Generational Differences in the Reporting of Tinnitus

Abstract

Objectives Recent research suggests that hearing impairment is declining among older adults compared to earlier generations of the same age. Tinnitus is often associated with hearing impairment, so one might hypothesize that the prevalence of tinnitus is declining in a similar manner. The purpose of this study was to utilize multi-generational data with repeated measures to determine if the prevalence of tinnitus is declining among more recent generations. Design Using data from the Epidemiology of Hearing Loss Study (1993-95, 1998-00, 2003-05, 2009-10) and the Beaver Dam Offspring Study (2005-08), we examined birth cohort patterns in the report of tinnitus for adults aged 45 years and older (n=12,689 observations from 5,764 participants). Participants were classified as having tinnitus if they reported tinnitus in the past year of at least moderate severity or that caused difficulty falling asleep. A low-frequency (500, 1000, and 2000 Hz) and high-frequency (3000, 4000, 6000, 8000 Hz) pure tone average from the worse ear were used to summarize hearing status. Other potential risk factors for tinnitus were also explored to determine if changes in the prevalence of these factors over time could explain any observed birth cohort differences in the prevalence of tinnitus. These included: education, history of head injury, history of doctor-diagnosed ear infections, history of cardiovascular disease (myocardial infarction, stroke or angina), current noisy job, longest-held job, target shooting in the past year, number of concerts ever attended, alcohol use in the past year, doctor-diagnosis of arthritis, current aspirin use, regular exercise, and consulting with a physician in the past year about any hearing/ear problem. Birth cohort effects were modeled with alternating logistic regression (ALR) models which use generalized estimating equations to adjust for correlation among repeated measurements over time that are nested within families. Results The report of tinnitus tended to increase with more recent birth cohorts compared to earlier birth cohorts. For example, at ages 55-59 years, 7.6% of participants born in 1935-39 reported tinnitus, compared to 11.0% of those born in 1940-44, 13.6% of those born in 1945-49, and 17.5% of those born in 1950-54. Similarly, at ages 65-69 years, 7.9% of participants born in 1925-29 reported tinnitus, compared to 10.0% of those born in 1930-34, 11.9% of those born in 1935-39, and 13.7% of those born in 1940-44. Final ALR model results indicated that, on average, after adjusting for age and other factors, participants in a given generation were significantly more likely to report tinnitus than participants from a 20-year earlier generation (Odds Ratio = 1.78, 95%CI = 1.44, 2.21). Conclusions Increased reports of tinnitus may reflect increased prevalence of symptoms, increased awareness of symptoms, or higher health expectations among more recent generations of adults. Regardless of the reasons, the increasing prevalence of tinnitus suggests that health care providers may s...

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