Hearing Loss and Dementia

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Most people can expect to deal with hearing loss in the course of normally long lives. 50% of people in their 70’s suffer from it, as do 80% of people in their 80’s. Unfortunately, besides being troublesome, it appears that hearing loss can have a direct causal effect on dementia, as well as other bad outcomes. (See the table in our post Nine Factors Contributing to Dementia — You Can Manage Them. Hearing loss, at 9%, is the largest factor.)

1,164 participants (average age 73.5) in a 24-year longitudinal study underwent assessments for hearing acuity and cognitive function between the years 1992 to 1996. All of them were followed for up to 24 years with up to five subsequent cognitive assessments at approximately four-year intervals. None used a hearing aid.

Almost half of the participants had mild hearing impairment, with almost 17% suffering moderate-to-severe hearing loss. Those with more serious hearing impairment showed worse cognitive performance at the initial visit. Hearing impairment was associated with greater decline in performance on cognitive tests over time, both for those with mild hearing impairment and those with more severe hearing impairment.

Here are two media articles on the work:
With age comes hearing loss and a greater risk of cognitive decline
How hearing impairment is associated with cognitive decline
Here is the abstract of the original research article:
Hearing impairment and cognitive decline in older, community-dwelling adults.

Similar conclusions arise from a study of 8 years of data from more than 10,000 men. The study compared the effects of hearing loss with measures of subjective cognitive decline, which is changes in memory and thinking that people notice in themselves.

The risk of subjective cognitive decline was 30 percent higher among men with mild hearing loss, compared with those with no hearing loss, while for men with moderate or severe hearing loss, the risk was between 42 and 54 percent higher.

Media article:
Hearing loss and cognitive decline: Study probes link
Research publication:
Longitudinal study of hearing loss and subjective cognitive function decline in men

In another study that covered over 154,000 adults 50 and older who had health insurance claims, but no evidence of hearing device use, researchers found that untreated hearing loss increased the risk of developing dementia by 50 percent and depression by 40 percent in just five years when compared to those without hearing loss. This study also demonstrated a clear association between untreated hearing loss and not only an increased risk of dementia and depression, but also falls and even cardiovascular diseases.

Here are three media articles on this study:
Hearing Loss Threatens Mind, Life and Limb
Higher risk of dementia and depression with an untreated hearing loss
Hearing Loss in Older Adults Linked to Depression, Dementia Among Other Comorbidities
Here is the original research publication:
Incident Hearing Loss and Comorbidity: A Longitudinal Administrative Claims Study

There is concrete evidence that using hearing aids can slow the rate of cognitive decline, as shown by two recent research studies.

Here is a review discussion of the first research publication on hearing aids:
Evidence that Hearing Aids Could Slow Cognitive Decline in Later Life
First research article:
Longitudinal Relationship Between Hearing Aid Use and Cognitive Function in Older Americans

Here are media articles about the second research publication on hearing aids:
Hearing aids linked to lower risk of dementia, depression and falls
Hearing aids lower the chance of dementia, depression, and falling
Second research article:
Can Hearing Aids Delay Time to Diagnosis of Dementia, Depression, or Falls in Older Adults?

Finally, we note a study, closely related to the “Administrative Claims Study” above, which shows that untreated hearing loss tends to lead to higher health care costs over time. (Users of hearing aids were not considered in the study, so, as yet, one cannot conclude that hearing aid use might lower costs, though that might be a reasonable inference.)

Media article:
Patients with untreated hearing loss incur higher health care costs over time
Research article:
Trends in Health Care Costs and Utilization Associated With Untreated Hearing Loss Over 10 Years

All links have been added to Aging and Alzheimers > Risk Factors

Visualization of Alzheimer’s Clinical Trials

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This image displays the massive amount of as-yet-not-successful effort which has gone into seeking understanding or cures or ameliorations of Alzheimer’s disease:


From: History and progress of hypotheses and clinical trials for Alzheimer’s disease

This link has been added to Alzheimers > .

Physical Activity And Dementia

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A study published early this year shows that there is an association between the level of a person’s physical activity (even light activity) and the level of cognitive ability, even if the person displays behavioral signs of Alzheimer’s or other dementia. While the study does not demonstrate a causal link, the known links between exercise and heart health make adding or maintaining physical movement a good bet for reducing the risk of, or diminishing the effects of, Alzheimer’s.

