Does Tinnitus Distress Depend on Age of Onset?

Abstract

ObjectivesTinnitus is the perception of a sound in the absence of any physical source of it. About 5–15% of the population report hearing such a tinnitus and about 1–2% suffer from their tinnitus leading to anxiety, sleep disorders or depression. It is currently not completely understood why some people feel distressed by their tinnitus, while others don't. Several studies indicate that the amount of tinnitus distress is associated with many factors including comorbid anxiety, comorbid depression, personality, the psychosocial situation, the amount of the related hearing loss and the loudness of the tinnitus. Furthermore, theoretical considerations suggest an impact of the age at tinnitus onset influencing tinnitus distress.MethodsBased on a sample of 755 normal hearing tinnitus patients we tested this assumption. All participants answered a questionnaire on the amount of tinnitus distress together with a large variety of clinical and demographic data.ResultsPatients with an earlier onset of tinnitus suffer significantly less than patients with an onset later in life. Furthermore, patients with a later onset of tinnitus describe their course of tinnitus distress as more abrupt and distressing right from the beginning.ConclusionWe argue that a decline of compensatory brain plasticity in older age accounts for this age-dependent tinnitus decompensation.

The influence of psychological factors on tinnitus severity

“…An association between tinnitus severity and age has already been suggested earlier [40,41]. It has also been reported that patients with an earlier onset of tinnitus suffer significantly less than patients with an onset later in life [42]. Decline of compensatory brain plasticity in older age has been suggested as an explanation for this age-dependent tinnitus decompensation.…”

“…Obviously, further factors, which are not reflected by the SCL-90-R, are relevant for tinnitus severity. Among them may be tinnitus loudness, coping behavior, comorbidities such as hearing loss, vertigo, dizziness and hyperacusis, tinnitus duration, age at tinnitus onset and etiology of tinnitus onset, which all have been proposed as factors that have an influence on the quality of life of tinnitus patients [17,[42][43][44][45][46][47].…”

The impact of tinnitus on adult Nigerians: health related Quality of Life assessment of sufferers using the Hospital Anxiety and Depression Scale (HADS) and the RAND-36 item health survey 1.0 questionnaire

“…These same brain areas also are responsible for the perception of tinnitus and tinnitus related comorbid distress 7,38,39 i.e., the limbic system responsible for emotions processes the neural impulses it receives from the auditory system 40 .…”

“…Some studies demonstrate that the QoL of younger sufferers is far more reduced than the elderly population 5,26 while Pinto et al 43 established no correlation between age and Tinnitus emotional comorbidities. In a large population study, older patients reported greater tinnitus related distress with the explanation that a decline in neuroplasticity with advancing age may be the underlying mechanism 7 . We propose that the younger and more active population will report greater tinnitus related distress as seen in our study because of the recorded significant limitation in daily life functions as a result of tinnitus comorbidities.…”

“…This multidirectional impact could vary from severe impairment of daily life functions to suicidal tendencies 6 . Studies report that 5-15% of the western populations experience a form of tinnitus requiring medical intervention with 1-2% experiencing significant impairments in their quality of life (QoL) 7 . Researchers have suggested that the quality of life of patients is reduced as a result of the severe distress of tinnitus 8,9 with depression and anxiety being reported to be the commonest psychological comorbidities suffered by these patients 10,11 .…”