scholarly journals Association of sudden sensorineural hearing loss with dementia: a nationwide cohort study

BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Shu-Yu Tai ◽  
Cheng-Ting Shen ◽  
Ling-Feng Wang ◽  
Chen-Yu Chien

Abstract Background 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. Methods 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. Results 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). Conclusions 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.

2019 ◽  
Vol 16 (4) ◽  
pp. 324-327 ◽  
Author(s):  
Hsin-Chien Chen ◽  
Chi-Hsiang Chung ◽  
Chieh-Hua Lu ◽  
Wu-Chien Chien

Background: The risk of sudden sensorineural hearing loss associated with metformin use in patients with diabetes mellitus has not been fully examined. Study design: It is a retrospective matched-cohort study. Subjects and methods: We examined the medical records of patients with diabetes mellitus over 18 years old in Taiwan’s National Health Insurance Research Database for the period between 1 January 2000 and 31 December 2013, to establish matched cohorts (14,109 with and 42,327 without metformin use) at a ratio of 1:3 by sex, age and index year. Results: We used a Cox regression hazard model to identify risk factors of sudden sensorineural hearing loss during 14 years of follow-up, and the results indicate that a significantly lower percentage of diabetes mellitus patients with metformin use ( p = 0.033) developed sudden sensorineural hearing loss compared with those without metformin use (0.21%, 29/14,109 vs 0.32%, 136/42,327). After adjustment for age and other variables [adjusted hazard ratio: 0.630 (95% confidence interval: 0.422–0.941, p = 0.024)], this study also demonstrated that metformin use appeared to reduce the risk of developing sudden sensorineural hearing loss. Conclusion: This study demonstrated an association between metformin use and lower incidence of sudden sensorineural hearing loss among patients with diabetes mellitus.


Cephalalgia ◽  
2012 ◽  
Vol 33 (2) ◽  
pp. 80-86 ◽  
Author(s):  
Chia-Huei Chu ◽  
Chia-Jen Liu ◽  
Jong-Ling Fuh ◽  
An-Suey Shiao ◽  
Tzeng-Ji Chen ◽  
...  

Background The pathophysiology of idiopathic sudden sensorineural hearing loss (SSNHL) is poorly understood. Few case reports have proposed a possible link between migraine and SSNHL. Objectives This study aimed to explore the risk of idiopathic SSNHL in patients with migraine in a nationwide, population-based cohort study. Methods We identified patients with migraine from the Taiwan National Health Insurance Research Database (NHIRD) between 2000 and 2009. Each migraine patient was matched with four randomly selected subjects without migraine for age, sex, and comorbidities. Both cohorts were followed up until the end of 2009. We compared the incidence rates of SSNHL in the two cohorts and identified the risk factors. Results A total of 10,280 migraine patients and 41,120 matched controls were enrolled with a median follow-up of five years. The migraine cohort had a greater risk of developing SSNHL than the matched cohort (81.6 vs. 45.7 per 100,000 person-years, incidence rate ratio (IRR) = 1.8; 95% confidence interval (CI) 1.22–2.61, p = 0.002). The Cox proportional hazards analysis revealed that among migraine subjects, comorbidity with hypertension was associated with a trend of developing SSNHL (hazard ratio (HR) = 1.92, 95% CI 0.97–3.79, p = 0.06). Conclusions This population-based study demonstrates that migraine is associated with an increased risk of idiopathic SSNHL, which, however, is a rare condition.


Author(s):  
Pei-Xun Zhong ◽  
I-Hsun Li ◽  
Jui-Hu Shih ◽  
Chin-Bin Yeh ◽  
Kuan-Wei Chiang ◽  
...  

Abstract Background Increasing numbers of animal studies have found that sudden sensorineural hearing loss (SSNHL) is related to the mechanism of serotonergic modulation. However, the relationship between antidepressants and SSNHL is unclear in humans. Therefore, this study aimed to evaluate the association between antidepressant use and risk of SSNHL. Methods Data from 218 466 antidepressant users and 1 116 518 nonusers were obtained from the Taiwan Longitudinal Health Insurance Database. We used propensity-score matching (PSM) and inverse-probability treatment weighting (IPTW) to eliminate any bias. Each patient was tracked for 5 years to ascertain whether or not they were diagnosed with SSNHL. Cox proportional-hazard regression analyses were performed to calculate the SSNHL risk. Results The adjusted hazard ratio (aHR) of SSNHL for antidepressant users was 1.36 compared with nonusers in the full cohort study. The aHR for antidepressant users was 1.44 and 1.49 compared with the nonusers in the IPTW and PSM cohorts, respectively. All classes of antidepressants consistently increased the SSNHL risk. Additionally, patients receiving four classes of antidepressants were associated with a much higher SSNHL risk (aHR, 2.05) and those receiving one or two classes of antidepressants had a relatively lower SSNHL risk. Conclusion Antidepressants increased SSNHL risk, regardless of their class. Furthermore, patients who took a higher number of antidepressant classes showed an increased risk of developing SSNHL than those who took a lower number of antidepressant classes. Therefore, physicians should estimate the risks and benefits of antidepressant use and avoid prescribing antidepressants concurrently.


BMJ Open ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. e038552
Author(s):  
Rishi Mandavia ◽  
Gerjon Hannink ◽  
Muhammad Nayeem Ahmed ◽  
Yaami Premakumar ◽  
Timothy Shun Man Chu ◽  
...  

IntroductionThe mainstay of treatment for idiopathic sudden sensorineural hearing loss (SSNHL) includes oral steroids, intratympanic steroid injections or a combination of both. The National Institute for Health and Care Excellence, in their recent hearing loss guidelines, highlighted the paucity of evidence assessing the comparative effectiveness of these treatments; and the National Institute for Health Research (NIHR) Health Technology Assessment Programme has since released a commissioned call for a trial to identify the most effective route of administration of steroids as a first-line treatment for idiopathic SSNHL. For such trials to be run effectively, reliable information is needed on patients with SSNHL: where they present, numbers, demographics, treatment pathways, as well as outcomes. This study will collect these data in a nationwide cohort study of patients presenting with SSNHL across 97 National Health Service (NHS) trusts. The study will be delivered through ear, nose and throat (ENT) trainee networks, the NIHR Clinical Research Network (CRN) Audiology Champions and the NIHR CRN. Importantly, this study will also provide a dataset to develop a prognostic model to predict recovery for patients with idiopathic SSNHL. The study objectives are to: (1) map the patient pathway and identify the characteristics of adult patients presenting to NHS ENT and hearing services with SSNHL, (2) develop a prognostic model to predict recovery for patients with idiopathic SSNHL and (3) establish the impact of idiopathic SSNHL on patients’ quality of life (QoL).Methods and analysisStudy design: national multicentre prospective cohort study across 97 NHS trusts.Inclusion criteria: adult patients presenting to NHS ENT and hearing services with SSNHL.Outcomes: change in auditory function; change in QoL score.Analysis: multivariable prognostic model, using prespecified candidate predictors. Mean change in QoL scores will be calculated from initial presentation to follow-up.Ethics and disseminationHealth Research Authority and NHS Research Ethics Committee approved the study. Publication will be on behalf of study sites and collaborators.Trial registration numberClinicalTrials.gov Registry (NCT04108598).


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