RELATIONSHIP BETWEEN NORMAL SERUM URIC ACID LEVELS AND COGNITIVE FUNCTION

Introduction: The objective of this study was to identify the possible effect of thiazide and thiazide-like diuretic use on the relationship between uric acid and cognitive function in geriatric patients with normal renal function. Method: Serum uric acid levels and Mini-Mental State Examination scores of 238 patients (age >= 65 years) treated in an outpatient geriatric clinic were evaluated in this observational, cross-sectional, retrospective study. The effect of thiazide diuretic use on Mini-Mental State Examination score was also assessed. Results: Compared to patients that are not currently taking thiazide diuretics (non-thiazide group) serum uric acid was significantly higher in patients using thiazide and thiazide-like diuretics (thiazide group) (5.27 +/- 0.12 vs 6.09 +/- 0.20; P< 0.001). Although the serum uric acid levels were higher in the thiazide group the Mini-Mental State Examination scores were similar to the non-thiazide group. There was a strong positive correlation between serum uric acid levels and Mini-Mental State Examination score in both groups (P< 0.001). The Mini-Mental State Examination score was significantly lower in the lowest serum uric acid quartile in both groups (P< 0.001). Conclusions: Low serum uric acid levels are associated with cognitive impairment; a slight but significant increase of serum uric acid due to thiazide diuretic use does not seem to enhance cognitive function in geriatric patients.