Hearing, and The Value of Hearing Screenings

Because hearing loss is often gradual, you may not realize that your hearing has declined. Many people lose some hearing by age 30 or 40, and hearing loss typically increases as a person gets older. The following signs indicate that your hearing may be damaged: People sound like they’re mumbling, especially when you’re in a crowd. It’s difficult to understand human speech, and consonants are particularly difficult to hear. You hear ringing in your ears. Sensory changes that people experience as part of the aging process are often misunderstood and lead to false stereotyping or labeling of a person as confused or failing. If you are an individual with reduced hearing, my hope is that this information will provide some tips to aid you in your daily functioning, happiness, and independence. If you are family or friend of a person with reduced hearing, my hope is that you too will gain some ideas about how to help your relatives and/or friends with their hearing loss. And, free hearing screenings will be offered for individuals who are interested. Be aware that as people age, there is a decline in their ability to hear. This age related hearing loss is usually greater for men than for women. The reason for this is unknown, but it is suspected that men have been exposed to more damaging noise during their lifetimes in the military service or in their jobs. People with hearing losses must depend upon others to speak clearly to them because they cannot compensate for their hearing loss themselves. When speaking to a hearing impaired individual, speak clearly and slowly and do not change the topic abruptly. Be sure to face the person at eye level and have light on your face so lip reading is possible. Ask the person what you can do to make hearing easier. People with normal hearing have a wide range between the quietest sound they can hear and the loudness which will be painful or irritating. For the hard of hearing, this range will be much smaller. Sounds may have to be quite loud to be heard, but if the sounds are even a little louder they may be too loud and become painful. Hearing loss is worse for high frequencies; some sounds will be heard while others will not. Sounds may be distorted, heard incorrectly, or misinterpreted. Talk to hard of hearing people to find out what tone is best to use with them. Do not assume that simply making things louder will resolve the problem. Try not to allow your voice to become high and shrill – women should be especially careful about this. When there is a sound system being used for music or an oral presentation of any kind, it should be adjusted so that the base and lower tones are predominant. This will make it easier for hard of hearing people to enjoy the music or understand what is being said. Hearing loss is greater for consonants than for vowels. S, Z, T, F, and G are particularly difficult to tell apart, causing difficulty in hearing words correctly. Similar words such as cat and sat can be difficult to discriminate. People should be aware that even if the sounds can be heard, they might not always be heard correctly. It is helpful to choose a quiet private place with out background noise for conversations. Some hearing deficits can be helped by the use of hearing aids. They must be worn and adjusted correctly in order to help. And, select a seller who promptly responds to your concerns and works with you to resolve fitting and volume adjustment problems. Look for a seller who will teach you how to use the device and be available to service it. Some hearing deficits cannot be helped by hearing aids and the hearing is so poor that verbal communication is difficult. In this case, encourage use of nonverbal communication such as big smiles, waving or demonstrating. Provide items which can be seen and handled as conversation starters. Also, do not overlook the potential for writing to communicate. Provide opportunities for people to participate in activities that are enjoyable but require little conversation; playing cards, doing puzzles, preparing food and taking walks for example. When people cannot hear what is being said, be sure that they know what is going on and what the conversation is about. If there is a conversation that does not concern them, tell him/her the topic so that he/she will not feel left out or talked about. Hearing is important to more than communication. It is also a way of getting signals from the surroundings and therefore relates to safety. People who work or live with a hard of hearing person should keep this in mind. People in the community should also consider that an older person crossing the street may or may not hear a car horn. Hearing loss affects several aspects of a person’s life and the lives of their family and friends. Learning how to handle the hearing loss can be beneficial to everyone. If you or somebody you care about would like a free hearing screening, appointments are now being scheduled for March 12th and March 26th from 12:00 noon – 2:30pm at The Dale Association, 33 Ontario Street, Lockport. The screenings will be done by Mr. David Pucci, an audiologist with Niagara Cerebral Palsy. Appointments are necessary, so please call 433-1886 to register.

How Old Is Your Heart?