Here are four media articles on the work:
Activity sharpens even dementia-affected brains, report suggests
Daily Movement — Even Household Chores — May Boost Brain Health In Elderly
Study Links Moving More in Older Age to Sharper Memory
Dementia care: The one activity you need to do in old age proven to protect the brain
Research article:
Physical activity, common brain pathologies, and cognition in community-dwelling older adults

A man epitomizing using physical activity to fight Alzheimer’s:
Meet the man living with Alzheimer’s who climbs the same mountain every day

All links have been added to Health > Physical Exercise and Alzheimers > Amelioration/Prevention. The last link above has also been added to Alzheimers > Coping & Caregivers Coping Stories.

New Aging Resource Page

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We’ve added a new page of links under Aging:

Aging > Useful Sponsored Web Pages for Seniors

Links to web pages are sent to us regularly by various commercial organizations, particularly for our Aging page. Some are ok for Strong Brain Blog, some have absolutely nothing to do with this blog, and some show their commercial origin, but the level of advertising is restrained.

We’ll be adding any reasonable new ones that arrive. Here’s a snapshot of the page right now:

Staying Healthy in Your Home as You Age
Simple Changes to Make Your Home Safe for Aging in Place
Make Your Bathroom Safer with a Walk-In Tub
Accommodating the Needs of a Multigenerational Household
Grab Bars: Why and How to Install Them

The complete medication management guide for seniors

AboutAssistedLiving.org

Financial Assistance & Funding Options for Assisted Living / Senior Living

The Complete Guide to Home Modifications to Prevent Falls
Selling a Home with Modifications for Older Adults
Falls an Early Sign of Alzheimer’s
Fall Prevention & Mobility: Practical Safety and Organization Strategies for Seniors
Preventing Falls for a Person with Dementia
Senior Fall Prevention: A Roadmap for Navigating Resources and Benefits

Best Medical Alert Systems – 2019

Sleep Help for Seniors

Category: Aging, Announcements

Catch Up II: Weight Training, A Wedding, History, COPD.

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Here we continue Catch Up I: Dementia Signs, Microbiome & Brain, Processed Foods & More, setting out four brief posts concerning links which either bring up to date earlier posts on Strong Brain, or which are simply of interest in and of themselves.

Weight Training & Brain Health

Add weight training to the list of types of exercise benefitting body and brain (even if the study deals with rats): Serious Exercise May Seriously Defer Aging.

Media articles:
How Weight Training Changes the Brain
Weight Training – Good for the Brain Too?
Research publication:
Resistance-exercise training ameliorates LPS-induced cognitive impairment concurrent with molecular signaling changes in the rat dentate gyrus

Category: Exercise, Aging

Another Bittersweet Wedding.

So sad, yet so sweet: A man descends into dementia, forgets he is married to his wife — who is his caregiver, and who he deeply loves — and pesters her to marry him. Which she does, again:
After Countless Proposals, She Finally Said Yes. Again.

See Coping & Caregiving: Bittersweet Stories for more such stories.
Category: Coping & Caregivers > Coping Stories

History of Alzheimer’s

The History of Alzheimer’s Disease

Category: Alzheimers > General & Resources > General

COPD and Your Brain

Chronic obstructive pulmonary disease (COPD) cuts down on the amount of oxygen supplied by your lungs to all parts of your body, including your brain. It is linked to a higher risk for memory and cognitive problems with older adults with COPD having nearly twice the risk for memory problems:
How COPD Affects Your Brain

Category: Risk Factors

Each group of links has been added to the indicated categories.

Catch Up I: Dementia Signs, Microbiome & Brain, Processed Foods & More

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Here we set out five brief posts concerning links which either bring up to date earlier posts on Strong Brain, or which are simply of interest in and of themselves.

Signs: Onset of Dementia

Our recent post Distilled: Signs of the Onset of Dementia listed 18 possible signs of the onset of dementia. The excellent article Recognizing Alzheimer’s Disease adds to that by providing a discussion of early warning signs and a view of diagnosis.

