Department of Family Medicine, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung City, 807, Taiwan.
Department of Family Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung City, 807, Taiwan.
BMC Neurol. 2021 Feb 25;21(1):88. doi: 10.1186/s12883-021-02106-x.
Impaired cochlear blood perfusion and microvascular damage can cause sudden sensorineural hearing loss (SSHL), which is a potential risk factor for dementia. This study explored the association between SSHL and dementia.
This retrospective cohort study used a random sample of 1000,000 individuals from Taiwan's National Health Insurance Research Database. We identified 3725 patients newly diagnosed with SSHL between January 1, 2000, and December 31, 2009, and propensity score matching according to age, sex, index year, comorbidities, and medications was used to select the comparison group of 11,175 patients without SSHL. Participants were stratified by age (<65 and ≧65 years) and sex for the subgroup analyses. The outcome of interest was all cause dementia (ICD-9-CM codes 290.0, 290.4, 294.1, 331.0). Both groups were followed up until December 31, 2010, for diagnoses of dementia. Cox regression models were used to estimate the hazard ratio (HR) of dementia.
During the average 5-year follow-up period, the incidence rate of dementia in the SSHL cohort was 6.5 per 1000 person-years compared with 5.09 per 10,000 person-years in the comparison group. After adjustment for potential confounders, patients with SSHL were 1.39 times more likely to develop dementia than those without SSHL (95% confidence interval = 1.13-1.71). When stratified by patients' age and sex, the incidence of dementia was 1.34- and 1.64-fold higher in patients with SSHL aged ≥65 years (P = .013) and in women (P = .001), respectively, compared with the comparison group. Women with SSHL who were < 65 years old had the highest risk (2.14, 95% CI = 1.17-4.11, P = .022). In addition, a log-rank test revealed that patients with SSHL had significantly higher cumulative incidence of dementia than those without SSHL (P = .002).
Patients with SSHL, especially women aged < 65 years, were associated with higher risk of dementia than those without SSHL. Thus, clinicians managing patients with SSHL should be aware of the increased risk of dementia.
耳蜗血液灌注受损和微血管损伤可导致突发性聋（SSHL），这是痴呆的潜在危险因素。本研究探讨了 SSHL 与痴呆之间的关联。
这是一项回顾性队列研究，使用了台湾全民健康保险研究数据库中的 100 万随机样本。我们在 2000 年 1 月 1 日至 2009 年 12 月 31 日期间确定了 3725 名新诊断为 SSHL 的患者，并根据年龄、性别、索引年、合并症和药物进行了倾向评分匹配，以选择 11175 名无 SSHL 的对照组患者。根据年龄（<65 岁和≧65 岁）和性别对亚组进行分层。主要结局为所有原因痴呆（ICD-9-CM 编码 290.0、290.4、294.1、331.0）。两组患者均随访至 2010 年 12 月 31 日，以诊断痴呆。采用 Cox 回归模型估计痴呆的风险比（HR）。
在平均 5 年的随访期间，SSHL 组的痴呆发生率为每 1000 人年 6.5 例，而对照组为每 10000 人年 5.09 例。调整潜在混杂因素后，与无 SSHL 患者相比，有 SSHL 患者发生痴呆的风险高 1.39 倍（95%置信区间 1.13-1.71）。按患者年龄和性别分层后，65 岁及以上患者的痴呆发生率分别高 1.34 倍（P=0.013）和 1.64 倍（P=0.001），女性患者高 1.64 倍（P=0.001）。65 岁以下的 SSHL 女性患者风险最高（2.14，95%CI=1.17-4.11，P=0.022）。此外，对数秩检验显示，与无 SSHL 患者相比，有 SSHL 患者的痴呆累积发生率显著更高（P=0.002）。
患有 SSHL 的患者，尤其是<65 岁的女性，发生痴呆的风险高于无 SSHL 的患者。因此，管理 SSHL 患者的临床医生应意识到痴呆的风险增加。
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