Cognitive Screening and Hearing Assessment in Patients With Chronic Tinnitus

Objectives. The study aimed to assess the relationship of tinnitus with hyperacusis with cognitive impairment as indicated by the Montreal Cognitive Assessment (MoCA) tool. Methods. This multicenter cross-sectional study included individuals with chronic tinnitus from the "Unification of Treat-ments and Interventions for Tinnitus Patients" (UNITI) database. Participants were recruited from four different ter-tiary clinical centers located in Athens and Granada (Mediterranean group), as well as Berlin and Regensburg (Ger-man group). In total, 380 individuals with a diagnosis of non-pulsatile chronic tinnitus (permanent and constant tin-nitus lasting more than 6 months) and no evidence of severe cognitive impairment (MoCA score >22) were enrolled. The evaluation utilized the following tools: MoCA, Tinnitus Handicap Inventory (THI), Hyperacusis Questionnaire (GuF), Patient Health Questionnaire (PHQ-9), and the European School for Interdisciplinary Tinnitus Research Screening Questionnaire. Results. MoCA scores differed between German and Mediterranean individuals (P<0.01), necessitating separate analyses for each group. In both cohorts, MoCA scores were significantly associated with education level, age, hearing thresh-old at 8 kHz, and THI. Furthermore, a significant correlation was observed between PHQ-9 scores and both THI and GuF (P<0.01 for both Germans and those from the Mediterranean). Conclusion. Our data suggest an association between tinnitus handicap, high-frequency hearing loss, and mild cognitive impairment. Additionally, PHQ-9 scores were associated with tinnitus and hyperacusis scores, independent of hear-ing loss thresholds.