Category: Diagnosis & Tests

Microbiome & Brain

Quite recently, it has become apparent that the microbiome (all the microbes resident in an organism) can affect the brain, including the amount of amyloid beta clumps and exhibition of autistic behaviors. Much of the work has been done with mice (surprise!), but some also on humans. This is a quite interesting article on these investigations:
Germs in Your Gut Are Talking to Your Brain. Scientists Want to Know What They’re Saying.

Category: Neuro-Psych

☞ More on Processed Foods

Recently we published a somewhat lengthy post Best To Avoid Over-Processed Foods. The article below adds to that post:
What’s so bad about processed foods? Scientists offer clues.

Category: Diet

Cancer Treatment and Dementia

A very large U.S. study of prostate cancer patients in their 70’s demonstrates a notable increased risk of Alzheimer’s among patients who received Androgen Deprivation Therapy.
Dementia tied to hormone-blocking prostate cancer treatment
Hormone Therapy for Prostate Cancer Tied to Dementia
Original research:
Association Between Androgen Deprivation Therapy Use and Diagnosis of Dementia in Men With Prostate Cancer

Category: Risk Factors

Dementia Screening During Wellness Exams

The article Alzheimer’s Screenings Often Left Out Of Seniors’ Wellness Exams discusses the situation vis-a-vie dementia screening during annual wellness exams for seniors. The number of seniors experiencing them, and the number of physicians administering them, are relatively low, for a variety of reasons discussed in the article. Most likely, large-scale routine screening won’t be happening until a moderately inexpensive blood test is widely available.

Category: Diagnosis & Tests

Each group of links has been added to the indicated category.

High Blood Pressure And Dementia

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The link between high blood pressure and dementia has been known for some time. Two recent research reports reinforce this existing knowledge.

One study set out to determine the effects of intensively lowering systolic blood pressure to less than 120 mm Hg on the heart, kidney, and brain in hypertensive older adults who did not have diabetes or stroke; the present report deals with a sub-study focused on brain health, and showed that aggressive treatment of hypertension to less than 120 mm Hg systolic blood pressure is not harmful to the brain, but beneficial.

The second study examined how blood pressure changes/patterns related to dementia risk over time. It was shown that the patterns consisting of midlife and late-life hypertension, and midlife hypertension and late-life hypotension, significantly increased risk of subsequent dementia as compared with people with normal blood pressure.

Here are three media articles about the reports:
Controlling blood pressure may help ward off dementia
Abnormal blood pressure in middle and late life influences dementia risk
Studies Tackle Blood Pressure, Cognition Relationship

Original research articles:
Association of Midlife to Late-Life Blood Pressure Patterns With Incident Dementia
Association of Intensive vs Standard Blood Pressure Control With Cerebral White Matter Lesions

Inspired by these reports, here is an article about lowering blood pressure:
Tips for lowering your blood pressure, which may reduce your risk of dementia

All links have been added to Alzheimer’s > Risk Factors.

Napping: Alzheimer’s Disease Destroys Alertness Neurons

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For some time, excessive daytime drowsiness and napping has been regarded as one of the earliest signs of Alzheimer’s. It was argued that daytime naps were a consequence of poor night’s sleep (common for Alzheimer’s patients). However, new research shows that the tau tangles characteristic of Alzheimer’s directly attack the brain regions responsible for maintaining daytime alertness. Hence, excessive daytime napping can indeed be seen as an early warning sign of the onset of Alzheimer’s.

Here are three media articles and a university post:
Alzheimer’s disease destroys neurons that keep us awake
Alzheimer’s Appears to Attack The Neurons That Keep Us Awake
Alzheimer’s disease destroys neurons that keep us awake
Alzheimer’s Disease Destroys Neurons that Keep Us Awake
Here is the research publication [paywall]:
Profound degeneration of wake-promoting neurons in Alzheimer’s disease

All links have been added to Neuro-Psych.

Closer To A Blood Test For Alzheimer’s

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Clumps of amyloid beta can begin building up in the brains of Alzheimer’s sufferers nearly 20 years before the individuals exhibit the memory loss and confusion characteristic of Alzheimer’s disease. Currently, the most reliable method of detecting amyloid beta buildup before exhibition of behavioral symptoms is using a PET scan (Positron emission tomography) (Brain Scans Prevent Alzheimer’s Misdiagnosis and Lead to Better Treatment—But They’re Not Covered By Medicare), but these are expensive, not covered by insurance, and take time and a visit to a site with the right scanning machinery. Because of this, few people have the scans done on a routine annual basis, and it is very difficult for drug researchers to recruit participants who might develop Alzheimer’s in the future, but don’t current exhibit memory loss and confusion.

