BACKGROUND:

It remains unknown whether hearing loss increases the risk of Alzheimer's disease. This study aimed to examine the association between hearing loss and risk of Alzheimer's disease in older people in Taiwan.

METHODS:

Analyzing the database from Taiwan's National Health Insurance Program, this case-control study enrolled 488 subjects ≥65 years old with newly diagnosed Alzheimer's disease as a case group and 1952 subjects without Alzheimer's disease as a control group from 1998-2011. Patients with Alzheimer's disease and other comorbidities were identified by analyzing ICD-9 coding in claims data. The association of hearing loss, other comorbidities, and risk of Alzheimer's disease were compared between groups.

RESULTS:

After controlling for confounders, multivariable logistic regression showed an adjusted odds ratio of Alzheimer's disease of 1.39 in people with hearing loss (95% CI, 1.05-1.84) versus those without. Parkinson's disease (OR 4.44; 95% CI, 2.54-7.78), head injury (OR 2.31; 95% CI, 1.46-3.66), depression (OR 1.68; 95% CI, 1.19-2.39), hypertension (OR 1.40; 95% CI, 1.10-1.79), and age (each year, OR 1.03; 95% CI, 1.01-1.05) also showed strong links with Alzheimer's.

CONCLUSIONS:

Hearing loss is associated with increased risk of Alzheimer's disease in older people in Taiwan.

Helicobacter pylori infection (HPI) imposes substantial social costs and is of major etiological importance in peptic ulcer disease, gastric cancer, and accelerated cardiovascular diseases. This study determined the risk of acute coronary syndrome (ACS) associated with HPI in a nationwide retrospective cohort study. By using the Taiwan National Health Insurance Research Database (NHIRD), we identified patients diagnosed with HPI from 1998 to 2010. In addition, we randomly selected non-HPI controls frequency-matched by age, sex, and index year from the general population free of HPI. The risk of ACS was analyzed using Cox proportional hazards regression models in which sex, age, and comorbidities were included as variables. We identified 17,075 participants for the HPI group and selected 68,300 participants for the comparison group. The incidence rates were increased in the patients in the HPI group compared with those in the comparison group. Overall, the HPI patients exhibited a 1.93-fold high crude hazard ratio for ACS, and a 1.48-fold adjusted hazard ratio after age, sex, and comorbidities were adjusted. However, the overall adjusted hazard ratio of ACS increased with increasing age with a 3.11 to 8.24 adjusted hazard ratio among the various age groups. Several comorbidities, such as diabetes, hyperlipidemia, and COPD exhibited synergistic effects for ACS risk. We determined a significant association between ACS and comorbidities and provide evidence to encourage clinicians to observe ACS-related comorbidities.

BACKGROUND & AIMS:

The relationship between hepatitis C virus (HCV) infection and peripheral arterial disease (PAD) development remains unclear.

METHODS:

Health insurance claims data were used to construct a cohort of HCV-infected patients diagnosed during the period 1998-2011. Patients younger than 20 years and those with history of hepatitis B or PAD were excluded. We selected 7641 HCV-infected patients and 30564 matched controls. The adjusted risk of developing PAD was analyzed using a multivariate Cox hazard model.

RESULTS:

The results show that the excess risk of PAD development in HCV-infected patients is 1.43-fold higher (95% CI=1.23-1.67) compared with non-HCV patients. The adjusted risk of PAD development increases with age; compared with the 20-34 year-old patients, the risk is 3.96-fold higher in HCV-infected patients aged 35-49 years, and 11.7-fold higher in those aged 65 years and above. CKD/ESRD has the highest risk for PAD (HR=1.80, 95% CI=1.29-2.53). HCV-infected patients with four comorbidities exhibit a substantially higher risk of developing PAD (HR=9.25, 95% CI=6.35-13.5). Excess risk of developing PAD is observed from the first year of follow-up till the third year.

CONCLUSION:

HCV-infected patients have an independently higher risk of developing PAD. HCV-infected patients with comorbidity have increased risk of developing PAD.

OBJECTIVE:

Patients diagnosed with depression are at an elevated risk of physical illness. Researchers have noted that depression negatively affects immune function and leads to increased susceptibility to infection, including herpes zoster. Few epidemiologic studies have been conducted on whether patients with depression are at a higher risk of herpes zoster. We conducted a retrospective population-based cohort study to investigate whether depression is associated with an increased risk of herpes zoster.

METHOD:

We identified 22,886 patients with depression (ICD-9: 296.2, 296.3, 300.4, and 311) in 2000-2005 from National Health Insurance (Taiwan) claims and selected 91,542 controls, frequency matched by sex, age, and index year. We calculated the risk of herpes zoster (ICD-9: 053) between the 2 cohorts in Cox proportional hazards regression.

RESULTS:

Incidence of herpes zoster was 1.3 times higher in patients with depression than in controls (4.58 vs 3.54 per 1,000 person-years, respectively), with an adjusted hazard ratio (HR) of 1.11 (95% CI, 1.01-1.21). In subjects aged 45-54 years, those with depression had a significantly higher risk than controls (HR = 1.44; 95% CI, 1.19-1.73). In multivariable analysis, malignant conditions (HR = 1.41; 95% CI, 1.15-1.72), rheumatic diseases (HR = 1.28; 95% CI, 1.14-1.44), hyperlipidemia (HR = 1.24; 95% CI, 1.14-1.36), renal diseases (HR = 1.21; 95% CI, 1.08-1.36), anxiety (HR = 1.21; 95% CI, 1.07-1.38), sleep disorder (HR = 1.20; 95% CI, 1.09-1.31), and hypertension (HR = 1.11; 95% CI, 1.02-1.21) were potential risk factors for herpes zoster.

CONCLUSIONS:

Patients diagnosed with depression are at an elevated risk of herpes zoster, particularly those aged 45 to 54 years and those with comorbidities, including renal diseases, hyperlipidemia, malignant conditions, rheumatic diseases, hypertension, anxiety, and sleep disorder.

BACKGROUND AND PURPOSE:

This study evaluated the effect of migraine on the subsequent development of epilepsy.

METHODS:

A total of 10,016 patients diagnosed with migraine [ICD-9-CM (International Classification of Diseases, Ninth Revision, Clinical Modification) 346] during the period between 2000 and 2009 who were aged older than 20 years were identified as the migraine cohort. A comparison cohort including 40 064 people were enrolled in this study. We calculated the adjusted hazard ratio (aHR) for developing epilepsy (ICD-9-CM 345) in the two cohorts after adjusting for age, sex and comorbidities. Kaplan-Meier analysis was used to measure the cumulative epilepsy incidence, and the log-rank test was used to estimate the differences between two curves.

RESULTS:

The cumulative incidence of epilepsy was significantly high in the migraine cohort. The aHR for developing epilepsy in the migraine cohort was 1.85 (95% CI = 1.22-2.81). The aHR for developing epilepsy in the female migraineurs was significantly different compared with that of the non-migraine cohort (aHR = 2.04, 95% CI = 1.20-3.48) and male migraineurs (aHR = 1.53, 95% CI = 0.78-3.00). The incidence of developing epilepsy was increased in patients aged 20-44 years, yielding an aHR of 2.14 (95% CI = 1.24-3.68). The comorbidity-specific aHR for developing epilepsy associated with migraine was 2.33 (95% CI = 1.25-4.34) in patients without any comorbidities, and 1.73 (95% CI = 1.02-2.93) in those with comorbidities.

CONCLUSION:

This population-based retrospective cohort study revealed a significant increase in subsequent epilepsy risk in young adults with migraine.