Source: By Robby Berman, https://www.medicalnewstoday.com/articles/326340.php#1

 

 

A new study finds that hearing devices benefit older adults in multiple ways, from physical safety to brain health.

Almost 1 in 4 people in the United States aged 65–74 have disabling hearing loss. In people over 75, the figure is 1 in 2.

Nonetheless, many people who would benefit from wearing a hearing aid do not wear them.

Experts have linked hearing loss to an increased likelihood of dementiaTrusted Source, depression and anxiety, walking problems, and falling.

Now, a study in the Journal of American Geriatrics Society finds that using a hearing device makes these problems significantly less likely to occur.

Study lead Elham Mahmoudi, Ph.D., from the University of Michigan, explains:

"We already know that people with hearing loss have more adverse health events and more co-existing conditions, but this study allows us to see the effects of an intervention and look for associations between hearing aids and health outcomes."

She continues, "Though hearing aids can't be said to prevent these conditions, a delay in the onset of dementia, depression, and anxiety, and the risk of serious falls could be significant both for the patient and for the costs to the Medicare system."

Looking into the data

The study carried out at the University of Michigan Institute for Healthcare Policy and Innovation looked at data from nearly 115,000 individuals who were over 66 years old and had hearing loss.

All the participants also had insurance through a Medicare Health Maintenance Organization (HMO).

The researchers chose Medicare HMOs because, unlike standard Medicare, they often cover hearing aid costs for members who have received a diagnosis with hearing loss from an audiologist.

The scientists tracked the participants' health from 1 year before their diagnosis to 3 years afterward. This allowed researchers to pinpoint any new diagnoses of dementia, depression, anxiety, or fall injuries.

The researchers noted significant differences between the outcomes of those with hearing loss who did wear a hearing aid compared with those who did not.

Wearing a hearing aid reduced:

• the relative risk of being diagnosed with dementia — including Alzheimer's — by 18%

• the relative risk of being diagnosed with depression or anxiety by 11%

• the relative risk of fall-related injuries by 13%

Previous research has looked into the links between hearing loss and dementia and mental health conditions. Some experts believe that social isolationTrusted Source, which sometimes comes with hearing loss, might result in less stimulation for the brain and, ultimately, cognitive decline.

Others have suggested that the deterioration of nerve impulses in the ear may be an indicator of a wider neural degeneration already underway.

 

Who gets a hearing aid?

The secondary goal of the study was to determine the adoption rate of hearing devices among different demographic groups.

Overall, the study found that just 12% of those diagnosed with hearing loss decide to use a hearing aid. The authors identified differences in adoption rates among different sexes, racial and ethnic backgrounds, and geographic locations.

• 13.3% of men with hearing loss in the United States are likely to acquire a hearing aid, as opposed to 11.3% of women with hearing loss.

• 13.6% of white participants with hearing loss received hearing aids, 9.8% of African Americans, and 6.5% of people with Latino heritage.

Clear as a bell

The Food and Drug Administration (FDA) has approved over-the-counter hearing aids for sale in 2020 in an effort to make hearing aids more widely available to people with mild-to-moderate hearing loss.

For older people with hearing loss, though, the study documents the value of acquiring a hearing aid. Mahmoudi says:

"Correcting hearing loss is an intervention that has evidence behind it, and we hope our research will help clinicians and people with hearing loss understand the potential association between getting a hearing aid and other aspects of their health."

 

 

Source: By Robby Berman, https://www.medicalnewstoday.com/articles/326340.php#1

Source: By Catharine Paddock, Ph.D. https://www.medicalnewstoday.com/articles/324323.php#1

Recent research adds to a growing body of knowledge that links hearing loss with cognitive decline, which is a hallmark of dementia and often precedes the disease.

 

After analyzing 8 years of data from a health study of more than 10,000 men, scientists at Brigham and Women's Hospital and Harvard Medical School, both in Boston, MA, found that hearing loss is tied to an appreciably higher risk of subjective cognitive decline.

In addition, the analysis revealed that the size of the risk went up in line with the severity of hearing loss.

The risk of subjective cognitive decline was 30 percent higher among men with mild hearing loss, compared with those with no hearing loss.

For men with moderate or severe hearing loss, the risk of subjective cognitive decline was between 42 and 54 percent higher.

