Tinnitus and its relationship with anxiety and depression in the elderly: a systematic review

ABSTRACT Objective: to verify, in the literature, a probable association of tinnitus with anxiety and depression in the elderly. Methods: a systematic review (through a search in the indexed databases - Lilacs, Scielo, Pubmed, Science Direct, The Cochrane Library) of studies published between 2013 and 2018, in Portuguese and in English, involving adults and/or elderly (18 years and older). The descriptors used were: “tinnitus", "depression", "anxiety", "adult", "elderly", interspersed by the Boolean operator AND. Results: 11 studies were selected, from which, 5 compared adults to elderly and only 2 evaluated such relationship in the elderly alone. Studies suggest that, as age increases, tinnitus severity and psychological symptoms also increase, affecting both men and women. Conclusion: few studies compared the relationship between the variables among the elderly. A probable association between the variables for both genders has been found, suggesting that the advancing age contributes to the increase of tinnitus severity and its psychological symptoms, affecting the quality of life of these individuals. Further studies are suggested to confirm the association between tinnitus, anxiety and depression in the elderly. Multi-professional work is important for the evaluation and treatment of these people.

摘要
研究目的：通过文献系统调研，验证老年人群耳鸣与焦虑、抑郁之间可能存在的关联。
研究方法：本研究采用系统综述设计，对2013年至2018年间发表的葡萄牙语及英语文献进行检索，检索覆盖的索引数据库包括Lilacs（拉丁美洲和加勒比健康科学文献数据库）、SciELO（科学电子图书馆在线）、PubMed（美国国立医学图书馆PubMed数据库）、Science Direct（科学直接数据库）及The Cochrane Library（考克兰图书馆），纳入研究对象为18岁及以上的成年人及老年人。本次检索所用的主题词为：“tinnitus”（耳鸣）、“depression”（抑郁）、“anxiety”（焦虑）、“adult”（成年人）、“elderly”（老年人），检索词间以布尔逻辑运算符“AND”进行组配。
研究结果：最终共纳入11项研究，其中5项研究对比了成年人与老年人的相关情况，仅2项研究单独针对老年人群评估了该关联。现有研究显示，随着年龄增长，耳鸣严重程度与心理症状均会加重，且该效应同时存在于男性与女性群体中。
研究结论：目前针对老年人群中各变量间关联的比较研究相对较少。现有结果提示，两类变量（耳鸣与焦虑、抑郁）在不同性别中均存在潜在关联，且年龄增长会加剧耳鸣严重程度及其伴随的心理症状，进而影响该人群的生活质量。建议开展更多研究以明确老年人群耳鸣与焦虑、抑郁之间的关联。多学科协作对于该类人群的评估与治疗具有重要意义。