{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T19:12:35Z","timestamp":1760037155882,"version":"build-2065373602"},"reference-count":32,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2025,8,15]],"date-time":"2025-08-15T00:00:00Z","timestamp":1755216000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Deanship of Scientific Research, King Khalid University","award":["RGP.2\/734\/46"],"award-info":[{"award-number":["RGP.2\/734\/46"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Brain Sciences"],"abstract":"<jats:p>Background\/Objectives: Tinnitus has been increasingly recognized not only as an auditory disturbance but also as a condition that is potentially linked to cognitive decline, particularly in older adults. However, the relationship between tinnitus characteristics and cognitive impairment remains underexplored in clinical settings. This study aimed to (1) evaluate the association between chronic tinnitus and cognitive function in adults aged 60 years and above using standardized tools, and (2) determine whether tinnitus severity and duration are associated with increased risk of cognitive impairment. Methods: A cross-sectional study was conducted among 240 older adults, divided into tinnitus (n = 120) and non-tinnitus (n = 120) groups. Cognitive function was assessed using the Mini-Cog (0\u20135) and SPMSQ (0\u201310) tools. Tinnitus severity and duration were evaluated using the Tinnitus Handicap Inventory (THI), Visual Analogue Scale (VAS), and duration categories. Results: Participants with tinnitus were significantly older and had higher rates of hearing loss (58.33% vs. 33.33%, p = 0.001), depression (37.50% vs. 18.33%, p = 0.002), and poor sleep quality (51.67% vs. 31.67%, p = 0.003). Mini-Cog and SPMSQ scores were significantly lower in the tinnitus group (2.87 \u00b1 1.14 vs. 3.52 \u00b1 1.06; 6.95 \u00b1 1.42 vs. 8.02 \u00b1 1.18; both p &lt; 0.001). Tinnitus presence, longer duration, and higher severity were independently associated with cognitive impairment. Each 10-point increase in THI score increased the odds of impairment by 45% (OR = 1.45, p &lt; 0.001). Conclusions: Tinnitus burden, particularly when severe and prolonged, is significantly associated with cognitive impairment in older adults. These findings highlight the need for cognitive screening and integrated management in this population.<\/jats:p>","DOI":"10.3390\/brainsci15080869","type":"journal-article","created":{"date-parts":[[2025,8,15]],"date-time":"2025-08-15T08:39:07Z","timestamp":1755247147000},"page":"869","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Tinnitus and Cognition in the Elderly: Unraveling the Impact of Symptom Burden on Cognitive Decline"],"prefix":"10.3390","volume":"15","author":[{"given":"Sarah","family":"Alshehri","sequence":"first","affiliation":[{"name":"Otolaryngology, Head and Neck Surgery, Department of Surgery, College of Medicine, King Khalid University, Abha 61421, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abdulaziz Abdulrahman S.","family":"Al Hatem","sequence":"additional","affiliation":[{"name":"Otolaryngology, Head and Neck Surgery, Department of Surgery, College of Medicine, King Khalid University, Abha 61421, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,8,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"100250","DOI":"10.1016\/j.lanepe.2021.100250","article-title":"Tinnitus prevalence in Europe: A multi-country cross-sectional population study","volume":"12","author":"Biswas","year":"2022","journal-title":"Lancet Reg. Health Eur."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1007\/s10162-024-00939-0","article-title":"Tinnitus: Clinical insights in its pathophysiology\u2014A perspective","volume":"25","author":"Langguth","year":"2024","journal-title":"J. Assoc. Res. Otolaryngol."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Mazurek, B., Rose, M., Schulze, H., and Dobel, C. (2022). Systems medicine approach for tinnitus with comorbid disorders. Nutrients, 14.","DOI":"10.3390\/nu14204320"},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Malesci, R., Brigato, F., Di Cesare, T., Del Vecchio, V., Laria, C., De Corso, E., and Fetoni, A.R. (2021). Tinnitus and neuropsychological dysfunction in the elderly: A systematic review on possible links. J. Clin. Med., 10.","DOI":"10.3390\/jcm10091881"},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Yang, D., Zhang, D., Zhang, X., and Li, X. (2024). Tinnitus-associated cognitive and psychological impairments: A comprehensive review meta-analysis. Front. Neurosci., 18.","DOI":"10.3389\/fnins.2024.1275560"},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Hu, J., Cui, J., Xu, J.