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Middle-age hearing loss may be associated with dementia: Research

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in middle age is associated with higher odds of cognitive decline and dementia in later years, suggests a large study in Taiwan.


Researchers tracked more than 16,000 men and women and found that a new diagnosis of between ages 45 and 65 more than doubled the odds of a dementia diagnosis in the next dozen years.


Even mild levels of could be a risk factor, so hearing protection, screening and hearing aids may be important means of reducing cognitive risk as well, the study team writes in JAMA Network Open.


“Hearing loss is a potential reversible risk factor for dementia, including Alzheimer’s disease,” said senior study author Charles Tzu-Chi Lee of National Taiwan Normal University in Taipei.


Past research suggests that about two thirds of the risk for dementia is hereditary or genetic, which means about one third of the risk is from things that are modifiable, Lee noted. Among modifiable risk factors, hearing loss accounts for about 9 per cent of dementia risk, a greater proportion than factors like hypertension, obesity, depression, diabetes and smoking.


“The early identification of hearing loss … and successful hearing rehabilitation can mitigate the negative effects of hearing loss,” Lee told Reuters Health by email. “However, the ideal time to perform hearing loss screening to reduce the risk of dementia remains unclear.”

Lee and colleague Chin-Mei Liu of the Taiwan Centers for Disease Control analysed data on people aged 45 and older from the National Health Insurance Research Database of Taiwan. They matched 8,135 patients newly diagnosed with hearing loss between 2000 and 2011 to 8,135 similar individuals without hearing loss and followed them all through 2013.


All were free of dementia at the start, but over time, 1,868 people developed dementia – and 59 per cent of them came from the hearing loss group.


Among people with hearing loss, new dementia cases were identified at a rate of 19 per 10,000 people, compared with 14 per 10,000 without hearing loss. Overall, hearing loss was associated with a 17 per cent risk increase for dementia, the researchers calculated.


But when they looked at subsets of people, almost all the increased risk was concentrated in the youngest age group. Among those 45-65, dementia risk was 2.21-fold higher with hearing loss.


“The present study suggests that screening for hearing loss should be performed when people are middle aged,” Lee said.


The results factored in variables such as sex, age and insurance type, as well as other known risks for cognitive decline and dementia. Among these, six other conditions were associated with an increased risk of dementia: cerebrovascular disease, diabetes, anxiety, depression, alcohol-related illnesses and head injury.


The study was not designed to determine how hearing loss might contribute to dementia, or if the two conditions share the same cause. One limitation of insurance data, the researchers note, is lack of precision in the dementia diagnoses.


“In an aging population, dementia will present one of the greatest challenges to society in this century,” said David Loughrey of the Trinity College Institute of Neuroscience in Dublin, who wasn’t involved in the study.


“There are now more people over the age of 65 than under the age of 5 for the first time in human history,” he told Reuters Health by email. “Pharmacological treatments for the most common cause of dementia, Alzheimer’s disease, only offer symptom-modifying effects. This has led to suggestions that a change in approach to prevention rather than treatment after diagnosis may be more beneficial.”

Future studies will investigate whether treating hearing loss can decrease the risk of dementia, the study team writes.


“Hearing health is critically important to the human experience,” said Dr. Richard Gurgel of the University of Utah in Salt Lake City, who wasn’t involved in the study.


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Sick hospital workers often expose patients to contagious illness

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Hospital workers often come to work with contagious respiratory illnesses, against the recommendations of public regulators, a Canadian study suggests.


Nearly all of the 2,093 care workers in the study who had such symptoms came to work at some point while sick.


For the study, published in the Journal of Infection Control & Hospital Epidemiology, nurses, doctors, and support staff at nine across Canada filled in online illness diaries during four flu seasons, recording symptoms such as a runny or stuffy nose, fever, cough or scratchy throat.


Of the 1,036 participants who had contagious respiratory illnesses during the study period, 52% reported working on every scheduled day of work and 94.6% reported working at least one day of their illness.


The most common reason given for working while sick was that the illness seemed mild and manageable. Compared to other care workers, physicians were more likely to work while sick and nurses were less likely.


But nurses who thought their managers expected them to show up unless they were too sick were more likely to feel obligated to work.


For most people, in fact, feeling obligated was a driving factor behind their decision to come to work sick, as was their perceptions of what managers expected from them. Younger workers, and workers without paid sick leave, were more likely to say they could not afford to stay home.


