Association between tinnitus and hearing impairment among older adults with age-related hearing loss: a multi-center cross-sectional study

Zhifeng Chen; Yan Lu; Chenyu Chen; Shaolian Lin; Ting Xie; Xiaoyang Luo; Yanchun Lin; Yuqing Chen; Yong Feng; Guanxia Xiong; Xiulan Ma; Chaojun Zeng; Chang Lin

doi:10.3389/fneur.2024.1501561

Association between tinnitus and hearing impairment among older adults with age-related hearing loss: a multi-center cross-sectional study

Front Neurol. 2024 Dec 17:15:1501561. doi: 10.3389/fneur.2024.1501561. eCollection 2024.

Authors

Zhifeng Chen^#^{1

2

3}, Yan Lu^#^{1

2}, Chenyu Chen^#^{4

5}, Shaolian Lin^#^{1

2}, Ting Xie⁶, Xiaoyang Luo^{1

2}, Yanchun Lin^{1

2}, Yuqing Chen^{1

2}, Yong Feng⁷, Guanxia Xiong⁸, Xiulan Ma⁹, Chaojun Zeng^{1

10

11}, Chang Lin^{1

2

3}

Affiliations

¹ Department of Otorhinolaryngology Head and Neck Surgery, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China.
² Department of Otorhinolaryngology Head and Neck Surgery, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, China.
³ Fujian Institute of Otolaryngology, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China.
⁴ ENT Institute and Department of Otorhinolaryngology, Eye & ENT Hospital, Fudan University, Shanghai, China.
⁵ NHC Key Laboratory of Hearing Medicine Research, Eye & ENT Hospital, Fudan University, Shanghai, China.
⁶ Department of Hepatopancreatobiliary Surgery, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China.
⁷ Department of Otorhinolaryngology, Xiangya Hospital Central South University, Changsha, China.
⁸ Department of Otorhinolaryngology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
⁹ Department of Otolaryngology Head and Neck Surgery, Shengjing Hospital of China Medical University, Shenyang, China.
¹⁰ Department of Otolaryngology, Affiliated Hospital of Putian University, Putian, China.
¹¹ Putian Institute of Otolaryngology, Affiliated Hospital of Putian University, Putian, China.

^# Contributed equally.

Abstract

Objective: The relationship between tinnitus in the elderly with hearing loss remains elusive. This study aimed to reveal the association between tinnitus and hearing impairment among older adults with age-related hearing loss (ARHL).

Methods: This cross-sectional study was conducted among a population of outpatients diagnosed with ARHL at four medical centers in different regions of China, from June 2020 to June 2023. ARHL patients were divided into two groups based on their self-reported tinnitus: tinnitus and non-tinnitus. Multivariable linear regression models were used to assess the association between tinnitus and hearing impairment in ARHL patients. Subgroup analyses, stratified by gender and age, were performed to further evaluate the association.

Results: A total of 418 older adults with ARHL were included in the study. Compared to the non-tinnitus group, ARHL patients with tinnitus had lower hearing thresholds (β = -5.07; 95% confidence interval (CI) -9.32 to -0.81; p = 0.020). On subgroup analyses stratified by gender and age, the male ARHL patients with tinnitus still had lower hearing thresholds compared to those without tinnitus (β = -6.96; 95% CI -12.70 to 1.22; p = 0.018). In females, tinnitus was not associated with hearing thresholds (β = -3.69; 95% CI -10.11 to 2.74, p = 0.262). There was no association between tinnitus and hearing thresholds in both the age group of ≥70 years (β = -4.31; 95% CI -9.65 to 1.03; p = 0.116) and the age group of <70 years (β = -3.54; 95% CI -9.96 to 2.89; p = 0.282).

Conclusion: Based on this multi-center cross-sectional study, we reveal that there is no evidence for the assumption that tinnitus may exacerbate hearing loss in the elderly for the first time. On the contrary, tinnitus is associated with better hearing in the male elderly with ARHL. More extensive longitudinal studies are needed to give a comprehensive insight of the present findings and the underlying mechanisms.

Keywords: age-related hearing loss; association; elderly; gender; pure-tone average; tinnitus.

Grants and funding

The author(s) declare that financial support was received for the research, authorship, and/or publication of this article. This research was supported by the Science and Technology Innovation Joint Funding Project of Fujian Province (Grant No. 2021Y9099), National Key Research and Development Project of China (Grant No. 2020YFC2005204), Fujian Provincial Clinical Medical Research Center for Ear, Nose, and Throat Difficulty Diseases (Grant No. EB-YJZX) under the Foundation Project to Fujian Provincial Science and Technology Innovation Platform (Grant NO. 2021Y2002), and Natural Science Foundation of Fujian Province (Grant No. 2022J01679).