-J., Yin, X., Wu, Y., and Qi, J. (2021). The neural mechanisms of tinnitus: A perspective from functional magnetic resonance imaging. Front. Neurosci., 15.","DOI":"10.3389\/fnins.2021.621145"},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Li, W., Ma, X., Wang, Q., He, X., Qu, X., Zhang, L., Chen, L., and Liu, Z. (2022). Intrinsic network changes in bilateral tinnitus patients with cognitive impairment: A resting-state functional MRI study. Brain Sci., 12.","DOI":"10.3390\/brainsci12081049"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"e137","DOI":"10.15190\/d.2021.16","article-title":"The pathological mechanisms and treatments of tinnitus","volume":"9","author":"Saeed","year":"2021","journal-title":"Discoveries"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"113493","DOI":"10.1016\/j.bbr.2021.113493","article-title":"On the impairment of executive control of attention in chronic tinnitus: Evidence from the attention network test","volume":"414","author":"Jensen","year":"2021","journal-title":"Behav. Brain Res."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1016\/bs.pbr.2021.01.028","article-title":"On the relationship between tinnitus distress, cognitive performance and aging","volume":"262","author":"Brueggemann","year":"2021","journal-title":"Prog. Brain Res."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"274","DOI":"10.1080\/14992027.2020.1822550","article-title":"The impact of tinnitus on working memory capacity","volume":"60","author":"Waechter","year":"2021","journal-title":"Int. J. Audiol."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Makani, P., Thioux, M., Koops, E.A., Pyott, S.J., and van Dijk, P. (2024). Hyperacusis in Tinnitus Individuals Is Associated with Smaller Gray Matter Volumes in the Supplementary Motor Area Regardless of Hearing Levels. Brain Sci., 14.","DOI":"10.3390\/brainsci14070726"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1007\/s10162-022-00874-y","article-title":"Low evidence for tinnitus risk factors: A systematic review and meta-analysis","volume":"24","author":"Biswas","year":"2023","journal-title":"J. Assoc. Res. Otolaryngol."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Hackenberg, B., D\u00f6ge, J., O\u2019Brien, K., Bohnert, A., Lackner, K.J., Beutel, M.E., Michal, M., M\u00fcnzel, T., Wild, P.S., and Pfeiffer, N. (2023). Tinnitus and its relation to depression, anxiety, and stress\u2014A population-based cohort study. J. Clin. Med., 12.","DOI":"10.3390\/jcm12031169"},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Neff, P., Sim\u00f5es, J., Psatha, S., Nyamaa, A., Boecking, B., Rausch, L., Dettling-Papargyris, J., Funk, C., Brueggemann, P., and Mazurek, B. (2021). The impact of tinnitus distress on cognition. Sci. Rep., 11.","DOI":"10.1038\/s41598-021-81728-0"},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Hamza, Y., and Zeng, F.-G. (2021). Tinnitus is associated with improved cognitive performance in non-hispanic elderly with hearing loss. Front. Neurosci., 15.","DOI":"10.3389\/fnins.2021.735950"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"23","DOI":"10.3390\/audiolres13010003","article-title":"Comparison of tinnitus handicap inventory and tinnitus functional index as treatment outcomes","volume":"13","author":"Cuesta","year":"2022","journal-title":"Audiol. Res."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1016\/bs.pbr.2020.08.008","article-title":"Using a visual analog scale (VAS) to measure tinnitus-related distress and loudness: Investigating correlations using the Mini-TQ results of participants from the TrackYourTinnitus platform","volume":"263","author":"Dode","year":"2021","journal-title":"Prog. Brain Res."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1111\/ggi.14367","article-title":"The Mini-Cog: A simple screening tool for cognitive impairment useful in predicting the risk of delirium after major urological cancer surgery","volume":"22","author":"Yajima","year":"2022","journal-title":"Geriatr. Gerontol. Int."