Link Between Hearing and Cognition Begins Earlier Than Once Thought

Research has shown that adults with age-related hearing loss have higher rates of cognitive decline.

Now, a study from researchers at Columbia University Vagelos College of Physicians and Surgeons has found that even the earliest stage of hearing loss—when hearing is still considered normal—is linked to cognitive decline.

The study was published online today in JAMA Otolaryngology-Head and Neck Surgery.

Link Between Hearing Loss and Cognitive Impairment

Age-related hearing loss is one of the most common health disorders of aging, affecting two-thirds of those over age 70. However, few adults are tested for hearing loss, and even fewer are treated. Only 14% of adults with hearing loss in the United States wear hearing aids, the standard treatment.

Because studies show people with age-related hearing loss are more likely to have impaired cognition, it is thought that hearing loss may trigger cognitive decline. But these studies have only examined people diagnosed with hearing loss, which is defined as the inability to hear sounds under 25 decibels (dB).

“Physicians in this field have used 25 dB—about the loudness of a whisper—to define the border between normal hearing and mild hearing loss in adults, but this level is arbitrary,” says Justin S. Golub, MD, MS, assistant professor of otolaryngology-head & neck surgery at Columbia University Vagelos College of Physicians and Surgeons and a hearing specialist at Columbia University Irving Medical Center and NewYork-Presbyterian.

“It has been assumed that cognitive impairment wouldn’t begin until people passed this threshold. But no one actually looked at whether this was true.”

Any Hearing Loss May Be Cause for Concern

The researchers looked at data from 6,451 adults (average age 59) who were enrolled in two ethnically diverse epidemiologic studies. Participants underwent hearing and cognitive testing as part of the studies.

Golub and his colleagues found that for every 10 dB decrease in hearing, there was a significant decrease in cognitive ability, a pattern seen across the entire spectrum of hearing.

Surprisingly, the largest decrease in cognitive ability occurred in those whose hearing was just starting to become impaired, just 10 dB off the perfect mark.

“Most people with hearing loss believe they can go about their lives just fine without treatment, and maybe some can,” says Golub. “But hearing loss is not benign. It has been linked to social isolation, depression, cognitive decline, and dementia. Hearing loss should be treated. This study suggests the earlier, the better.”

Can Hearing Aids Prevent Cognitive Loss?

The current study did not address whether hearing loss causes cognitive impairment. It is possible that early declines in both hearing and cognitive performance are related to common aging-related processes, the researchers noted.

“But it’s also possible that people who don’t hear well tend to socialize less and, as a result, they have fewer stimulating conversations. Over many years, this could have a negative impact on cognition,” says Golub. “If that’s the case, preventing or treating hearing loss could reduce dementia incidence by more than 9%, according to a recent analysis published in The Lancet.”

A new study, funded by the National Institutes of Health, is now testing the possibility that hearing aids can slow cognitive decline in older people with age-related hearing loss.

More studies are needed before recommending changes in hearing loss categories. “One possibility is to formally introduce a new category, such as borderline hearing loss, ranging from 16 to 25 dB of hearing ability,” says Golub.

Source: Columbia University


Today’s Comic

New Research Reveals Protein Bars Not as Healthy as People Think

A new research report launched today by safefood has revealed that chocolate is the main ingredient in almost 40% of protein bars surveyed, with many also being high in saturated fat and containing added sugar and salt. The research also found that over 1 in 3 people (37%) surveyed think protein bars are “healthy”. When comparing current protein intakes among adults with what’s recommended, both men and women are already consuming more protein than they need from their diet.

The safefood research looked at the nutritional content of 83 high-protein snack foods and drinks available for sale in supermarkets on the island of Ireland. These foods included protein bars, yoghurts, yoghurt-style products and milk drinks. According to industry sources², there was a 498% increase in products launched between 2010 and 2016 with a high-protein claim.

Introducing the research, Dr Catherine Conlon, Director of Human Health & Nutrition, safefood said, “We’ve witnessed a significant and consistent upsurge in the number and variety of foods and drinks for sale which claim to be ‘high-protein’. From bars to milks and yoghurts, high-protein foods have now become mainstream in our supermarkets. When we asked people about protein bars, a third of them thought they were healthy. However, many of these bars are, in reality, highly processed foods with a calorie content similar to that of a bar of chocolate”.

