目的：探索血清尿酸与认知功能损害的关系。方法：基于社区的前瞻性研究，选自2011年上海五里桥和马陆社区正常人群的随访队列（≥50岁），终点指标为2016年末次随访的认知功能评估结果。认知功能评估采用简易精神状态检查（mini-mental status examination，MMSE）量表。研究人群的尿酸水平根据性别分别进行四分位分层，从低到高分为Q₁~Q₄。Logistic回归用于分析血清尿酸与认知功能损害的关系。结果：纳入312名平均年龄为（68.36±6.45）岁，其中男性124名（39.7%）。在5年随访中新发认知功能损害43例，患病率为13.8%。多因素Logistic回归结果提示，在校正了年龄、性别等相关危险因素后，与低尿酸水平人群（Q₁）相比，较高尿酸水平人群（Q₃）发生认知功能损害的风险更高，优势比（odds ratio，OR）为2.53[95%置信区间（confidence interval, CI）：0.91~7.02]。按照年龄分层（50~70岁、70~90岁）后未发现阳性结果。而按照性别分层后，发现男性中最高尿酸水平人群（Q₄）比最低尿酸水平人群（Q₁）发生认知功能损害的风险高（OR=18.60，95%CI：1.26~274.13）；而女性中未发现相关阳性结果。结论：在50岁以上社区人群中，较高尿酸水平（尤其是男性）会增加认知功能损害的风险。

Objective To explore the relationship between serum uric acid and cognitive impairment. Methods This was a community-based prospective study. The baseline population(2011) was enrolled from a cohort(≥50 years old) of normal people in Wuliqiao and Malu community in Shanghai. The endpoint was the cognitive function assessment results of the last follow-up (2016). Cognitive assessment was performed using mini-mental status examination(MMSE). The uric acid level of the study population was divided into four quartiles from low to high score (Q₁-Q₄) in both male and female. Logistic regression was used to analyze the relationship between serum uric acid and cognitive impairment. Results A total of 312 people with an average age of (68.36±6.45) years old were enrolled, and there were 124 males (39.7%). During 5-year follow-up, the total people with cognitive impairments was 43, and the incidence rate was 13.8%. After adjusting age, gender and other related risk factors, multivariate Logistic regression analysis showed that people with higher uric acid level (Q₃) had higher risk of cognitive impairment than those with low uric acid level (Q₁), with an odds ratio(OR) of 2.53 [95% confidence interval (CI): 0.91-7.02]. After age stratification (50-70 years old; 70-90 years old), no positive results were found. However, stratified by gender, it was found that men with the highest uric acid level(Q₄) had a higher risk of cognitive impairment than those with the lowest uric acid level (Q₁)(OR=18.60，95%CI: 1.26-274.13), while no positive results were found in women. Conclusions Higher uric acid levels, especially in men, might increase the risk of cognitive impairment in people over 50 years.