ObjectiveTo assess incidence and changes in tinnitus and bothersome tinnitus as well as associated risk factors in a large sample of UK adults.DesignProspective cohort study.SettingUK.ParticipantsFor cross-sectional analysis, a group of 168 348 participants aged between 40 and 69 years with hearing and tinnitus data from the UK Biobank resource. Longitudinal analysis included a subset of 4746 people who attended a 4-year retest assessment.Main outcome measuresPresence and bothersomeness of tinnitus.Results17.7% and 5.8% of participants reported tinnitus or bothersome tinnitus, respectively. The 4-year incidence of tinnitus was 8.7%. Multivariate logistic regression models suggested that age, hearing difficulties, work noise exposure, ototoxic medication and neuroticism were all positively associated with both tinnitus and bothersome tinnitus. Reduced odds of tinnitus, but not bothersome tinnitus, was seen in alcohol drinkers versus non-drinkers. Male gender was associated with increased odds of tinnitus, while female gender was associated with increased odds of bothersome tinnitus. At follow-up, of those originally reporting tinnitus, 18.3% reported no tinnitus. Of those still reporting tinnitus, 9% reported improvement and 9% reported tinnitus becoming more bothersome, with the rest unchanged. Male gender and alcohol consumption were associated with tinnitus being reported less bothersome, and hearing difficulties were associated with the odds of tinnitus being reported as more bothersome.ConclusionsThis study is one of the few to provide data on the natural history of tinnitus in a non-clinical population, suggesting that resolution is relatively uncommon, with improvement and worsening of symptoms equally likely. There was limited evidence for any modifiable lifestyle factors being associated with changes in tinnitus symptoms. In view of the largely persistent nature of tinnitus, public health strategies should focus on: (1) primary prevention and (2) managing symptoms in people that have tinnitus and monitoring changes in bothersomeness.

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This study aimed to estimate the prevalence of hearing loss in the Philippines using a nationally representative sample. A cross-sectional national survey was undertaken utilizing a 3-stage stratified cluster design. Participants in the present study comprised 2275 adults and children with pure tone hearing assessment results. Prevalence of moderate or worse hearing loss, defined as 4FA ≥41 dBHL, was 7.5% in children <18 years, 14.7% in adults between 18 and 65 years, and 49.1% in adults >65 years. Factors associated with greater risk of moderate hearing loss in the better ear were presence of a middle ear condition (adjusted odds ratio = 2.39, 95% confidence interval = 1.49-3.85) and socioeconomic status (household income; adjusted odds ratio = 1.64, 95% confidence interval = 1.23-2.19). Age was also associated with increased risk, with adjusted odds ratios varying with age category. Prevalence of wax occlusion and outer and middle ear disease was 12.2% and 14.2%, respectively. Prevalence of hearing loss, outer, and middle ear disease appear comparatively high in the Philippines when compared with rates reported in high-income countries. Higher proportions of severe to profound hearing loss were also identified, indicating that there is both an increased prevalence and severity of hearing loss in this population.

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Objectives: Adverse prenatal and early childhood development may increase susceptibility of hearing loss in adulthood. The objective was to assess whether indices of early development are associated with adultonset hearing loss in adults ≥18 years.Design: In a systematic review and meta-analysis, four electronic databases were searched for studies reporting associations between indices of early development (birth weight and adult height) and adult-onset hearing loss in adults ≥18 years. We screened studies, extracted data, and assessed risk of bias. Authors were contacted to provide adjusted odds ratios from a logistic regression model for relationships between birth weight/adult height and normal/impaired hearing enabling a twostep individual patient data random-effects meta-analysis to be carried out. The study is registered with PROSPERO, CRD42020152214.Results: Four studies of birth weight and seven of adult height were identified. Three studies reported smaller birth weight associated with poorer adult hearing. Six studies reported shorter height associated with poorer hearing. Risk of bias was low to moderate. Four studies provided data for two-step individual patient data random-effects meta-analysis. Odds of hearing impairment were 13.5% lower for every 1 kg increase in birth weight [OR: 0.865 (95% confidence interval: 0.824 to 0.909)] in adulthood over two studies (N=81,289). Every 1 cm increase in height was associated with a 3% reduction in the odds of hearing impairment [OR: 0.970 (95% confidence interval: 0.968 to 0.971)] over four studies (N=156,740). Conclusions:Emerging evidence suggests that adverse early development increases the likelihood of hearing impairment in adulthood.Research and public health attention should focus on the potential for prevention of hearing impairment by optimizing development in early life.

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Hearing impairment affects a person’s ability to communicate effectively. People with hearing loss (HL) report difficulty communicating in noise, even when the HL is compensated by conventional amplification. This study aims to investigate factors that contribute to understanding speech in noise. Nine adults with HL and nine controls participated in the study. The test-battery include auditory, cognitive and linguistic tests. For the HL group, auditory stimuli were filtered with NAL-RP prescription to compensate for their HL. Results indicate a significant difference in performance between the groups on the Modulation Detection Threshold (MDT) test [F (1, 15) = 3.24, p =0.04] and the speech recognition in noise test [f (1, 15) = 25.6, p&lt;0.001]. HL group performed better on the MDT and poorer at recognising speech in noise possibly due to broadening of auditory filters. With the broadened auditory filters in mind, this result supports the fact that they would have poor frequency specificity, detrimental for speech recognition. HL group performed better than the control group on the cognitive spare capacity test [f (1, 15) = 4.72, p= 0.04]. Preliminary data suggests that adults with HL may compensate for hearing-related difficulties in certain situations by using their cognitive skills.

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