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

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.