Cross-sectional and Longitudinal Associations Between Tinnitus and Mental Health in a Population-Based Sample of Middle-aged and Elderly Persons

Oosterloo, Berthe C; Feijter, Maud de; Croll, Pauline H.; Jong, Robert J. Baatenburg de; Luik, Annemarie I.; Goedegebure, André

doi:10.1001/jamaoto.2021.1049

Cited by 13 publications

(16 citation statements)

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“…Several recent studies have reviewed the positive influence of physical activity on mental health, mood, depression, anxiety, and their biological and psychosocial mechanisms (Penedo & Dahn 2005;Kanning & Schlicht 2010;Rebar et al 2015;Kandola et al 2019). Associations between tinnitus and these negative states have been confirmed in several studies (Bhatt et al 2017;Trevis et al 2018;Oosterloo et al 2021). Based on these, we can reasonably speculate that physical activity has a direct or indirect positive impact on tinnitus.…”

Section: Introductionmentioning

confidence: 70%

Associations Between Physical Activity, Tinnitus, and Tinnitus Severity

et al. 2022

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Objectives: To examine the associations between physical activity and tinnitus development and physical activity and tinnitus severity in a large representative sample of US adults.Design: Data were obtained from 3826 eligible participants (20 to 69 years) in the National Health and Nutrition Examination Survey between 2015 and 2016. Physical activity was assessed using a Global Physical Activity Questionnaire. We used multivariable logistic regression to test the associations of physical activity (without physical activity, with physical activity) and amount of physical activity (min/week, in quartiles) with tinnitus symptoms. Adults with depressive symptoms were excluded, and the models were controlled for relevant sociodemographic, lifestyle, and health-related covariates. A restricted cubic spline was used to explore the dose-response relationship between the amount of physical activity and tinnitus.Results: Overall, 12.8% of the population who engaged in physical activity reported tinnitus, compared with 18.5% of the population who did not (p = 0.005). Subgroup analysis based on the amount of physical activity showed that participants who performed physical activity (150 to 300, 310 to 540, and 550 to 4800 min/week) had lower risks of tinnitus than those with no physical activity (odds ratio = 0.72, 0.56, and 0.62, respectively), after adjusting for covariates. However, no correlation was observed between physical activity and tinnitus severity in the present study. The dose-response analysis showed a nonlinear relationship (P for nonlinearity = 0.04) between the amount of physical activity and the risk of tinnitus.Conclusions: Physical activity may be associated with a reduced risk of tinnitus. Further research using a longitudinal design is required to confirm these findings and clarify the direction of causation.

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Section: Introductionmentioning

confidence: 70%

Associations Between Physical Activity, Tinnitus, and Tinnitus Severity

et al. 2022

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“…Previous literature has shown an association between tinnitus and depression, but these studies either had small samples or were not population-based samples, impeding generalization of findings to the population level (3). In addition, although a cross-sectional study is not inherently inferior to a cohort study, prior studies were cross-sectional (13,16,18,21,22), which might not permit the identification of a causal relationship. Furthermore, some studies advocate that tinnitus does not relate to depression (23).…”

Section: Discussionmentioning

confidence: 99%

Increased Risk of Major Depressive Disorder Following Tinnitus: A Population-Based Study

et al. 2022

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Background and PurposeIn this study, we aimed to evaluate the relationship between tinnitus and a subsequent diagnosis of major depressive disorder (MDD) by studying the incidence of both entities.DesignA retrospective cohort study.MethodsData for this observational follow-up study were retrieved from the Taiwan's National Health Insurance Dataset. A total of 375,272 patients with newly diagnosed tinnitus (study group) were retrieved. The date of first diagnosis of tinnitus was assigned as their index date. Comparison patients were selected by propensity score matching (one per case, n = 375,272 controls) from the same dataset, with their index date being the date of their first health service claim in the year of diagnosis of their matched index case. We tracked each patient's claims records for 1 year from the index date to identify those who received a diagnosis of MDD. Cox proportional hazards regression was performed to calculate the MDD hazard ratio for cases vs. controls.ResultsWe found that the overall incidence rate for MDD was 0.78 (95% CI = 0.76~0.80) per 100 person-years, being 1.17 (95% CI = 1.14~1.21) among the study cohorts and 0.38 (95% CI = 0.36~0.40) among the comparison cohorts. The log-rank test revealed that the patients in the study cohort had significantly lower one-year MDD-free survival when compared to the comparison cohort (p < 0.001). Cox proportional hazards analysis showed that the patients in the study cohort had a higher hazard of developing MDD than the patients in the comparison cohort (adjusted HR = 3.08, 95% CI = 2.90~3.27).ConclusionsIn this study, we demonstrate that tinnitus is associated with an increased hazard of subsequent MDD in Taiwan.

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“…This cohort was set up in 1990 with the main aim to examine neurological, cardiovascular, and other chronic age-related diseases. Details of the study design have been described by Ikram et al (2020).…”

Section: Participants and Designmentioning

confidence: 99%

The Cross-Sectional Association Between Tinnitus and Actigraphy-Estimated Sleep in a Population-Based Cohort of Middle-Aged and Elderly Persons

et al. 2022

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Objectives: Tinnitus is a common and burdensome disease, often accompanied by complaints of poor sleep. However, associations of tinnitus with objective estimates of sleep remain unclear, particularly in the general population. We assessed these associations in a population-based cohort of middle-aged and elderly persons. Design: This study included 1456 participants (mean age: 65.0 ± 7.1 years, 52% women) from the population-based Rotterdam Study. Tinnitus was self-reported and in those who reported tinnitus daily, symptom severity was assessed with the Tinnitus Handicap Inventory. We used actigraphy to estimate sleep and 24-hour activity rhythms objectively and sleep diaries to assess self-reported sleep. We estimated the difference in sleep and 24-hour activity rhythms first between those with and those without tinnitus and secondly with tinnitus severity. Results: Tinnitus, reported by 341 (23%) participants, and tinnitus severity, assessed in 194 participants with daily tinnitus, were not associated with actigraphy-estimated sleep or 24-hour activity rhythms, but were associated with a longer self-reported sleep onset latency (adjusted differencetinnitus = 2.36, 95% confidence interval [CI] = 0.95–3.78, adjusted differencetinnitus severity = 0.27, 95% CI = 0.013–0.54). After stratification for hearing loss, tinnitus was associated with longer self-reported sleep onset latency (adjusted difference = 2.26, 95% CI = 0.98–3.53) and less stable 24-hour activity rhythms (adjusted difference = −0.02, 95% CI = −0.04 to −0.00) in those with hearing loss. In those without hearing loss, tinnitus was associated with more stable rhythms (adjusted difference = 0.03, 95% CI = 0.01–0.05). Conclusions: Having tinnitus is associated with a longer self-reported sleep onset latency, but not with objective estimates of sleep, suggesting that the subjective experience of sleep may be particularly disturbed in those with tinnitus. In addition, hearing loss may modify the association of tinnitus and 24-hour activity rhythms.

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Cross-sectional and Longitudinal Associations Between Tinnitus and Mental Health in a Population-Based Sample of Middle-aged and Elderly Persons

Cited by 13 publications

References 42 publications

Associations Between Physical Activity, Tinnitus, and Tinnitus Severity

Associations Between Physical Activity, Tinnitus, and Tinnitus Severity

Increased Risk of Major Depressive Disorder Following Tinnitus: A Population-Based Study

The Cross-Sectional Association Between Tinnitus and Actigraphy-Estimated Sleep in a Population-Based Cohort of Middle-Aged and Elderly Persons

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