Risk of Alzheimer Disease and Vascular Dementia in Patients With Peripheral Vestibular Disorders: A Longitudinal Study of 140,726 Participants.

Objective: The associations between peripheral vestibular disorders (PVDs)-specifically Meniere's disease, benign paroxysmal positional vertigo (BPPV), vestibular neuritis, and unspecified PVD-and dementia risk are unclear. Methods: By using data from the Taiwan National Health Insurance Research Database, this study included 70,363 patients aged ≥45 years with PVD between 1998 and 2011. An age-matched control group of 70,363 individuals without PVD was also established. All the included participants were followed up from the time of enrollment until the end of 2013 to assess the risk of dementia-related conditions, including Alzheimer's disease (AD), vascular dementia, and unspecified dementia. Results: Cox proportional hazards regression models, adjusted for demographic characteristics and psychiatric comorbidities, revealed that patients with PVD exhibited a significantly elevated risk of any form of dementia during the follow-up period (hazard ratio [HR] = 1.83, 95% CI, 1.69-1.97) compared with the control group. Notably, patients with BPPV exhibited the highest risk of AD (HR = 3.14, 95% CI, 2.35-4.19), followed by Meniere's disease (HR= 2.79, 95% CI, 2.17-3.59) and vestibular neuritis (HR = 2.66, 95% CI, 2.11-3.35). Conclusions: PVDs are a risk factor for dementia, regardless of psychiatric comorbidities. Further research is warranted to elucidate the pathophysiological mechanisms underlying the association between PVDs and dementia.