These are all reasons why a blood test which could detect buildup of amyloid beta as early as PET scans would be highly desirable. A recent research publication reports on work coming very close to such a test. A certain amount of amyloid beta is naturally present in both brain and blood. The test first chops up the amyloid obtained from a blood sample with enzymes. The amounts of two fragments, called a-beta 42 and a-beta 40, are obtained by mass spectrometry, and their ratio is computed. As amyloid beta starts building up in the brain, less of the fragment a-beta 42 is available for circulation in the blood, and so the computed ratio goes down. Utilizing this ratio, together with an individual’s age and genetic risk, the test was able to match PET scan performance on 94% of the study participants.

Although at present there are no reliable methods of treating Alzheimer’s, a positive result on a blood test such as this would enable one to take steps to defer the onset of the disease, using:

And, sensibly, one could ensure that one’s will and healthcare advance directive were up to date, and one could consider creating an Advance Directive for Dementia.

Here are three media articles on the blood test work:
Blood test can identify Alzheimer’s 2 decades before symptoms
Blood test is 94% accurate at identifying early Alzheimer’s disease
New Alzheimer’s Blood Test Proved 94% Accurate in Finding Brain Changes Related to the Disease

Here is the published research article:
High-precision plasma β-amyloid 42/40 predicts current and future brain amyloidosis

All links have been added to Alzheimers > Diagnosis & Tests

Anticholinergic Drugs Might Lead To Dementia

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Acetylcholine (ACh) is a neurotransmitter (chemical messenger) occurring widely in the brains and bodies of humans and many animals. Anticholinergics are chemical substances (drugs) which block the action of acetylcholine at synapses in the central and the peripheral nervous system. For some years, many scientists have suspected that long-term use of various anticholinergics might tend to increase the risk of dementia. A succession of studies have shown a strong association between long-term use of various anticholinergics and the later development of dementia. We set out three of them here. In total, the three studies involved 637,843 participants.

The most recent study was published June 24, 2019. It showed that the strongest associations between anticholinergics and dementia was for these classes of drugs: antidepressants, bladder antimuscarinics (treating overactive bladder), antipsychotics and antiepileptic drugs.

Here are four media articles about the most recent work:
Anticholinergic Drugs Associated With Dementia Risk
Commonly prescribed drugs are tied to nearly 50% higher dementia risk in older adults, study says
Widely used class of drugs linked to dementia
Anticholinergic Drugs Could Account for 10% of Dementia Cases

Here is the original research article, together with a page of commentary by related experts:
Anticholinergic Drug Exposure and the Risk of Dementia, A Nested Case-Control Study
expert reaction to anticholinergic drug exposure and risk of dementia

Here are summaries concerning anticholinergic drugs:
Anticholinergic Drugs to Avoid in the Elderly
List of Anticholinergic Drugs and Why Some of Them are Dangerous for Seniors
Here is a table merging the information from the two pages above:
Table of Anticholinergic Drugs


The next study was published April 25, 2018 and showed that anticholinergics for depression, Parkinson’s and urinary incontinence carry a higher risk of dementia than others.

Here are three media articles about this research:
Some antidepressants linked to dementia risk
Certain common medications tied to 30% higher dementia risk, study finds
Some antidepressants and incontinence drugs linked to dementia
CAN ALLERGY MEDICATIONS HARM YOUR BRAIN?

Here is a summary concerning anticholinergic drugs:
Anticholinergics

Here is an NIH abstract of the research, together with the original research article:
Anticholinergic drugs and risk of dementia: case-control study. (NIH Abstract)
Anticholinergic drugs and risk of dementia: case-control study (Full Publication)


The research reports above both build on earlier work, in particular research reported on March 1, 2015. Here are two articles about that work:
Common anticholinergic drugs like Benadryl linked to increased dementia risk
Benadryl and Other Common Medications are Linked to Dementia in Men and Women

And here is the original research article:
Cumulative use of strong anticholinergics and incident dementia: A prospective cohort study

All links have been added to Alzheimers > Risk Factors.