“It is only by knowing these reasons that managers and employers can take steps to mitigate the risk of infection to other people,” said Brenda Coleman, senior study author of the study from the Dalla Lana School of Public Health, University of Toronto, in email to Reuters Health. Eleven percent of the hospital workers said they had come to work even while feeling miserable because they had “things to do.” Physicians were under-represented in the study, and self-reporting of the illnesses may also confound the results, the authors acknowledge in their report.


The US Centers for Disease Control and Prevention advises workers to take seven days off or consider temporary reassignment if they have a fever and respiratory symptoms.


The research team suggests that changing sick leave policies and cultural norms could help reduce the risk of disease transmission from sick health care workers to patients.


Also needed, the researchers say, is an understanding of how to balance the costs and risks of absenteeism by sick workers against the costs and risks of illness transmission associated with working while ill.


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First two cases of Ebola confirmed in Congo’s South Kivu: Officials

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A woman and her child were the first two cases confirmed with in Congo’s South Kivu region this week, opening a new front in the fight against the outbreak.


Health officials said on Friday that the latest cases were more than 700 km (430 miles) south of where the outbreak was first detected.


has killed at least 1,900 people in Democratic Republic of Congo over the past year. This is the second biggest toll ever and militia violence combined with local resistance have made the outbreak harder to contain.


The 24-year-old woman had been identified as a high-risk contact of another case in Beni, more than 700 km north, last month, according to a government statement issued on Friday.


She travelled by bus, boat and road with her two children to Mwenga, in South Kivu, where she died on Tuesday night, according to a slide from a presentation by health officials.


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Research shows how nordic walking may benefit breast cancer patients

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Nordic walking, an aerobic activity performed with walking poles similar to ski poles, may benefit patients with breast cancer, according to a review of existing research.


The low-impact exercise improved swelling, physical fitness, disability and quality of life, the study authors conclude in the European Journal of Cancer Care.


“The main strategy in rehabilitation for women with is a change of habits, where physical exercise is a fundamental tool,” said study co-author Jorge Torres of the Faculty of Educational Sciences and Sports at the University of Vigo in Pontevedra, Spain.


“It’s not easy to turn a sedentary person into an amateur athlete, so sports such as Nordic walking are accepted more easily,” Torres told Reuters Health by email, particularly since the activity doesn’t require expensive equipment, can be done in a group with others, and is easy to learn.


Introduced in the 1980s as a summer training exercise that was similar to cross-country, or Nordic, skiing, Nordic walking became more widespread in the 2000s. It’s now part of some exercise-based rehabilitation programs, especially in Northern Europe where it is more common, Torres noted.


He also owns a personal training company, Vigo Entrena, that creates physical activity programs for people with specific needs, including injuries, obesity, pregnancy, postpartum and women with breast cancer, and he specializes in Nordic walking training.


To see if this form of exercise helps women treated for to reduce side effects like arm swelling, and offers other benefits of exercise, Torres and his colleagues analyzed nine studies. Four studies were randomized controlled trials comparing Nordic walking to other activities; the other studies focused on specific effects of Nordic walking.


Periods of exercise in the studies ranged from 30 to 80 minutes and were performed on one to five days a week for up to 12 weeks.


In eight of the nine studies, Nordic walking had a positive effect on a number of symptoms, including lymphedema, fitness, upper-body strength, disability and perceptions of pain and swelling.


A handful of studies also showed improvements in depression, self-efficacy for managing pain and improvements in physical activity levels. They didn’t find any adverse effects, and the study participants seemed to stick with the programs.


The biomechanical gesture of Nordic walking, compared to just walking, seemed to counteract some of the side effects that can come from cancer treatment, such as shoulder-arm mobility and postural problems, the study team writes.


“(Many) health professionals and therapists do not realize that there are contraindicated exercises during breast cancer rehabilitation and that alternatives such as Nordic walking can be very effective,” Torres said.


“Nordic walking is a structured form of physical activity which nowadays has been shown to be ‘more complete’ than basic walking,” said Marco Bergamin of the University of Padova in Italy, who wasn’t involved in the research review.


“Another important point that is less stressed by these authors: quality of life,” Bergamin said in an email. “Nordic walking gives huge benefits because breast cancer patients are survivors, and from a socio-psychological point of view, that really impacts their life.”


Future studies should also investigate the intensity, frequency, duration, and length of exercise needed to help breast cancer patients, said Lucia Cugusi of the University of Cagliari in Italy, who also wasn’t involved in the review.


“What is most evident is the growing interest of the scientific community in tracking the needs, interests and preferences of patients,” Cugusi said by email.


“Offering them novel forms of physical activity that are both effective and engaging has become one of the new and stimulating research fields in cancer therapy and management.”


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