Heart disease is the leading cause of death in the United States. It has been estimated that up to 40 percent of the general population underestimates their risk of cardiovascular disease, with women exhibiting more of this “optimistic bias” than men. The World Health Organization estimates that up to 80 percent of cardiovascular disease-related premature deaths could be avoided if healthier habits in diet, exercise, and smoking were adopted. Yet the public health challenge remains: how to communicate risks of heart disease in a way that can produce behavior changes that lead to reduced cardiovascular risk. Recently, an online tool called Heart Age (www.heartage.me) was developed to communicate risk for cardiovascular disease in a novel, easy-to-understand way. Rather than communicating the risk in conventional ways, this short survey of health factors related to risk of cardiovascular disease assesses risk, which is then communicated as your “heart age.” The heart age uses the normal, modifiable risk factors of someone at a given age as a baseline. The heart age given to an individual using this tool then indicates the impact of various risk factors compared to what is normal for an individual of that age. For example, if a 65-year-old female has more risk factors than an average female her age, she would have a heart age of over 65 years. The risk factors measured by Heart Age are age, gender, height, weight, waist circumference, family medical history of heart problems, cholesterol, blood pressure, and diabetes. By the way, I completed the on-line tool at www.heartage.me and it was easy! I was honest because there is a history of heart disease in my family. This type of tool can be reassuring, too. I encourage you to try it if you have a computer with internet access. The effectiveness of this Heart Age tool was compared to that of conventional medical advice, as well as a traditional percentage risk-based tool for communicating cardiovascular disease risk factors. The group receiving conventional health advice was given recommendations common to an annual health checkup, including general guidelines on a healthy lifestyle. The traditional tool for communicating heart disease risk gives a patient the probability of developing a cardiovascular event in the next 10 years. In this study, 3,153 adults were studied and after 12 months, risk scores were compared. At the start of the study, the following measurements were obtained for all participants: weight, height, waist circumference, self-reports of physical activity, blood pressure and blood levels of cholesterol, glucose, and triglycerides. These measurements were then also taken one year later. Those participants who were only given conventional health advice had increased blood pressure, glucose, cholesterol, and triglyceride levels when they were measured a year later. This group also gained weight during that period, and had increased rates of smoking, due to relapses of ex-smokers. Overall, men in this group had greater increased risk from baseline than women. By contrast, the study group who used the on-line tool had decreased blood pressure, glucose, cholesterol, and triglyceride levels compared to one year earlier. The group also showed weight loss and a decrease in the number of smokers during this period. This research suggests that Heart Age’s simplicity and use of concepts familiar to the general population make it a more effective intervention tool for communicating the cardiovascular risks associated with modifiable behavior. Learning about cardiovascular risk framed as heart age not only prevented the deterioration seen in the conventional health advice group, but it also led to an improvement in measured heart age over baseline that was significantly greater than the improvement from learning about the risk framed as a risk of a heart event in 10 years. This data shows that presenting risks in clear, easy-to-understand ways not only impacts intention to change unhealthy habits, but also changes behaviors in ways that lead to a measureable decrease in the risk of heart disease. Not only does this make Heart Age a valuable health education tool, but it also suggests the importance of finding ways of presenting health-related data in ways that are meaningful and motivating for the target audience.

Adversity and Human Resilience

A recent study lends a fresh perspective to the famous quote, “That which does not kill us, makes us stronger.” The authors of this study examined the relationship between cumulative lifetime adversity and human resilience. By analyzing a nationally representative sample of the population, the authors found that individuals who experienced a moderate amount of adversity during their lifetimes had higher levels of mental health and wellbeing than (a) people with an extensive history of adversity and (b) people without any history of adversity. Taken at face value, these results seem to contradict prior research which has consistently found the experience of adversity to be positively correlated with poor mental and physical health. That said, the authors of the current article emphasize that this is the first study to examine cumulative life adversity—compared to prior research which has historically analyzed individual events or singular categories of events. In other words, in the past, researchers have either studied the occurrence of a single event in a person’s life (e.g., asking a person to describe one adverse event that occurred during their lifetime), or a single category of adverse events that can be experienced by many people. This study took a novel approach by to the topic of adversity by combining both of these methodological techniques to assess the cumulative effects of multiple events affecting the same individual across multiple categories of adverse events that tend to affect different individuals. If both the prior findings and the current study are valid, this would suggest that the experience of adversity, can produce both a debilitating effect in the immediate time-frame in which the event occurs, and a toughening (i.e., overall strengthening) affect over one’s entire life time. Consequently, this accrual of lifetime toughness would continue to bring new perspective to one’s future appraisals by placing them in a position of greater wisdom via the confidence stemming from the knowledge that they have successfully dealt with past experiences of adversity. In short, if aging is defined by the wisdom and strength that comes from it, then what doesn’t kill us may actually make us stronger—in moderation.

