Neurology
Tinnitus Risk Factors in Young Adults in the United States: National Longitudinal Study of Adolescent to Adult Health (Add Health) Howard J. Hoffman* Howard J. Hoffman Chuan-Ming Li Christa L. Themann Bryan K. Ward Gregory A. Flamme
Objectives: Estimate tinnitus prevalence and risk factors in adults aged 24-42.
Methods: Add Health, a nationally representative, longitudinal cohort study, recruited students aged 12-19 from Grades 7-12 in 1994-1995. Participants in Wave 4 (2008; age 24-32, n=15,701) and Wave 5 (2016-2018; age 32-42, n=14,738) were asked: “In the past 12 months have you been bothered by ringing, roaring, or buzzing in your ears or head (tinnitus) that lasts 5 minutes or more?” Additional questions asked about hearing and balance, other health issues, work, and social/lifestyle factors. We used multivariable logistic regression to estimate odds ratios (OR) and 95% confidence intervals (CI).
Results: Tinnitus prevalence in Wave 4 was 6.7% (7.3% males; 6.1% females) and in Wave 5 was 11.1% (13.0% males; 8.9% females). Tinnitus prevalence was 30% higher for non-Hispanic whites. Persistent tinnitus (Waves 4 and 5) was reported by 0.8%; 10.3% had new onset tinnitus in Wave 5. Tinnitus was strongly associated with hearing loss. In Wave 5 multivariable models, risks included: male (OR=1.9; 95% CI: 1.5-2.7); head trauma (OR=1.5; CI: 1.2-1.9); headaches (OR=1.8; CI: 1.5-2.2); anxiety (OR=1.3; CI: 1.0-1.6); balance/dizziness problems (OR=2.7; CI: 2.2-3.3); and “moderate or worse trouble” hearing (OR=16.2; CI: 10.9-24.1). Persistent tinnitus in Waves 4 and 5 was associated with age (OR=1.15; CI: 1.02-1.3); head trauma (OR=1.3; CI: 1.1-3.6); headaches (OR=2.3; CI: 1.3-3.9); balance problems (OR=3.3; CI: 1.8-5.9); and “moderate or worse trouble” hearing (OR=13.3; CI: 3.5-49.9).
Conclusions: Tinnitus is a common impairment; risk factors include lower income and education, occupation, head trauma, headaches, and hearing and balance trouble. Most tinnitus reported in Wave 4 (age 24-32) appeared to resolve. At Wave 5, 93% of reported tinnitus was from new onset cases in the 8-10 years since Wave 4. Tinnitus status should be assessed for age-related changes in future Add Health waves.