Higher social support is associated with lower tinnitus-related disability among institutionalized older adults: a cross-sectional study.

BACKGROUND

Tinnitus-related disability among older adults in long-term care facilities may reflect not only auditory symptoms but also functional and psychosocial vulnerability. This study examined the association between perceived social support and Tinnitus Handicap Inventory (THI)-defined tinnitus-related disability among older long-term care residents with chronic subjective tinnitus.

METHODS

We conducted a cross-sectional study between July and November 2025 among 390 residents aged 60 years or older with chronic subjective tinnitus in long-term care facilities in urban Wuhan, China. Perceived social support was measured using the 13-item Short-form Social Support Appraisals Scale for older adults, and tinnitus-related disability was assessed using the THI. The primary outcome was continuous THI score; severe/catastrophic THI was additionally analyzed as a binary outcome. Ordinal THI severity and moderate-or-worse THI were examined in sensitivity analyses. Multivariable linear, logistic, ordinal logistic, quartile-based, restricted cubic spline, subgroup, and sensitivity analyses were performed with adjustment for demographic, socioeconomic, lifestyle, institutional, clinical, and tinnitus-related covariates.

RESULTS

The mean age was 79.85 years (SD 8.32), and 237 participants (60.8%) were female. Among the covariates included in the fully adjusted model, hypertension was associated with a higher THI score (adjusted β = 23.82, 95% CI 19.00 to 28.65; p < 0.001). Per 1-SD higher SSA-13 score, the fully adjusted THI total was 5.24 points lower (β = -5.24, 95% CI -7.34 to -3.14; p < 0.001), and the odds of severe/catastrophic THI were lower (OR = 0.60, 95% CI 0.45 to 0.80; p < 0.001). The highest SSA-13 quartile had a lower adjusted THI score than the lowest quartile (β = -12.11, 95% CI -17.39 to -6.84), but intermediate-quartile estimates were non-monotonic; the spline nonlinearity test was significant (p < 0.001).

CONCLUSION

Among older adults with chronic subjective tinnitus living in long-term care facilities, higher perceived social support was associated with lower tinnitus-related disability. Because of the cross-sectional design, these findings should be interpreted as evidence of association rather than causation. Brief assessment of perceived social support may help identify residents who need additional psychosocial attention within long-term care settings.