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"311","DOI":"10.1016\/j.jpsychires.2021.01.012","article-title":"Ecological momentary assessment of depressive symptoms using the mind. me application: Convergence with the Patient Health Questionnaire-9 (PHQ-9)","volume":"135","author":"McIntyre","year":"2021","journal-title":"J. Psychiatr. Res."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Leong, S.L., Tchen, S., Robertson, I.H., Alsalman, O., To, W.T., and Vanneste, S. (2020). The potential interruptive effect of tinnitus-related distress on attention. Sci. Rep., 10.","DOI":"10.1038\/s41598-020-68664-1"},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Han, S.-Y., Kim, H., Yun, Y., Lee, M.J., Lee, J.-Y., Park, S.-W., Kim, Y.K., and Kim, Y.H. (2024). Comparative study on structural and functional brain differences in mild cognitive impairment patients with tinnitus. Front. Aging Neurosci., 16.","DOI":"10.3389\/fnagi.2024.1470919"},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Cui, Y., and Du, H. (2025). The Role of Chronic Tinnitus in Hearing Loss-Related Depression: Insights for Middle-Aged and Older Adults. Clin. Gerontol., 1\u201317.","DOI":"10.1080\/07317115.2025.2482877"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"995","DOI":"10.1016\/j.jfma.2021.07.022","article-title":"Sleep disturbance and psychological distress in adult patients with tinnitus","volume":"121","author":"Li","year":"2022","journal-title":"J. Formos. Med. Assoc."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"413","DOI":"10.1007\/s10162-024-00960-3","article-title":"The current state of tinnitus diagnosis and treatment: A multidisciplinary expert perspective","volume":"25","author":"Kleinjung","year":"2024","journal-title":"J. Assoc. Res. Otolaryngol."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Dauman, N., Hobeika, L., Erlandsson, S., Cima, R., McKenna, L., Samson, S., and Londero, A. (2024). Psychological models of tinnitus. Textbook of Tinnitus, Springer.","DOI":"10.1007\/978-3-031-35647-6_21"},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Ruan, J., Hu, X., Liu, Y., Han, Z., and Ruan, Q. (2022). Vulnerability to chronic stress and the phenotypic heterogeneity of presbycusis with subjective tinnitus. Front. Neurosci., 16.","DOI":"10.3389\/fnins.2022.1046095"},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Kondziella, D., and Waldemar, G. (2023). Differential Diagnosis: \u201cWhat Is the Lesion?\u201d. Neurology at the Bedside, Springer.","DOI":"10.1007\/978-3-031-43335-1"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1659","DOI":"10.1007\/s00429-021-02284-x","article-title":"Auditory thalamus dysfunction and pathophysiology in tinnitus: A predictive network hypothesis","volume":"226","author":"Brinkmann","year":"2021","journal-title":"Brain Struct. Funct."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"453","DOI":"10.1007\/s10162-023-00905-2","article-title":"Abnormal functional connectivity within default mode network and salience network related to tinnitus severity","volume":"24","author":"Xiong","year":"2023","journal-title":"J. Assoc. Res. Otolaryngol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"708","DOI":"10.1001\/jamaoto.2021.1049","article-title":"Cross-sectional and longitudinal associations between tinnitus and mental health in a population-based sample of middle-aged and elderly persons","volume":"147","author":"Oosterloo","year":"2021","journal-title":"JAMA Otolaryngol. Head Neck Surg."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Del Vecchio, V., Tricarico, L., Pisani, A., Serra, N., D\u2019Errico, D., De Corso, E., Rea, T., Picciotti, P.M., Laria, C., and Manna, G. (2023). Vascular factors in patients with midlife sensorineural hearing loss and the progression to mild cognitive impairment. Medicina, 59.","DOI":"10.3390\/medicina59030481"}],"container-title":["Brain Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-3425\/15\/8\/869\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T18:28:00Z","timestamp":1760034480000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-3425\/15\/8\/869"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,15]]},"references-count":32,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2025,8]]}},"alternative-id":["brainsci15080869"],"URL":"https:\/\/doi.org\/10.3390\/brainsci15080869","relation":{},"ISSN":["2076-3425"],"issn-type":[{"type":"electronic","value":"2076-3425"}],"subject":[],"published":{"date-parts":[[2025,8,15]]}}}