Overeating and Cognitive Impairment

Here’s something to think about before you hit the all-you-can-eat buffet: Mayo Clinic researchers found that overeating doubles the risk of memory loss in those age 70 and over. The study looked at 1,200 adults, ages 70 to 89, none with dementia, but 163 with mild cognitive impairment. The researchers found that those who ate more than 2,142 calories a day had nearly twice the risk of mild cognitive impairment compared to those who ate fewer than 1,526 calories a day, according to study author. The researchers also observed that the higher the amount of calories consumed each day, the higher the risk of mild cognitive impairment, noting that dietary intake has been associated previously with cognitive impairment, but the role of daily energy consumption has not been clear. The findings may have clinical implications, as doctors and patients discuss the links between common healthy living practices and overall cognitive function. People with mild cognitive impairment are not regarded as having dementia, but they have cognitive deficits that appear to precede the development of such diseases as Alzheimer's. To understand the links between caloric intake and cognitive impairment, the study asked a random sample of 1,233 non-demented study participants, ages 70 trough 89, to fill out a food frequency questionnaire for the year preceding an interview. The volunteers included 1,070 cognitively normal people and 163 with mild cognitive impairment, as determined by an expert panel. The volunteers were divided into three groups, based on the caloric intake derived from their questionnaire answers. The group with the highest daily calorie consumption was associated with a greater chance of having mild cognitive impairment. One implication of the study might be that "cutting calories and eating foods that make up a healthy diet may be a simpler way to prevent memory loss as we age, the study suggests.

Glaucoma the "Sneak Thief of Sight"

There are many good reasons to get an eye exam each year, and perhaps one of the most important is to find out if you have indications of glaucoma, a group of eye diseases that can lead to blindness. January is Glaucoma Awareness Month. This can serve as a public service to people of all ages to get a comprehensive eye exam. While there is no cure for glaucoma, there are treatments available to preserve sight. According to the World Health Organization, glaucoma is the second leading cause of blindness in the world. Some estimates state there are over 60 million people worldwide with suspected glaucoma. The Glaucoma Research Foundation, a non-profit organization dedicated to finding a cure for glaucoma, states that there are currently 2.7 million people in the United States over age 40 with glaucoma. The National Eye Institute is projecting that there will be a 58% increase in this number by 2030. There are risk factors for glaucoma. Glaucoma can strike at any age, from newborns to elders; everyone is at risk for glaucoma. However, certain groups are at a higher risk that others. People over age 60 are at a higher risk (you are six times more likely to get glaucoma if you are over 60 years), as are family members of those who have glaucoma (the most common type of glaucoma is hereditary; family history increases risk of glaucoma four to nine times), and people with diabetes. People who are severely nearsighted are also at risk for glaucoma. Some evidence links high doses of steroid use to glaucoma. Eye injuries may cause glaucoma, also. This type of glaucoma can occur immediately after the injury or years later. Glaucoma is sometimes called the “sneak thief of sight” because often there are no symptoms of the disease and once vision is lost it cannot be regained. The Glaucoma Research Foundation states that as much as 40% of vision can be lost without a person noticing. If you receive a diagnosis of glaucoma, it is important to know what it may mean. First, it does not necessarily mean that you will go blind. Blindness from glaucoma is a relatively rare occurrence. Sight impairment from glaucoma occurs in about 10% of patients. Glaucoma can be controlled with treatments for life – eye drops, laser treatment or surgery – and these treatments may be able to help prevent additional vision loss. Is it time for your annual eye exam? It may be a good time for you to schedule your eye exam for 2014.

Healthcare System Facing Many Challenges

Up to a fifth of Americans over 65 years old have mental-health or substance-abuse conditions, according to a report released by the Institute of Medicine, an independent government-advisory group. According to this study, at least 5.6 million up to as many as 8 million older adults in America have one or more conditions, which present unique challenges for their care. And, the health-care system isn’t set up to adequately address their concerns. With the number of adults age 65 and older projected to soar from 40.3 million in 2010 to 72.1 million by 2030, the aging of America holds profound consequences for the nation. Substance abuse appears to be a growing problem among Baby Boomers, and there’s no reason to believe the trend will stop. Between 2002 and 2007, the percentage of people aged 50 to 59 nearly doubled to 9.4%, and non-medical use of prescription drugs also increased substantially to 4% from 2.2%. Also, of particular concern are depression and dementia-related behavioral or psychiatric symptoms. Some of this may be brought on by the events more commonly experienced later in life, such as the death of loved ones. Another factor in the looming increase in demand on the mental health-care system is simply a larger number of aging Americans. However, older people are less likely to seek psychiatric treatment compared with younger ones, and the availability of services and professionals geared to treat this population is lacking, according to the report. Many older people with mental-health problems also have physical ailments, so clinicians have to be especially careful to avoid unsafe drug interactions. An older person’s goals for mental-health treatment also may be different than a younger patient’s. Instead of a total cure, an older individual may just want to function better while reducing the amount of needed medications. For decades, policymakers have been warned that the nation’s health care workforce is ill-equipped to care for a rapidly growing and increasingly diverse population. In the specific disciplines of mental health and substance use, there have been similar warnings about serious workforce shortages, insufficient workforce diversity, and lack of basic competence and core knowledge in key areas. An expert committee assessed the needs of this population and the workforce that serves it. The breadth and magnitude of inadequate workforce training and personnel shortages have grown to such proportions, says the committee, that no single approach can adequately address the issue. Overcoming these challenges will require focused and coordinated action by all.

