Monday, 13 November 2017

Aging for Amateurs: Hearing loss tied to dementia

Earlier this year, a group of international experts on dementia commissioned by The Lancet, a British medical journal, to study “dementia prevention, intervention and care,” reported their findings.


Part of the report took a fresh look at risk factors for dementia and found that more than a third of our risk is likely modifiable. That is, we can do something about it, as opposed to risk controlled by genetics. Most of the modifiable risk factors have been discussed in previous columns (increasing formal education, controlling high blood pressure and diabetes, exercising regularly, avoiding obesity and smoking, treating depression adequately and being socially engaged). But the single strongest potentially modifiable risk factor in their research was a surprise to me and many others — hearing loss.

According to their calculations, 35 percent of dementia can be blamed on the nine risk factors listed above. Among those factors, more than one-fourth is linked to hearing loss. 
Why does hearing loss make dementia more likely? The mechanism for creating problems with thinking due to decreased hearing is “not yet clear," according to the authors of the report, but is probably related to adding to the “cognitive load” of a vulnerable brain. If you don’t hear well, it makes the brain work harder to try to interpret what is going on around it, increasing levels of background stress in many minute-by-minute interactions. In addition, not hearing well may lead to increased risk of social disengagement and even depression.

Certain subgroups seem more likely to develop poor hearing. Men are twice as likely as women to have hearing impairment. Years in school also seem to matter, less education is associated with hearing loss. However, noise on the job (previously associated with lower education levels in workers) didn’t seem to matter, even though very loud noise can damage hearing.


People are exposed to less noise at work than they were 30-50 years ago due to changes in regulations regarding noise on the job and an increase in white collar positions. Obesity also increases the risk for hearing loss, as does smoking and poorly controlled diabetes (but the high level of risk for dementia due to hearing loss is present even without these “co-factors”).
What can we do to protect our hearing? First, avoid very loud noises. Prolonged exposure to any noise over 85 decibels (dB), such as heavy city traffic, a busy school cafeteria or a lawn mower, can cause gradual hearing loss.

No more than 15 minutes of unprotected exposure to noise above 100dB (wood shop, snowmobile, maximum volume level of a personal listening device) is recommended.
Remember that few types of headphones shut out all or even most ambient noise, so listening to music on your iPhone or other device while mowing the lawn creates additive noise levels. Regular exposure to more than a minute of 110dB noise risks permanent hearing loss (rock concerts, ambulance sirens, jet take-offs, fireworks at close range , shotgun blasts, etc.)
If your ears ring after a noise exposure, this suggests that a least a tiny bit of permanent damage has been done to your hearing. 

What about dietary supplements? We have said before that a wide variety of fruits and vegetables (filling half our plates when we eat) is better than a load of supplements. Research suggests that folate, beta-carotene and other carotenoids, and omega-3 fats are some of the likely protective components, but there are likely many more in that half plate of fruits and vegetables. The healthy fats in a couple of servings of fish per week are also likely to help us hear better.
What about hearing aides? We don’t have research to support their use to decrease risk of dementia yet.
But we do know that effective aides can improve social interactions and make interpersonal relationships less stressful. If you are over 50 and haven’t had your hearing tested, it is probably a good idea (at your primary doctor’s office; ear, nose and throat specialist, or independent audiologist). If you prefer, another low cost screening called the National Hearing Test requires only a land line telephone and a quiet room in your home.


SOURCE: The Post and Courier, Lauren Sausser

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