Subjective cognitive decline refers to changes in memory and thinking that people notice in themselves. Such changes can be an early indication of cognitive decline that objective performance tests do not pick up on.

"Our findings," says lead study author Dr. Sharon Curhan, who works as a physician and epidemiologist, "show that hearing loss is associated with new-onset of subjective cognitive concerns which may be indicative of early-stage changes in cognition."

They could also "help identify individuals at greater risk of cognitive decline," she adds.

Dementia and early diagnosis

The World Health Organization (WHO) have identified dementia as a public health priority that requires more research, especially into causes and modifiable risk factors.

Today, there are around 50 million people living with dementia worldwide, and this figure is set to rise to 75 million by 2030.

There are currently no effective treatments that prevent or reverse the course of the disease.

However, early diagnosis can do much to improve the quality of life for people with dementia and those who care for them.

Identifying early decline in memory and thinking capacity could also help develop treatments that are more effective than those that target later stages of dementia, note the authors.

They go on to explain that subjective cognitive decline, that is, the changes in memory and thinking skills that people notice in themselves can indicate "subtle features" of cognitive decline that do not show up in objective tests of performance.

This is borne out by imaging studies that have linked subjective cognitive function to brain changes that precede dementia.

Such findings support the notion that subjective cognitive function lies on a spectrum that includes mild cognitive impairment and predementia.

Hearing loss and cognitive decline

In the United States, a national survey has estimated that around 23 percent of those aged 12 or older have some level of hearing loss.

The majority of individuals affected have mild hearing loss. However, in those aged 80 or older, moderate loss is more common than mild loss.

Hearing loss and cognitive decline have some features in common. Their causes involve several factors and, in many cases, both get worse over time.

Dr. Curhan and colleagues remark that these common features likely point to a buildup of "auditory and neurodegenerative damage" over the lifespan.

For their investigation, they analyzed data from the Health Professionals Follow-Up Study (HPFS).

The HPFS recruited 51,529 men from health professions who were aged between 40 and 75 years when the study began in 1986. Their professions ranged from podiatry and dentistry to veterinary medicine and optometry.

Following enrolment, the men completed questionnaires about lifestyle, medication use, diet, and medical history every 2 years.

Results of analysis

In 2006, over 28,000 of the men responded to a question about their hearing. Of these, nearly 26,000 completed regular six-item questionnaires that included items about subjective cognitive function.

From this cohort, the researchers extracted data on just over 10,000 men who met the criteria for their analysis. They left out, for example, men who did not complete all the follow-up questionnaires on subjective cognitive function.

They also excluded men with severe diseases such as Parkinson's or stroke, as either the condition or the medication could influence the results.

The team defined subjective cognitive decline as the appearance, during the follow-up, of at least one new concern.

When they analyzed the data, the researchers found that compared with participants who reported no hearing loss in 2006:

Those who reported mild hearing loss had a 30 percent higher risk of subsequent subjective cognitive decline. Those who reported moderate hearing loss had a 42 percent higher risk. Those who reported severe hearing loss — but who were not using hearing aids — had a 54 percent higher risk.

Further analysis revealed that participants with severe hearing loss who did use hearing aids had a lower, 37 percent, risk of subsequent subjective cognitive decline.

However, the authors point out that this result was not statistically significant. This could mean that the size of the effect is only slight, or that the numbers were too low to give the statistical analysis sufficient power.

The team plans to continue the study in more diverse groups using other tools and measures.

Dr. Curhan says that it is still not clear whether there is a causal link between hearing loss and cognitive decline.

 

 

Source: By Catharine Paddock, Ph.D. https://www.medicalnewstoday.com/articles/324323.php#1

Source: By Nicole Bentley, MD & Caroline Paul, MD, FAAP https://www.healthychildren.org/English/health-issues/conditions/ear-nose-throat/Pages/When-a-Sore-Thoat-is-a-More-Serious-Infection.aspx

 

Sore throats are common in kids. However, it can be difficult to sort out when your child has a sore throat that will get better on its own, or one caused by a more serious infection.

Here's some information on common infections that may include a sore throat.

The Common Cold

Sore throats are most often caused by a viral infection like the common cold. These illnesses show up more commonly during winter but can happen year-round. In addition to a sore, scratchy throat, a cold virus can cause your child to have a fever, runny nose and cough. Antibiotics will not help a sore throat caused by a virus. These infections usually get better without medication in 7 to 10 days. The best way to care for a cold and sore throat is to help keep your child comfortable and make sure he or she gets plenty of fluids and rest.

