Department of Health Promotion and Health Education, National Taiwan Normal University, Taipei, Taiwan.
Taiwan Centers for Disease Control, Taipei, Taiwan.
JAMA Netw Open. 2019 Jul 3;2(7):e198112. doi: 10.1001/jamanetworkopen.2019.8112.
Hearing loss (HL) may be a modifiable risk factor for dementia, and longitudinal studies are needed to examine the association of HL and dementia.
To investigate the association of HL with incident dementia in Taiwanese adults in the general population.
DESIGN, SETTING, AND PARTICIPANTS: This population-based cohort study collected data from the National Health Insurance Research Database of Taiwan. Patients newly diagnosed with HL from January 1, 2000, through December 31, 2011 (n = 8135), constituted the exposed (HL) group. The HL group patients were matched by sex, age, residence, and insurance premium to individuals without HL (non-HL group) (n = 8135). Data were analyzed from January 1, 2000, to December 31, 2013.
Hearing loss defined according to International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes.
Dementia classified according to ICD-9-CM codes.
Of a total of 16 270 participants (9286 [57.1%] men; mean [SD] age, 65.2 [11.1] years), 1868 developed dementia. The dementia incidence rate in the HL group was higher than that in the non-HL group (19.38 [95% CI, 18.25-20.57] per 1000 person-years vs 13.98 [95% CI, 13.01-15.00] per 1000 person-years) during the follow-up period. In the fully adjusted multivariate Cox proportional hazards regression model applied for risk analysis, patients with HL had a significant risk of dementia (hazard ratio [HR], 1.17; 95% CI, 1.07-1.29; false discovery rate [FDR] P = .003). Subgroup analysis revealed that, among 3 age groups (45-64, 65-74, and ≥75 years), the group aged 45 to 64 years was associated with a risk of dementia (HR, 2.21 [95% CI, 1.57-3.12]; FDR P < .001). In sensitivity analysis, the presence of HL among those aged 45 to 64 years (HR, 1.40; 95% CI, 1.12-1.75; FDR P = .01) was associated with a risk of dementia.
In this study, hearing loss was positively associated with a risk of dementia, especially in patients aged 45 to 64 years. Hearing protection, screening, and treatment may be used as strategies for mitigating this potential risk factor.
听力损失（HL）可能是痴呆的一个可改变的危险因素，需要进行纵向研究来检查 HL 和痴呆之间的关联。
在台湾的一般人群中，研究 HL 与新发生的痴呆之间的关联。
设计、地点和参与者：本基于人群的队列研究从台湾的全民健康保险研究数据库中收集数据。2000 年 1 月 1 日至 2011 年 12 月 31 日期间新诊断为 HL 的患者（n=8135）构成了暴露组（HL 组）。HL 组患者通过性别、年龄、居住地和保险费与无 HL 的个体（非 HL 组）（n=8135）相匹配。数据分析从 2000 年 1 月 1 日开始，一直持续到 2013 年 12 月 31 日。
根据国际疾病分类，第九修订版，临床修正（ICD-9-CM）代码定义的听力损失。
根据 ICD-9-CM 代码分类的痴呆。
在总共 16270 名参与者（9286[57.1%]名男性；平均[标准差]年龄 65.2[11.1]岁）中，有 1868 人患上了痴呆症。HL 组的痴呆症发病率高于非 HL 组（HL 组每 1000 人年为 19.38[95%CI，18.25-20.57]，而非 HL 组为 13.98[95%CI，13.01-15.00]）。在随访期间进行的风险分析的完全调整多变量 Cox 比例风险回归模型中，HL 患者痴呆的风险显著增加（风险比[HR]，1.17；95%CI，1.07-1.29；错误发现率[FDR]P=0.003）。亚组分析显示，在 3 个年龄组（45-64、65-74 和≥75 岁）中，45 至 64 岁年龄组与痴呆风险相关（HR，2.21[95%CI，1.57-3.12]；FDRP<0.001）。敏感性分析显示，45 至 64 岁的 HL 患者（HR，1.40；95%CI，1.12-1.75；FDRP=0.01）与痴呆风险相关。
在这项研究中，听力损失与痴呆风险呈正相关，尤其是在 45 至 64 岁的患者中。听力保护、筛查和治疗可能被用作减轻这一潜在危险因素的策略。
