Prevalence and risk factors of self-reported hearing and balance dysfunction in a population-based sample from rural northeastern Germany

Abstract

Objectives. A close anatomical and physiological relationship is known between the senses of hearing and balance, while an additional pathophysiological interaction is supposed. The pathophysiological mechanisms underlying this association are not fully understood, especially in individuals without a known specific otologic disorder. Therefore, further insight is required into the prevalence of the audiovestibular symptoms hearing loss, tinnitus and dizziness as only scarce information on the combined occurrence is available so far. Additionally, the influence of potential risk factors from lifestyle habits as well as cardiovascular and metabolic conditions on the development of those symptoms should be studied. Design. To evaluate the prevalence of self-reported hearing loss, tinnitus and dizziness in two separate population-based samples from Western Pomerania, a rural region of north-eastern Germany. Datasets from 8134 individuals aged 20 to 79 years were available from the baseline investigations of the cohorts START and TREND of the Study of Health in Pomerania (SHIP). Audiovestibular symptoms were assessed by structured questionnaires. The cohorts were comprehensively characterized regarding modifiable lifestyle factors as well as cardiovascular and metabolic disorders, allowing the assessment of the role of those influencing factors. Results. We observed a weighted prevalence of 14.2% for hearing loss, 9.7% for tinnitus and 13.5% for dizziness in the population. The prevalence increased with age and differed among the sexes. A relevant subgroup of 28.0% of affected individuals reported more than one symptom. The prevalence of hearing loss as well as tinnitus increased between the two cohorts. A moderate positive correlation was found between hearing loss and tinnitus (phi-coefficient 0.318). In multivariable regression analyses, education was identified as a significant protective factor while only smoking was significantly associated with all three symptoms. Furthermore, several cardiovascular risk factors contributed to both hearing loss and dizziness. Conclusions. Audiovestibular symptoms are highly prevalent in the general population. A considerable but complex influence of risk factors points towards a relation with neuronal as well as cardiovascular disease processes. To clarify the underlying mechanisms, the interaction between the senses of hearing and balance as well as the mode of action of the risk factors should be evaluated in more detail in the future.