INTRODUCTION Hearing loss (HL) is considered a potentially modifiable risk factor for dementia. We aimed to examine the relationship between HL and incident dementia diagnosis in a province-wide population-based cohort study with matched controls. METHODS Administrative healthcare databases were linked to generate a cohort of patients who were aged ≥40 years at their first claimed hearing amplification devices (HAD) between April 2007 and March 2016 through the Assistive Devices Program (ADP) (257,285 with claims and 1,005,010 controls). The main outcome was incident dementia diagnosis, ascertained using validated algorithms. Dementia incidence was compared between cases and controls using Cox regression. Patient, disease, and other risk factors were examined. RESULTS Dementia incidence rates (per 1,000 person-years) were 19.51 (95% confidence interval [CI]: 19.26-19.77) and 14.15 (95% CI: 14.04-14.26) for the ADP claimants and matched controls, respectively. In adjusted analyses, risk of dementia was higher in ADP claimants compared with controls (hazard ratio [HR]: 1.10 [95% CI: 1.09-1.12, p < 0.001]). Subgroup analyses showed a dose-response gradient, with risk of dementia higher among patients with bilateral HADs (HR: 1.12 [95% CI: 1.10-1.14, p < 0.001]), and an exposure-response gradient, with increasing risk over time from April 2007-March 2010 (HR: 1.03 [95% CI: 1.01-1.06, p = 0.014]), April 2010-March 2013 (HR: 1.12 [95% CI: 1.09-1.15, p < 0.001]), and April 2013-March 2016 (HR: 1.19 [95% CI: 1.16-1.23, p < 0.001]). CONCLUSION In this population-based study, adults with HL had an increased risk of being diagnosed with dementia. Given the implications of HL on dementia risk, understanding the effect of hearing interventions merits further investigation.

中文翻译：

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听力损失和痴呆症：一项基于人群的队列研究。

简介 听力损失 (HL) 被认为是痴呆症的一个潜在可改变的风险因素。我们的目的是在一项全省范围内的人群队列研究中通过匹配对照研究 HL 与痴呆症诊断之间的关系。方法 将行政医疗保健数据库关联起来，生成一组年龄≥40岁的患者，这些患者在 2007 年 4 月至 2016 年 3 月期间通过辅助设备计划 (ADP) 首次索赔听力放大设备 (HAD)（257,285 名索赔者和 1,005,010 名对照者） 。主要结果是使用经过验证的算法确定的痴呆症诊断。使用 Cox 回归比较病例和对照之间的痴呆发生率。对患者、疾病和其他危险因素进行了检查。结果 ADP 索赔人和匹配对照组的痴呆发病率（每 1,000 人年）分别为 19.51（95% 置信区间 [CI]：19.26-19.77）和 14.15（95% CI：14.04-14.26）。在调整分析中，与对照组相比，ADP 索赔者患痴呆症的风险较高（风险比 [HR]：1.10 [95% CI：1.09-1.12，p < 0.001]）。亚组分析显示剂量反应梯度，双侧 HAD 患者患痴呆的风险较高（HR：1.12 [95% CI：1.10-1.14，p < 0.001]），以及暴露反应梯度，风险随着时间的推移而增加2007年4月至2010年3月（HR：1.03 [95% CI：1.01-1.06，p = 0.014]），2010年4月至2013年3月（HR：1.12 [95% CI：1.09-1.15，p < 0.001]），以及2013 年 4 月至 2016 年 3 月（HR：1.19 [95% CI：1.16-1.23，p < 0.001]）。结论 在这项基于人群的研究中，患有 HL 的成年人被诊断为痴呆症的风险增加。鉴于 HL 对痴呆风险的影响，了解听力干预的效果值得进一步研究。