Retrospective Analysis of Hearing Loss and Tinnitus Determinants and Their Health Impact among Old Adults

Yong Liao^1,2*Lu Zhang²

• ¹Central Hospital of Enshi Tujia and Miao Autonomous Prefecture, Wuhan University, Enshi, China
• ²Department of Otolaryngology Head and Neck Surgery, The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture, Enshi, Hubei, 445000, China., Hubei, China

Background: Age-related hearing loss (ARHL) and tinnitus are common sensory symptoms that impair communication, psychosocial functioning, and QoL. Clinic-level investigations of QoL factors, comorbidities, and combination effects are scarce despite their public health importance. Objective: This study examined the determinants of ARHL and tinnitus in older persons, their relationships with demographic, clinical, and psychosocial characteristics, and their effects on global and domain-specific health-related quality of life. Methods: A retrospective study comprised of 1,000 patients aged 60–85 years old. Structured interviews and medical records provided demographic, clinical, lifestyle, and psychosocial data. Hearing impairment was classified using established audiological standards based on pure-tone audiometry, and QoL was assessed with HRQOL measures. We used audiological standards to evaluate ARHL and tinnitus severity. Multivariable logistic regression assessed global and domain-specific QoL associations after covariate adjustment. Results: Increasing severity of ARHL and tinnitus was strongly associated with older age, male sex, comorbidities, lifestyle risk factors, and psychological burden. Severe ARHL combined with tinnitus conferred the highest odds of impaired global QoL (OR 5.48, 95% CI 3.09–9.71), psychological distress (OR 6.89, 95% CI 3.82–12.43), and social limitations (OR 5.72, 95% CI 3.01–10.86; all p<0.001). Tinnitus alone independently predicted poorer outcomes, while hearing aid use showed a modest but nonsignificant protective effect. Depression, anxiety, sleep disturbance, cognitive impairment, social isolation, and comorbid medical conditions further exacerbated QoL declines. Conclusions: ARHL and tinnitus worsen physical, psychological, and social health, while intensity and duration increase risk. These findings emphasize the need for early detection, targeted therapies, and integrated care to reduce functional decline and improve QoL in older persons.