title: Regional Pattern of Dementia and Prevalence of Hearing Impairment in Germany.
abstract: OBJECTIVE
  To determine the association between hearing impairment and dementia.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Claims data of the Allgemeine Ortskrankenkasse, the largest public health insurance company in Germany.
  
  
  METHODS
  Age-stratified sample of all insured persons aged 65 and above in the first quarter of 2007 (N = 1,338,462).
  
  
  METHODS
  Metaregression analysis on the association between regional prevalence of dementia and hearing impairment controlled for major vascular risk factors, including hypertension, hypercholesterolemia, diabetes mellitus, and cerebrovascular disease. Dementia and hearing impairment diagnoses were defined according to International Classification of Diseases, Tenth Revision, codes. Ninety-five regions were distinguished according to the two-digit postal code of the place of residence.
  
  
  RESULTS
  A significant association was found between regional prevalences of dementia and hearing impairment that was preserved when controlling for major vascular risk factors (P = .003). Regional dementia prevalence increased by approximately 0.23% when the prevalence of hearing impairment increased by 1 standard deviation.
  
  
  CONCLUSIONS
  The relationship between hearing impairment and dementia has been repeatedly demonstrated on the individual level. The results of the current study confirm that this relationship also exists on a regional level. These findings underscore the potential role of hearing impairment as a risk factor for dementia that will be relevant for the management of elderly patients in general practice.
authors.affiliation: Department of Psychosomatic Medicine, University Medicine Rostock, Rostock, Germany.|German Center for Neurodegenerative Diseases (DZNE), Rostock, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Teipel
authors.affiliation: German Center for Neurodegenerative Diseases (DZNE), Rostock, Germany.|Rostock Center for the Study of Demographic Change, Rostock, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Fritze
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, University Medicine Rostock, Rostock, Germany.
authors.forename: Attila
authors.initials: A
authors.lastname: Ovari
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, University Medicine Rostock, Rostock, Germany.
authors.forename: Anne
authors.initials: A
authors.lastname: Buhr
authors.affiliation: Department of Psychosomatic Medicine, University Medicine Rostock, Rostock, Germany.|German Center for Neurodegenerative Diseases (DZNE), Rostock, Germany.
authors.forename: Ingo
authors.initials: I
authors.lastname: Kilimann
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, University Medicine Rostock, Rostock, Germany.
authors.forename: Gabriele
authors.initials: G
authors.lastname: Witt
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, University Medicine Rostock, Rostock, Germany.
authors.forename: Hans-Wilhelm
authors.initials: HW
authors.lastname: Pau
authors.affiliation: Rostock Center for the Study of Demographic Change, Rostock, Germany.|Institute for Sociology and Demography, University of Rostock, Rostock, Germany.|German Center for Neurodegenerative Diseases, Bonn, Germany.|Max Planck Institute for Demographic Research, Rostock, Germany.
authors.forename: Gabriele
authors.initials: G
authors.lastname: Doblhammer
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D003704:Dementia / Q000150:complications / Q000453:epidemiology*; D005260:Female; D005858:Germany / Q000453:epidemiology; D034381:Hearing Loss / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors
keywords: cardiovascular disease; dementia prevalence; hearing loss; risk factors; sensory deprivation