Hand, Foot, and Mouth Disease

Hand, foot, and mouth disease are caused by a family of viruses called enteroviruses. This infection most often spreads among young children during summer and fall, although cases may occur year-round. Early symptoms may include fever and sore throat or mouth pain, followed by a rash that appears as a mix of small red bumps and blisters, particularly on the hands, feet, buttocks, and around the mouth. Blisters and sores may form in the mouth and throat, making it painful to swallow. As with other viruses, antibiotics will not help this type of sore throat. Your pediatrician may recommend acetaminophen or ibuprofen for the fever and pain, along with fluids and rest at home until the blisters heal.

Strep Throat

Strep throat is an infection caused by the bacterium Streptococcus pyogenes. It's most commonly seen among children 5 to 15 years old, usually during winter and early spring. Only 20% to 30% of throat infections in school-age children are caused by strep throat. Symptoms include sore throat, pus on the tonsils, difficulty swallowing, fever, and swollen glands. Children may also complain of headaches, stomachaches, and may develop a red, sandpaper-like rash on their bodies. Cough and runny nose are NOT typical symptoms of strep throat among older children. Strep throat is extremely uncommon in infants and toddlers. When they do get strep, though, their symptoms may be different. Your pediatrician will prescribe antibiotic medicine for strep throat.  

Why is it important to know the difference?

The cause of sore throats in children usually is viral infections, which do not benefit from antibiotics and go away on their own. Children with strep throat also may also recover without antibiotics. However, antibiotics can speed up recovery time, reduce contagiousness, and lower the risk of developing certain complications from strep throat. The most important complications to avoid include acute rheumatic fever, a disease that can damage the heart and joints. Antibiotics are important for treating bacterial infections like strep throat but have their own risks, including diarrhea, yeast infections, allergic reactions, and the development of antibiotic resistance. That's why it is important to know when antibiotics are necessary for sore throat and when they are not.

Sore Throat: Diagnosis & Treatment

Your pediatrician can diagnose a sore throat caused by a virus after examining your child and ruling out a bacterial infection. The best way to care for a sore throat caused by a virus is to keep your child comfortable and making sure they get plenty of fluids and rest. Your pediatrician may recommend acetaminophen or ibuprofen to relieve the fever and pain. For hand, foot and mouth disease, which is highly contagious, your child should stay home until the blisters begin to heal.

If your pediatrician is concerned about a possible strep throat infection, he or she may swab the back of your child's throat to collect a test sample. Most pediatric clinics can do a rapid strep test, which gives results within about 10-15 minutes and can detect most cases of strep throat. If this test is negative, the pediatrician may send the sample to a lab where they will try to grow the bacteria. If either test is positive, your child may be diagnosed with strep throat. If both tests are negative, your child does not have strep throat.

Preventing Illnesses that Cause Sore Throat

The viruses and bacteria that cause a sore throat are passed from person to person through droplets of moisture in the air (from a sneeze or cough) or on the hands of someone who is infected. The illnesses may spread through schools and childcare centers. One challenge for prevention is that people are often most contagious before they even begin to have symptoms. Washing hands, covering coughs and sneezes with a tissue or upper arm (rather than hand), cleaning toys, and not sharing drinking cups is the best way to try to prevent the spread of illness.

When to Call the Pediatrician  

If your child complains of a sore throat that does not improve over the course of the day―especially after drinking water―you should call your pediatrician. This is especially true if there's a fever, headache, stomachache, drooling (because it hurts to swallow), or signs of dehydration. Your child's pediatrician may want him or her to come in for to determine if a strep test is needed.

If your child tests negative for strep throat or if your pediatrician does not think your child needs a throat swab, that is great news. Your child most likely has a virus that will get better with time. However, if his or her symptoms don't get better after 3 to 5 days, or if they develop other symptoms such as an earache or a new fever, he or she should see the pediatrician again to determine if more tests are needed.

 

 

Source: By Nicole Bentley, MD & Caroline Paul, MD, FAAP https://www.healthychildren.org/English/health-issues/conditions/ear-nose-throat/Pages/When-a-Sore-Thoat-is-a-More-Serious-Infection.aspx