New Year’s Motivation for Seniors

January 3, 2020

It’s that time of year when we all look forward to making positive changes in our lives and setting goals for ourselves in 2020. For seniors and those working in the senior industry, last year brought some encouraging news in the area of dementia and Alzheimer’s prevention that could serve as motivation for you and your family. One bit of good news comes from a study in the Journal of Geriatrics Society that found hearing aids lower the chance of dementia, depression, and falling. First, the facts, almost 1 in 4 people in the United States aged 65–74, have disabling hearing loss. In people over 75, that number is 1 in 2. Yet, many people who would benefit from wearing a hearing aid don’t wear them. Experts have linked hearing loss to an increased likelihood of dementia, depression and anxiety, walking problems, and falling. 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. The scientists tracked the participants' health from 1 year before their diagnosis to 3 years afterward. This allowed them to pinpoint any new diagnoses of dementia, depression, anxiety, or fall injuries. The researchers found significant differences between the outcomes of those with hearing loss who did wear a hearing aid, compared with those who did not. They found that wearing a hearing aid reduced: • The relative risk of being diagnosed with dementia — including Alzheimer's — by 18 percent • The relative risk of being diagnosed with depression or anxiety by 11 percent • The relative risk of fall-related injuries by 13 percent The question is, why? According to previous research, some experts believe that social isolation, 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. The study lead, Elham Mahmoudi, Ph.D., said they already know that people with hearing loss have more adverse health events and more co-existing conditions, but this study allowed them to see the effects of an intervention and look for associations between hearing aids and health outcomes. Though they can’t say hearing aids prevented these conditions, a delay in the onset of dementia, depression and anxiety, and the risk of serious falls could be significant both for patients and for the costs to the Medicare system. The study also wanted to learn who gets a hearing aid among different demographic groups. Overall, they found that just 12 percent of those diagnosed with hearing loss decide to use a hearing aid. Also:

13.3 percent of men with hearing loss in the U.S. is likely to acquire a hearing aid, as opposed to 11.3 percent of women.

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

Finally, the Food and Drug Administration (FDA) has approved over-the-counter hearing aids for sale in 2020 to make hearing aids more widely available to people with mild-to-moderate hearing loss. As Dr. Mahmoudi added, “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." The other good news out last year found that exercise may help to slow down Alzheimer’s. A study in the Journal of Alzheimer’s Disease and written about in Medical News Today suggests that exercising four or five times a week may delay the progression of Alzheimer's disease in people who already have toxic buildups of beta-amyloid protein. The research examined the effects of exercise in 70 adults aged 55 or over. The participants had amnestic mild cognitive impairment — the most common form of mild cognitive impairment that affects memory. It was conducted by Prof. Rong Zhang, who is affiliated with the departments of neurology, neurotherapeutics, and internal medicine at the University of Texas Southwestern Medical Center in Dallas. The participants' brains had accumulations of beta-amyloid — a protein that is a marker of Alzheimer's when it builds up to toxic levels. The researchers monitored "the effect of a progressive, moderate to high intensity" program of aerobic exercise on memory, executive function, brain volume, and cortical levels of beta-amyloid. They also monitored total brain volume and the brain volume of the hippocampus as secondary outcomes. (The hippocampus deals primarily with learning and memory, and Alzheimer's usually severely affects the area.) The participants were divided into two groups: one group did aerobic training, while the other engaged in stretching and toning control activities. At the end of the trial, both groups had similar levels of cognitive ability, particularly in terms of memory and problem-solving. However, brain imaging revealed unique benefits for participants who already had buildups of beta-amyloid and who had exercised regularly. Their hippocampus had decreased in size a lot less, compared with participants who had not exercised at all. Prof. Zhang said that while the interventions didn't stop the hippocampus from getting smaller, even slowing down the rate of atrophy through exercise could be an exciting revelation. He emphasized that more research is necessary because they still don’t know if this reduced atrophy resulted in cognitive benefits. “If these findings can be replicated in a larger trial, then maybe one day doctors will be telling high-risk patients to start an exercise plan. There's no harm in doing so now,” said Prof. Zhang. He is now leading a national clinical trial that will further investigate the link between exercise and dementia.