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Gout and hearing impairment in the elderly: a retrospective cohort study using the US Medicare claims data
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  • Published on:
    Gout and hearing impairment
    • Shih-Wei Lai, Attending physician 1College of Medicine, China Medical University, Taichung, 404, Taiwan

    One retrospective cohort study conducted by Singh and colleagues reported that gout is associated with a 1.4-fold increased risk of hearing impairment in older adults (hazard ratio 1.44, 95% CI 1.40-1.49).1 Some caveats should be discussed. Gout is a form of arthritis due to the deposition of monosodium urate crystals within joints, which is associated with persistently high levels of uric acid in the blood.2 Clinically, it is not feasible to check the uric acid levels every day. So we cannot be sure the onset date of hyperuricemia. Because hearing impairment is an insidious condition without a well-defined onset date, we can only approximate the onset date by applying the claims-based definition of ICD-9-CM 389. When a cohort study examines the relationship between hyperuricemia and hearing impairment, we cannot definitely determine which condition comes first because of the onset date not clear. Gout is characterized by recurrent acute attacks of joint inflammation.3 When an acute attack subsides, the joint inflammation is also relieved. Thus, how can we make a reasonable link between the remission state of gout and hearing impairment? That is, how does the remission state of gout have an impact on the insidious course of hearing impairment? Similarly Parkinson’s disease is an insidious condition, but no association is detected between gout and Parkinson’s disease in older adults in Taiwan.4
    Perhaps there could be an association between gout and hearing impairment....

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    Conflict of Interest:
    None declared.