%0 Journal Article
%T Gout and hearing impairment in the elderly: a retrospective cohort study using the US Medicare claims data
%A Jasvinder A Singh
%A John D Cleveland
%J -
%D 2018
%R 10.1136/bmjopen-2018-022854
%X Objectives To evaluate whether gout is associated with a higher risk of hearing loss in older adults.

Design Retrospective cohort study.

Setting USA.

Participants 5% random sample of US Medicare claims 2006¨C2012, representative of US adults aged 65 years or older.

Primary and secondary outcomes Incident (new) hearing loss identified by the presence of at least two claims at least 4 weeks apart with an International Classification of Diseases, Ninth Revision, 389.xx, with no respective claim in the baseline 1-year observation period.

Results Among the 1.71£¿million eligible people, 89£¿409 developed incident hearing impairment. The crude incidence rates of incident hearing impairment in people with versus without gout were 16.9 vs. 8.7 per 1000 person-years. Using Cox regression analyses adjusted for demographics, medical comorbidity and common cardiovascular and gout medications, we found that gout was associated with a significantly higher HR of incident hearing impairment, HR was 1.44 (95% CI 1.40 to 1.49, p<0.0001). Findings were confirmed in sensitivity analyses that substituted continuous Charlson-Romano Index with categorical variable or all comorbidities and additionally cardiovascular risk factors, with minimal attenuation of HR.

Conclusions Gout is associated with a higher risk of development of hearing loss in older adults. Future studies need to assess the underlying mechanisms of this association
%U https://bmjopen.bmj.com/content/8/8/e022854