Tag Archive: dementia

Treating hearing loss may help prevent dementia

By Daniel Fink, MD, Chair, The Quiet Coalition

A recent Canadian newspaper article discussing a report in The Lancet, the premier British medical journal, about preventing dementia.

The Lancet article highlights the importance of treating hearing loss for possibly preventing dementia. If you’re interested in dementia, know someone with dementia, or want to see what you can do to avoid developing dementia yourself, I recommend the Lancet article. It summarizes a large body of research in a readable fashion that should be accessible even to the lay reader.

There are many factors correlated with dementia risk, including genes, blood lipid levels, and diseases or conditions such as diabetes, hypertension, obesity, and factors such as social isolation and cigarette smoking. The association between hearing loss and dementia is well-known and research is under way to see if treating hearing loss reduces the risk of dementia. Despite only correlations, and no clear understanding of how hearing loss may increase the risk, the Lancet authors think the scientific evidence is strong enough to recommend treatment of hearing loss as a possible prevention measure for dementia.

Of course, the only treatment for hearing loss is hearing aids, with cochlear implants reserved for the more severely impaired. We think that people with hearing loss should use hearing aids just to be able to hear others, whether hearing aids prevent dementia or not.

That said, hearing aids are a poor substitute for preserved natural hearing.

Perhaps the Lancet article should have gone a step further and highlighted the importance of preventing noise-induced hearing loss (NIHL) to delay or avoid the onset of dementia. After all, we think it’s significantly better to prevent NIHL than to treat it, and that’s simple: avoid exposure to loud noise or wear ear protection when you cannot.

Dr. Daniel Fink is a leading noise activist based in the Los Angeles area. He serves on the board of the American Tinnitus Association, is the interim chair of Quiet Communities’s Health Advisory Council, and is the founding chair of The Quiet Coalition, an organization of science, health, and legal professionals concerned about the impacts of noise on health, environment, learning, productivity, and quality of life in America.

New Zealand researchers agree: hearing loss is probably a dementia risk factor

By Daniel Fink, MD, Chair, The Quiet Coalition

Many people don’t understand the process of medical and scientific research and how different hypotheses are developed and tested, using different methods in different human populations with animal studies when possible, until a consensus is reached. This was how researchers–including doctors, epidemiologists, researchers using animal models, and scientists doing basic research at the cellular, molecular, and genetic levels–figured out that cigarette smoke causes cancer and many other diseases, and how it does this. Despite the broad scientific and public health consensus, there are still skeptics, such as those at the conservative Heartland Institute, who say there is still doubt about whether smoking causes lung cancer. There is also a Flat Earth Society. Many Americans think that evolution is an unproven theory despite more than a century of research and strong evidence supporting evolution.

For the rest of us who believe in evidence-based science and evidence-based social and economic policies, our understanding of reality is always evolving based on the evidence. Sometimes something long thought to be true is found not to be correct after all. In medicine, one of the best examples may be ulcers in the stomach and small intestine, which for decades were thought to be caused by too much stomach acid but were found to be caused by bacteria. Australians Barry Marshall and J. Robin Warren won the Nobel Prize in 2005 for making this discovery. But most of the time an early hypothesis is confirmed by one study, and then another, and then by studies in animal models, and then by basic science research, until a broad consensus is reached.

This is what is happening with the hypothesis that hearing loss is associated, probably causally, with dementia. Dr. Frank Lin at Johns Hopkins University may be the best-known researcher in this field but other researchers in other countries are studying the same question. This report from New Zealand discusses what is being done there. And this report from the UK discusses research presented there.

It’s always good to have confirmation of research by different researchers using different techniques in different populations. Such confirmation helps validate initial findings in one population and help move our understanding forward. We know that noise exposure causes hearing loss. If hearing loss is shown to be causally associated with the development of dementia, then preventing hearing loss should help to also prevent dementia. One theory is that they brain needs input to maintain function, and without auditory input and/or social connections, brain function declines. Another theory is that whatever degenerative process causes hearing loss also causes loss of mental function. Ongoing studies, providing hearing aids to those with hearing loss but not to others and then measuring intellectual function over time, may elucidate the cause-effect relationship. Regardless, we don’t need to wait for more evidence for the link. Preserving one’s hearing should be enough reason to avoid loud noise or to wear ear plugs if you can’t.

