The Role of Chronic Tinnitus in Hearing Loss-Related Depression: Insights for Middle-Aged and Older Adults

This study examines whether chronic tinnitus mediates the relationship between hearing loss and depression in middle-aged and older adults, providing insights into the pathways linking auditory impairment and mental health challenges. Data from 3,241 adults aged 50 and older were obtained from the 2011-2012, 2015-2016, and 2017-2018 NHANES cycles and analyzed. Logistic regression assessed the hearing loss - depression association, and mediation analysis tested the mediating role of chronic tinnitus. Subgroup analyses explored age differences. Hearing loss increased the odds of depressive symptoms, with chronic tinnitus mediating 16.83% of this effect. In middle-aged adults, chronic tinnitus served as a full mediator in the hearing loss - depression pathway, acted as a partial mediator in adults aged 60-69, and showed no mediating effect in those aged 70 and older. Hearing loss, chronic tinnitus, and depression are closely linked in middle-aged and older adults. Age-sensitive screening and integrated care addressing both hearing and mental health are crucial to improve well-being. Combining hearing rehabilitation with tinnitus counseling and mental health support may improve psychological outcomes in older adults.