Clin Exp Otorhinolaryngol.  2020 Feb;13(1):8-14. 10.21053/ceo.2018.01914.

Neurocognition of Aged Patients With Chronic Tinnitus: Focus on Mild Cognitive Impairment

Affiliations
  • 1Department of Otorhinolaryngology-Head and Neck Surgery, SMG-SNU Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
  • 2Department of Psychiatry, SMG-SNU Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea

Abstract


Objectives
. To investigate the neurocognition of aged patients with chronic tinnitus and reveal the possible association between tinnitus severity and cognitive function, with attention to mild cognitive impairment (MCI).
Methods
. Fifty-eight elderly patients (≥65 years old) with chronic tinnitus (≥6 months) were prospectively enrolled in this study. All patients assessed the neurocognitive batteries including the Korean version of the patient health questionnaire-9 (K-PHQ-9), the Lawton instrumental activities of daily living scale (K-IADL), and the Montreal cognitive assessment (MoCA-K). After initial evaluation to exclude moderate or severe cognitive impairment by a psychiatrist, the patients were classified into two groups: MCI and non-MCI, according to the MoCA-K scores (cutoff value, 22/23). All patients underwent audiological examinations including psychoacoustic tests of tinnitus.
Results
. Of 58 patients, 10 (17.2%) met the MCI criteria. The tinnitus handicap inventory (THI) score in the MCI group was significantly higher than that in the non-MCI group. Based on multivariate regression analysis, a significant association between tinnitus severity and MoCA-K score was also detected. Specifically, bothersome tinnitus (THI score ≥30) was closely linked to the presence of MCI. Meanwhile, the impact of MCI on both K-PHQ-9 and K-IADL scores was not evident in patients with chronic tinnitus.
Conclusion
. Tinnitus severity appears to be a potential independent determinant for predicting the MCI, suggesting the underlying mechanism between chronic tinnitus and cognitive deficit. Given that MCI highly links to dementia, the evaluation of cognitive functions in aged patients with chronic tinnitus need to be considered at the initial assessment of tinnitus.

Keyword

Tinnitus; Mild Cognitive Impairment; Montreal Cognitive Assessment

Figure

  • Fig. 1. Comparison of neurocognitive test results based on the presence of mild cognitive impairment (MCI) in aged patients (≥65 years) with chronic tinnitus. In the MCI group, the Korean version of the Montreal cognitive assessment (MoCA-K) score was significantly lower than that in the non-MCI group (P<0.001). However, Korean version of the Lawton instrumental activities of daily living scale (K-IADL) and Korean version of the patient health questionnaire-9 (K-PHQ-9) scores were similar regardless of the presence of MCI (P=0.411 and P=0.261, respectively). *P<0.05 by independent t-test.

  • Fig. 2. Association between tinnitus severity and cognitive function in aged patients (≥65 years) with chronic tinnitus. (A) A statistically significant negative correlation was detected between tinnitus handicap inventory (THI) and Korean version of the Montreal cognitive assessment (MoCA-K) scores in all patients (r=–0.837, P<0.001). (B) A plot for odds ratios of the final model. As a result of logistic regression analysis, either mean hearing threshold or THI scores significantly contributed to the developing mild cognitive impairment. *P<0.05 by logistic regression analysis.


Cited by  2 articles

Beyond Hearing Loss: Does Tinnitus Cause Cognitive Impairment?
Ho Yun Lee
Clin Exp Otorhinolaryngol. 2020;13(1):2-3.    doi: 10.21053/ceo.2019.01949.

Tinnitus and Cognitive Decline
Hyun-Jin Lee, Ye Ji Shim, Munyoung Chang
Korean J Otorhinolaryngol-Head Neck Surg. 2023;66(10):641-645.    doi: 10.3342/kjorl-hns.2023.00913.


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