The influence of tinnitus and hearing loss on the functional status of military Service members and Veterans

Abstract

Objective

This study evaluated the influence of tinnitus and hearing loss on the functional status of military Service members and Veterans.

Design

Participants completed audiologic testing and self-report instruments to assess tinnitus, hearing, and general functioning. We conducted multiple linear regression analyses using cross-sectional data with functional status as the dependent variable. The primary independent variables were tinnitus and average low-, high-, and extended high-frequency hearing thresholds. Secondary independent variables were subjective tinnitus severity and hearing difficulties. Each of the independent variables was modelled separately for Service members and Veterans; covariates for each multivariable model were identified a priori and, depending on the association being modelled, included age, gender, blast-wave exposure, and history of military traumatic brain injury.

Study Sample

Data were analysed from 283 Service members and 390 Veterans.

Results

After controlling for potential confounders, presence of tinnitus, tinnitus severity, average low-frequency hearing thresholds, and subjective hearing difficulties were significantly associated with functional status in Service members and Veterans.

Conclusions

These results suggest that tinnitus and poorer low-frequency hearing, and the perceived severity of tinnitus and hearing difficulties, may be associated with poorer functional status among Service members and Veterans.

Keywords:

• Noise
• epidemiology
• tinnitus
• psycho-social/emotional

Acknowledgments

The authors would like to thank Wendy Helt, Sarah Theodoroff, Donald Austin, Emily Thielman, Samrita Thapa, Rozela Melgoza, and Cody Evans for their contributions to this project and Tanisha Hammill and Victoria Tepe for their feedback on this manuscript. We also would like to thank our military Service members and Veteran participants for their time and contribution of personal health information to this study.

Disclosure statement

The U.S. Army Medical Research Acquisition Activity, 820 Chandler Street, Fort Detrick MD 21702-5014 is the awarding and administering acquisition office. This work was supported by the Office of the Assistant Secretary of Defense for Health Affairs, through the Joint Warfighter Medical Research Program under Award No. W81XWH-17-1-0020. The views expressed in this publication are those of the authors and may not reflect the official policy or position of the Department of the Army, Department of Defense, or the U.S. Government.

Due to the nature of this research, participants of this study did not agree for their data to be shared publicly, so supporting data are not available.

An earlier data analysis was presented in a poster presentation at the 2016 meeting of the American Academy of Audiology, AudiologyNOW!, in Phoenix, AZ and at the 2019 Collaborative Auditory Vestibular Research Network (CAVRN) meeting in Boston, MA. Some of these data were presented at the 2021 virtual meeting of the National Hearing Conservation Association.

Notes

1 Thresholds reaching the maximum output of the audiometer were set to the limit plus 1 dB.

Additional information

Funding

This work was supported by grants from the United States (U.S.) Department of Defense (DoD) Congressionally Directed Medical Research Program (PR121146, JW160036, and JW210396), the DoD Hearing Center of Excellence (HCE; Air Force Research Laboratory S-16945-02 and Air Force Medical Operations PR121146), and U.S. Department of Veterans Affairs Rehabilitation Research and Development (RR&D) Research Career Scientist Awards (C9247S and 1 IK6 RX002990). This work was also supported with resources and the use of facilities at the DoD HCE, Lackland Air Force Base, San Antonio, Texas, and the VA RR&D National Center for Rehabilitative Auditory Research (Award #C9230C) at the VA Portland Health Care System, Portland, Oregon. The School of Audiology at Pacific University in Hillsboro, Oregon has provided salary support and resources to the first author.