Identifying Health-Related Conditions Associated with Tinnitus in Young Adults

Abstract

Objective: The present study investigated the epidemic of tinnitus in college-aged young adults. Our first objective was to identify health conditions associated with tinnitus in young adults. The second objective was to evaluate the predictive utility of some known risk factors.

Study design: A cross-sectional design was used to investigate the prevalence and risk factors for tinnitus.

Setting: A questionnaire was distributed, reaching out to a large college-aged population. A total of 2258 young adults aged 18-30 years were recruited from April 2021 to February 2022.

Interventions: A questionnaire was administered to investigate the epidemiology of tinnitus in a population of college-aged young adults.

Results: About 17.7% of young adults reported bothersome tinnitus perception lasting for ≥5 min in the last 12 months. The prevalence of chronic tinnitus (bothersome tinnitus for ≥1 year) and acute tinnitus (bothersome tinnitus for <1 year) was 10.6% and 7.1%, respectively. About 19% of the study sample reported at least one health condition. Individuals reporting head injury, hypertension, heart disease, scarlet fever, and malaria showed significantly higher odds of reporting chronic tinnitus. Meningitis and self-reported hearing loss showed significant associations with bothersome tinnitus. The prevalence of chronic tinnitus was significantly higher in males reporting high noise exposure, a positive history of reoccurring ear infections, European ethnic background, and a positive health history. Risk modeling showed that noise exposure was the most important risk factor for chronic tinnitus, followed by sex, reoccurring ear infections, and a history of any health condition. A positive history of COVID-19 and self-reported severity showed no association with tinnitus. Individuals reporting reoccurring ear infections showed a significantly higher prevalence of COVID-19.

Conclusions: While young adults with health conditions are at a higher risk of reporting tinnitus, the predictive utility of a positive health history remains relatively low, possibly due to weak associations between health conditions and tinnitus. Noise, male sex, reoccurring ear infections, European ethnicity, and a positive health history revealed higher odds of reporting chronic tinnitus than their counterparts. These risk factors collectively explained about 16% variability in chronic tinnitus, which highlights the need for identifying other risk factors for chronic tinnitus in young adults.

Keywords: COVID-19; cochlear synaptopathy; epidemiology; noise; prevalence; risk factor; tinnitus; tinnitus phenotypes.

Figure 1

A bar chart on the top left panel shows the prevalence of tinnitus in the study sample. The rest of the bar charts show the category-specific prevalence of tinnitus for sex, ethnicity, reoccurring ear infections, any health conditions, and COVID-19.

Figure 2

Bar charts showing the category-specific prevalence of tinnitus between individuals with and without a positive history of health conditions. Hypertension, head injury, hearing loss, and heart disease revealed a significant association with tinnitus.

Figure 3

The top row presents the receiver operating curves (ROC) (mean ± 95% CI) for tinnitus categories obtained using the logistic regression model and Gaussian Naive Bayes. The logistic regression model revealed the highest ROC values for predicting tinnitus categories among other tested models. The middle and bottom rows present tinnitus category-specific feature analysis for the logistic regression model. The Shapley additive explanations (SHAP) values present the relative importance of the predictors. Positive SHAP values for a specific feature indicate that the model weighted it higher than the features with negative SHAP values. For example, the model weight noise exposure values “4” and “5” were more than “1” and “2” while categorizing a participant in the chronic tinnitus group. The model weighted noise exposure values “1” and “2” were more than “4” and “5” while categorizing a participant in the no tinnitus group. The SHAP values for each model are sorted in descending order of importance of the predictors contributing to the model’s performance.