Effects of Tinnitus Severity on Cognitive, Emotional, and Sleep Outcomes in Older Adults with Controlled Age Related Hearing Loss

Background Tinnitus is associated with sleep disturbances, cognitive impairment, and mental health problems. This study examined sleep quality, depressive symptoms, and cognitive functioning in older adults with mild and severe tinnitus, controlling for hearing loss and excluding individuals who used hearing aids or received tinnitus therapy. Methods A total of 144 older adults (median age: 65 years) participated in the study. Hearing thresholds were assessed, and the Tinnitus Handicap Inventory(THI), Beck Depression Inventory(BDI), Pittsburgh Sleep Quality Index(PSQI), and Montreal Cognitive Assessment(MoCA) were administered. Based on THI scores, participants were classified into mild tinnitus(level 2) and severe tinnitus(level ≥ 3) groups. Results There was a difference between the groups in BDI and PSQI, MoCA scores and Memory Index Score(MIS) and Recall subtests. There was a medium correlation between THI and BDI(r= .658;p=.001), PSQI score(r=.303;p= .038), MoCA(r=-.472;p=.001), and MoCA-MIS(r=-.376;p=.008).This study revealed that increasing tinnitus level in older adults increases problems in sleep, depression, memory and recall. Conclusions Increasing tinnitus severity is associated with poorer sleep quality, greater depressive symptoms, and impaired cognitive performance—particularly working memory and delayed recall—in older adults. When hearing loss is controlled, tinnitus severity alone appears to negatively affect cognitive and emotional functioning, underscoring the need to consider tinnitus as an independent risk factor in the aging population.