title: Association of Hearing Loss and Tinnitus with Health-Related Quality of Life: The Korea National Health and Nutrition Examination Survey.
abstract: BACKGROUND
  Hearing loss and tinnitus are global public health concerns. There have been some studies suggesting a relationship between hearing loss and tinnitus and impaired health-related quality of life (HRQoL), but there have been no large cross-sectional epidemiologic studies of a representative sample of the entire country population investigating this possible association.
  
  
  OBJECTIVE
  The aim of this study was to investigate the relationship between hearing loss and tinnitus and HRQoL in South Korea using data from the Korea National Health and Nutrition Examination Surveys during 2010-2012.
  
  
  METHODS
  Cross-sectional data of 11,266 adults who completed the Korea National Health and Nutrition Examination Surveys were analyzed. Subjects were divided into four groups as follows: normal hearing without tinnitus, normal hearing with tinnitus, hearing loss without tinnitus, and hearing loss with tinnitus.
  
  
  RESULTS
  Among the population that was ≥19 years of age, the prevalence of unilateral hearing loss was 9.69% and that of tinnitus in the prior 12 months was 32.76%. The hearing loss with tinnitus group had the highest percentage of subjects who responded "some or extreme problems" in all five dimensions (mobility, self-care, usual activities, pain/discomfort, and anxiety/depression) of HRQoL. After adjustment for age, gender, body mass index, smoking status, alcohol intake, regular exercise, house income, education level, diabetes, hypertension, and stress level, the HRQoL odds ratios (OR) were 1.47 (95% confidence interval [CI], 1.07-2.02) for mobility, 1.59 (95% CI, 1.07-2.37) for usual activity, and 1.84 (95% CI, 1.25-2.70) for anxiety/depression in the hearing loss with tinnitus group, compared with the normal hearing without tinnitus group. The ORs for the normal hearing with tinnitus group compared with the hearing loss without tinnitus group was increased in all five dimensions of HRQoL after adjustment for confounders.
  
  
  CONCLUSIONS
  Hearing loss with tinnitus has a considerable impact on HRQoL in the Korean population. In our study, the hearing loss without tinnitus group showed better a HRQoL than the normal hearing with tinnitus group.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Young-Hoon
authors.initials: YH
authors.lastname: Joo
authors.affiliation: Department of Biostatistics, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Kyung-do
authors.initials: KD
authors.lastname: Han
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Kyung Ho
authors.initials: KH
authors.lastname: Park
mesh_terms: D000368:Aged; D016001:Confidence Intervals; D005163:Factor Analysis, Statistical; D005260:Female; D006262:Health; D034381:Hearing Loss / Q000150:complications* / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009749:Nutrition Surveys; D016017:Odds Ratio; D015995:Prevalence; D011788:Quality of Life; D056910:Republic of Korea / Q000453:epidemiology; D011795:Surveys and Questionnaires; D014012:Tinnitus / Q000150:complications* / Q000453:epidemiology*