New Year Healthy You Resolutions

As we start the New Year, many people make resolutions; often times it is to be healthier. What are some of the lifestyle changes that can lead to a more healthy life – and not fade away as the idea of making resolutions wears off? A balanced diet and participation in regular exercise are paramount in maintaining a healthy life for people of all ages. Routine exercise and healthy diet can have an even more noticeable impact on our general well being. Different people prefer different types of exercise. Whether you are looking for exhilarating work out such as Zumba or are trying to ease into a lifestyle change and are looking for exercise that would be beneficial but gentler – several options are available for your level. A few examples follow: Chair Exercise Class – chair exercise increases strength, flexibility, balance and endurance to those individuals with mobility limitations, arthritis and a decreased level of functioning. Classes are Tuesdays and Thursdays from 10:30 – 11:30. Meditation – Discover a new level of peace with yourself. Dress comfortably, bring a towel or mat to sit on and learn the basics of meditation. Thursdays for 4 weeks starting January 16th at 7:00pm. Qi Gong – Low impact exercise that can be practiced standing or sitting. Promotes relaxation, balance, and coordination with the use of gentle, fluid movements. Each class is 30 minutes. Wednesdays at 9:00am. Yoga – this relaxed, open class is offered ongoing for all levels. Come as often as you like and work at your own pace. Wear comfortable clothes and bring a yoga mat. Mondays from 10:00 -11:30AM. Zumba Fitness – feature exotic rhythms set to high energy Latin and international beats. Zumba is easy to do, effective and totally exhilarating. Mondays for 6 weeks beginning January 13th from 8:15 – 9:15am. Zumba Gold – modifies the moves and pace of Zumba to suit the needs of the active older participant, as well as those just starting their journey to a fit and healthy lifestyle. Wear comfortable clothes and good sneakers. Fridays for 6 weeks beginning January 16th from 8:15 – 9:15am. All of the above take place at The Dale Association, 33 Ontario Street, Lockport. Please call 433-1886 for additional information, costs, and to register. As always, be sure to check with your physician before starting any new exercise program. Many diseases in adulthood may be preventable or at least slowed down as a result of healthy lifestyle. Osteoporosis, arthritis, heart disease, high blood pressure, diabetes, high cholesterol, dementia and depression are some of the common conditions that can be positively modified through diet, exercise, and other simple lifestyle changes. A free diabetes prevention program is being offered on Thursdays, starting January 23rd at 10:00am. The workshop is being presented by Niagara County Department of Health, Nursing Department. This interactive and empowering program is for adults with pre-diabetes and diabetes. For more information or to register for this program, please call 297-1900. Workshop will take place at 33 Ontario Street, Lockport, NY. Also, Let’s talk about Cholesterol – is a free health seminar being offered on Thursday, February 13th at 10:00am at 33 Ontario Street, Lockport. Participants will learn about cholesterol and how it affects your body. Find out the difference between good and bad cholesterol, and discover how diet and exercise can help control cholesterol. Tips about eating healthier will also be provided. This free workshop is being presented by BlueCross Blue Shield of Western New York. The public is invited to attend and reservations can be made by calling 433-1886. A Parkinson’s Disease or a Movement Disorder Support Group meets the first Friday of every month at 12:30pm. This support group welcomes all. Please call Beth at 433-1886 for information or questions. Memory Minders is a social day program for people with mild memory impairment and welcomes new participants to the program on Mondays and/or Fridays from 10:00am – 2:00 pm. Participants enjoy activities and support designed to slow the further deterioration of mild memory loss. To schedule a pre-screening and for additional information, please call Angie at 433-1886. Some other important lifestyle modifications include: smoking cessation, going to your primary care doctor routinely, reviewing your list of medications with your doctor, visiting the dentist annually, following up with your eye doctor and engaging in regular and ongoing social activities. Here’s to a healthy you and happy New Year!