Epidemiology of Menieres Disease
Timothy C. Hain, MD Page last modified: November 11, 2013
There is considerable disagreement in the world literature about the incidence (new cases/year) and prevalence (all cases in population) of Menieres disease. To summarize, it appears that that Menieres disease has a prevalence of about 200 cases/100,000 persons in the United States, or in other words, about 0.2 % of the population has Meniere's disease. The prevalence may vary internationally, possibly being lower by as much as a factor of 10 in some populations. The prevalence increases with age, rather linearly, up to the age of 60.
|Our experience at Chicago Dizziness and Hearing -- Meniere's disease is roughly equally distributed between women and men, with a peak age of onset of about 60.|
The author's clinical practice, Chicago Dizziness and Hearing, has a large experience with Meniere's. Simply looking at age in persons diagnosed with Meniere's, according to gender (blue are women), produces the graph above. Of course this graph is drawn from the clinic population, but might reasonably reflect the prevalence of Meniere's in Chicago Illinois. It again shows increasing prevalence with age up to the age of 60.
For England, Cawthorne and Hewlett (1954) reported 157 cases/100,000 cases based on the records of 8 general practices in England during the year ending March 1952. It is unclear in their report whether those figures reflect incidence or prevalence, although Arenberg et al suggested that it is an incidence figure (1980). If prevalence, this figure would be quite similar to a figure reported for the US by Wadislowvsky and associates, later). If incidence, this figure would suggest a much higher prevalence (roughly .16 * 25%, or about 4 % of the population). We think this is highly unlikely. While others have alsosuggested a prevalence rate as high as 1% (e.g. Morrison, 1995; Harrison and Naftalin, 1968), there seems to be little good evidence for this assertion. Goodman (1957) presented data suggesting of a prevalence of .056%, which is similar to the figure found in the US by Wadislowvsky and associates.
In Japan there have been several large epidemiological studies. According to Watanabe (1988), Meniere's disease was rare until the 1950's. Since the end of the second World War, there was a rapid increase in the number of patients seen with Meniere's disease. In these studies they defined Menieres as the combination of repeated attacks of vertigo, fluctuating cochlear symptoms with vertigo, and exclusion of other diseases (Watanabe et al, 1995). They reported average age of onset of 41-42 years of age, with a peak incidence at age 30-39. The prevalence was 16-17 per 100,000. This figure appears low. A more recent study of Shojaku and Watanabe (1997) found a prevalence of between 21.4 and 36.6/100,000 , which may still be a low estimate.
There have been several studies of the US population. In the Framingham study, (Framingham, Mass, USA) 1.48 % of the population claimed to have a history of Menieres disease (Moscicki et al, 1985). This large prevalence figure likely derives from a tendency of many physicians to lump all cases of recurrent vertigo into the category of Meniere's disease (Slater, 1988). Wladislavosky and associates, at the Mayo Clinic reported a prevalence in 1980 in the Rochester Minnesota population of 218.2 cases/100,000, and a incidence rate of new cases of 15.3/100,000/year. They also reported a diagnosis rate basically proportional to age up to the age of 60, with a decline thereafter. Bilaterality was found in 34% of their cohort. They commented that rates in Rochester MN appear less than those reported in England and Sweden.
In Finland, prevalence was reported to be 43/100,000 and incidence was 4.3/100,000 (Kotimaki et al, 1999). This figure appears low compared to the United States and England.
In Sweden, Stahle et al reported the incidence for 1973 of Menieres in Uppsala at 45/100,000 population.This study also used more stringent criteria for diagnosis than others have had, and is generally thought to be an underestimate. Menieres disease, by their criteria, is about 4 times as common as Otosclerosis.
In Italy, Celestino and Ralli reported an incidence rate of 8/100,000, and estimated that the prevalence was about 0.4% of the population. This would assume that most people with Meniere's live with the disease, on average, for 50 years. Their case distribution, not normalized for the age of the the population, peaked at 41-50.
It is generally felt that both sexes are equally affected. However there may be a difference in the distribution of severely disabled patients. Stahle (1976) noted that the number of males exceed females (206:150) in this group.
Little data is available regarding racial predisposition to Menieres disease. In 1972 Nsamba reported that Meniere's disease was uncommon in Uganda. Caparaosa (1963) reported that Meniere's disease was predominantly a disease of the white race and occurred only rarely in the black. On the other hand, Kitahara and Futaki (1974) found that the incidence of Meniere's disease was approximately the same between American whites and American Blacks. Meniere's disease is rare in the southwestern American Indian (Wiet, 1979). To summarize, at present it is not clear whether there are racial predispositions to Meniere's disease.