Objective The data showing the association between gout and dementia are inconsistent. The objective of this study was to examine whether gout is associated with the risk of dementia in the elderly. Methods This retrospective cohort study used population-based representative claims data from the National Health Insurance Service in Korea. We used the Elderly Cohort database which represents 10% of the elderly Koreans over the age of 60, from 2002 to 2013. We assessed the association of gout with a new diagnosis of dementia with Cox proportional hazard models and adjusted the data for potential covariates such as demographics (age, sex) and comorbidities. Results We included 22,178 patients with gout and 113,590 without. In each group, 2,557 (11.53%) and 18,264 (16.08%) patients, respectively, had dementia. In multivariable analyses, gout was independently associated with a significantly lower hazard ratio of incident dementia, with an adjusted hazard ratio of 0.63 (95% CI, 0.60–0.66). A sub-group analysis conducted to find out the effects of gout medication showed that febuxostat use significantly decreased incident dementia. Conclusion Gout was independently associated with a 37% lower risk of dementia in the elderly.
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