Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Aug;11(8):e02074.
doi: 10.1002/brb3.2074. Epub 2021 Jul 21.

The evaluation of global cognitive and emotional status of older patients with chronic tinnitus

Anna Rita Fetoni  1   2 , Tiziana Di Cesare  2 , Stefano Settimi  2 , Bruno Sergi  1   2 , Giorgia Rossi  2 , Rita Malesci  3 , Camillo Marra  2   4 , Gaetano Paludetti  1   2 , Eugenio De Corso  1   2
Affiliations

The evaluation of global cognitive and emotional status of older patients with chronic tinnitus

Anna Rita Fetoni et al. Brain Behav. 2021 Aug.

Abstract

Objectives: Tinnitus is a common symptom largely impactful on quality of life, especially in the elderly. Our aim was to evaluate the efficacy of self-administered screening tests to correlate the severity of subjective perception of tinnitus with emotional disorders and the overall cognitive status.

Methods: Patients aged ≥ 55 years with chronic tinnitus were recruited and submitted to a complete audiological evaluation; Tinnitus Handicap inventory (THI); Hospital Anxiety and Depression Scale (HADS-A and HADS-D) and Mini-Mental State Examination (MMSE). Demographic and audiological features of patients with and without cognitive impairment (MMSE score cut-off of 24/30) were analyzed in order to reveal the relationship among tinnitus, emotional disorders, and cognitive dysfunction.

Results: 102 patients were recruited (mean age: 70.4 ± 9.6). THI score was directly related to HADS-A score (r = .63) HADS-D score (r = .66), whereas there was no relationship between tinnitus severity and MMSE (r = .13). CI and n-CI groups did not differ in the characteristics of tinnitus (p > .05), however, hearing threshold (p = .049) and anxious depressive traits measured with HADS-A (p = .044) and HADS-D (p = .016) were significantly higher in the group with cognitive impairment. Furthermore, age ≥ 75 years (p = .002, OR = 13.8), female sex (p = .032; OR = 6.5), severe hearing loss (p = .036; OR = 2.3), and anxiety (p = .029; OR = 9.2) resulted risk factors for CI. Therefore, in CI group MMSE score was inversely related to age (r = -.84).

Conclusions: Cognitive impairment and psychiatric discomfort should be considered in tinnitus patients, related to increasing age, female sex, and severe hearing loss. Thus, self-administered questionnaires can be useful in addressing clinical approach.

Keywords: cognitive impairment; older patients; psychiatric disorders; tinnitus.

PubMed Disclaimer

Conflict of interest statement

Authors have not received any funds from any kind of organization; the study is entirely the result of our work. We deny any kind of conflict of interest.

Figures

FIGURE 1
FIGURE 1
The average audiogram of both ears in our sample (mean PTA = 39.7 ± 22.65 dB HL); min: lowest observation; max: highest observation
FIGURE 2
FIGURE 2
Histograms display percentage distribution of patients in the different levels of severity of hearing loss and tinnitus perception
FIGURE 3
FIGURE 3
Relationship between THI score and HADS‐A score; Pearson's r = .63
FIGURE 4
FIGURE 4
Relationship between THI score and HADS‐D score; Pearson's r = .66
FIGURE 5
FIGURE 5
Relationship between THI score and MMSE score; Pearson's r = .13
See this image and copyright information in PMC

References

    1. Anzivino, R., Conti, G., Di Nardo, W., Fetoni, A. R., Picciotti, P. M., Marra, C., Guglielmi, V., Fortunato, S., Forli, F., Paludetti, G., & Berrettini, S. (2019). Prospective evaluation of cognitive functions after rehabilitation with cochlear implant or hearing aids: Preliminary results of a multicentric study on elderly patients. American Journal of Audiology, 28, 762–774. 10.1044/2019_AJA-HEAL18-18-0176 - DOI - PubMed
    1. Araneda, R., De Volder, A. G., Deggouj, N., & Renier, L. (2015). Altered top‐down cognitive control and auditory processing in tinnitus: Evidences from auditory and visual spatial stroop. Restorative Neurology and Neuroscience, 33, 67–80. 10.3233/RNN-140433 - DOI - PubMed
    1. Beaudreau, S. A., & O'Hara, R. (2008). Late‐life anxiety and cognitive impairment: A review. American Journal of Geriatric Psychiatry, 2008(6), 790–803. 10.1097/JGP.0b013e31817945c3 - DOI - PubMed
    1. Bhatt, J. M., Lin, H. W., & Bhattacharyya, N. (2016). Prevalence, severity, exposures, and treatment patterns of tinnitus in the United States. JAMA Otolaryngology–head & Neck Surgery, 142, 959. 10.1001/jamaoto.2016.1700 - DOI - PMC - PubMed
    1. Bigelow, R. T., Reed, N. S., Brewster, K. K., Huang, A., Rebok, G., Rutherford, B. R., & Lin, F. R. (2020). Association of hearing loss with psychological distress and utilization of mental health services among adults in the United States. JAMA Netw Open, 3, e2010986. 10.1001/jamanetworkopen.2020.10986 - DOI - PMC - PubMed