Dr. Daniel Fink is a leading noise activist based in the Los Angeles area. He serves on the board of the American Tinnitus Association, is the interim chair of Quiet Communities’s Health Advisory Council, and is the founding chair of The Quiet Coalition, an organization of science, health, and legal professionals concerned about the impacts of noise on health, environment, learning, productivity, and quality of life in America.

Have a friend or family member who is showing signs of hearing loss?

In “Hearing loss: Listening to the signs,” Treva Lind, The Spokesman Review, writes about the 37.5 million Americans who have some degree of hearing loss, focusing on the baby boomers who are 20 to 25% of that population.  Lind states that “[t]he American Speech-Language Hearing Association recommends that people age 50 and older have a hearing test every three years.”  She sits in on a hearing exam for 67-year-old Dale Fowler, who came to the University Hearing and Speech Clinic in Spokane, Washington to see if he needed a hearing aid, a visit scheduled at the urging of family members.  Fowler’s exam revealed that he “had some minor hearing loss at high frequencies in one ear, but it wasn’t enough to warrant a hearing aid.”  Fowler’s audiologist, Barbara Peregoy, said that his result was “common among baby boomers.”

Peregoy said that baby boomers often fall into a “gray area,” where they don’t yet need hearing aids but still have some minor hearing loss.  She then explained why people who need hearing aids don’t get them right away (cost, denial, vanity, or fear of appearing older) and the consequences of not addressing hearing loss, noting that hearing loss is a risk factor for dementia.  As for her patient Dale Fowler, although he left without a hearing aid, he did not leave empty-handed–Peregoy handed him a list of good communication skills to help him deal with his minor hearing loss.

Click the link above to read the whole piece, including Barbara Peregoy’s “Ten commandments for good communication skills.”

 

 

Consumer Reports looks at affordable solutions to hearing loss:

No More Suffering in Silence? Julia Calderone, Consumer Reports, has written a thoughtful piece about hearing loss and the toll it takes on those who suffer from it.  Calderone states that hearing loss “has long been thought of as an inevitable part of getting older, more a nuisance than a life-altering medical condition—at least by those not experiencing it.”  But that opinion is changing, she asserts, as “the President’s Council of Advisors on Science and Technology (PCAST) and the National Academy of Sciences (NAS) have published reports calling untreated hearing loss a significant national health concern­, one that’s associated with other serious health problems, including depression and a decline in memory and concentration.”

Calderone not only treats hearing loss with the seriousness it deserves, she offers solutions to sufferers, particularly those who can’t afford to buy hearing aids, which “cost an average of $4,700 per pair in 2013.”  This is a very steep price, particularly since hearing aids are usually not covered by health insurance or Medicare.  To help with those who need hearing aids but can’t afford them, Calderone reviews a handful of hearing aid alternatives, namely personal sound amplification products (PSAPs), to see if they can fill the gap for those who need hearing aids but can’t afford to buy them.

Two PSAPs not covered in Calderone’s review are also worth considering: Doppler Labs HERE One and Nuheara’s IQbuds.  Neither company markets their PSAPs as a hearing aid or hearing aid substitute, but at around $300 a pair they offer personal amplification and soundscape management to people who might have no other options.

And a final thought about the sorry state of hearing health in the U.S.: For people who are suffering noise-induced hearing loss (NIHL), the personal and economic costs could have been avoided in the first place because NIHL is 100% preventable.

 

A little self-help can’t hurt

In light of the recent study linking traffic noise to an increased risk of acquiring dementia, this article is a must read: How To Reduce Noise Pollution At Home.

Of course, one would hope that governments would think about how best to limit noise after reading that frightening study.  The medical costs alone should be enough to motivate even the most dispassionate bean counter.  But until they do, we really must take matters into our own hands and try to make our homes as peaceful and noise free as possible.

Link via @QuietMark.

 

Here’s some frightening noise news:

Dementia rates “higher near busy roads.”, “[t]he researchers adjusted the data to account for other risk factors like poverty, obesity, education levels and smoking so these are unlikely to explain the link.”

Said Dr. Hong Chen, from Public Health Ontario and one of the paper’s authors, “increasing population growth and urbanisation have placed many people close to heavy traffic, and with widespread exposure to traffic and growing rates of dementia, even a modest effect from near-road exposure could pose a large public health burden.”

Still, the study only suggests that there is a link. As Dr. Chen concludes, “[m]ore research to understand this link is needed, particularly into the effects of different aspects of traffic, such as air pollutants and noise.”