Hearing Loss and Incident Dementia: Claims Data From the New York SPARCS Database

OBJECTIVE: Age-related hearing loss (HL) may be a risk factor for incident dementia. The objective was to use population-based claims data from the New York Statewide Planning and Research Cooperative System (SPARCS) to establish if HL is associated with incident dementia. STUDY DESIGN: Retrospective cohort study. SETTING: Comprehensive all-payer data reporting system (2007-2017). PATIENTS: Two hundred six thousand eight hundred one subjects more than 60 years (56,523 with HL, random sample of 150,278 without HL). INTERVENTIONS: None. MAIN OUTCOME MEASURES: The main outcome was incident dementia, measured by initial dementia diagnosis (ICD-9/ICD-10 code) associated with a patient visit/insurance claim. The main exposure was HL, measured by at least two separate HL diagnoses associated with claims before dementia diagnosis. Cox proportional-hazards models were used to examine the relationship of baseline HL with incident dementia, adjusting for age, sex, cardiovascular disease, cerebrovascular disease, diabetes, and smoking. RESULTS: Dementia incidence rates per 1,000 person-years were 10.16 (95% confidence interval [CI] = 9.81-10.51; subjects with HL) and 5.43 (5.28-5.57; subjects without HL). Fewer (2-10) HL claims (n = 56,523), compared with no (0) HL claims, was associated with 1.10 (95% CI = 1.05-1.15, p < 0.001) times the hazard of incident dementia, adjusting for covariates. Greater (>10) HL claims (n = 3,414), compared with no (0) HL claims, was associated with 1.63 (95% CI = 1.42, 1.86, p < 0.001) times the hazard of incident dementia, adjusting for covariates. CONCLUSIONS: HL diagnosis was associated with increased risk of incident dementia based on a comprehensive all-payer data reporting system. Individuals with a more established diagnosis of HL (more HL claims) demonstrated an increased hazard ratio.