“What’s also evident from dietary data is that men and women are already consuming more than enough protein in their diets and simply don’t need this extra, highly processed protein,” stated Dr Conlon.

Of the 39 protein bars surveyed, 38% listed chocolate as their main ingredient. 77% were high in saturated fat with 79% being a source of salt. The average bar size was 55g with an average price of €2.27 / 1.78 though some bars cost as much as €3.00 / £2.49 each.

“Processed snack foods high in protein need to be combined with fat, sugar or salt in order to make them tasty,” continued Dr Conlon. “People would be better sticking to natural sources of protein in their diet, which tend to be much healthier. And if you need a source of protein as a snack, alternatives like some nuts, a small glass of milk or a yoghurt is the way to go instead of these foods with added chocolate.”

Source: Safefood


Read the full report . . . . .

Fish Oil Is Good Medicine for Heart Failure

Amy Norton wrote . . . . . . . . .

Fish oil might help people with heart failure avoid repeat trips to the hospital, a new study suggests.

The findings come from an analysis of a clinical trial first published last year, where researchers tested the effects of fish oil and vitamin D on people’s risk of heart disease and cancer.

That main trial — called the Vitamin D and Omega-3 Trial (VITAL) — had some encouraging results. Healthy older adults given a fish oil supplement were less likely to suffer a heart attack over the next several years, especially if they had never been big fish eaters.

The current analysis looked at whether supplements had any effect on participants’ risk of being hospitalized for heart failure.

Heart failure is a chronic condition in which the heart gradually loses its ability to efficiently pump blood to the body. Often, it stems from heart-muscle damage caused by a heart attack — which raised the question of whether the benefits seen in the trial might extend to heart failure, explained Dr. Luc Djousse.

Djousse, of Brigham and Women’s Hospital and Harvard Medical School in Boston, led the current study.

Overall, his team found, neither vitamin D nor fish oil curbed the risk of first-time hospitalization for heart failure over five years. But people using fish oil were somewhat less likely to need repeat hospital stays.

The finding offers a “signal” that the supplements might help prevent heart failure hospitalizations, Djousse said.

But, he stressed, that still needs to be backed up by further study.

Fish oil is rich in omega-3 fatty acids, which are known to help lower triglycerides, lessen inflammation and blood clotting, and help stabilize heart rhythm.

The American Heart Association (AHA) recommends that people eat fish twice a week — preferably fatty varieties higher in omega-3, such as salmon, mackerel, sardines and albacore tuna.

Djousse advised following that recommendation. “But don’t fry your fish,” he added. “Have it broiled or baked.”

The findings, published Nov. 11 in Circulation, come from a trial involving nearly 26,000 adults aged 50 and older who were initially free of heart problems. They were randomly assigned to take either 1 gram of prescription-grade fish oil (Omacor), 2,000 IU of vitamin D, or a placebo every day.

Over five years, the fish oil group was 28% less likely to suffer a heart attack compared to the placebo group. The effect was more pronounced among people whose diets had been low in fish: They were 40% less likely to have a heart attack than placebo users.

When Djousse’s team looked at heart failure hospitalizations, there was no clear effect of either fish oil or vitamin D on first-time admissions. But fish oil users were 14% less likely to have repeat hospitalizations: There were 326 recurrent hospital stays in that group and 379 in the placebo group.

Why wouldn’t fish oil prevent a first hospitalization? It’s not clear. But Djousse said there were fewer first-time hospital stays, so the numbers might have been too small to detect an effect.

That is a possibility, agreed Dr. David Siscovick, a senior research scientist with the New York Academy of Medicine who was not involved in the study.

More research is needed, Siscovick said. But, he added, at this point, there is no evidence that fish oil can prevent heart failure from developing.

There is, however, evidence that patients with existing heart failure may benefit.

Siscovick chaired an AHA committee that, in 2017, issued an advisory on omega-3 supplements and heart disease.

The advisory said it was “reasonable” for doctors to prescribe omega-3 to heart failure patients, based on an Italian clinical trial called GISSI. In that trial, researchers randomly assigned heart failure patients to either take an omega-3 supplement or a placebo (olive oil). Over four years, patients on omega-3 had a 9% lower risk of being hospitalized or dying.

The current study, Siscovick said, is “very consistent” with that evidence.

He also stressed, though, that heart failure is a complex condition, with different forms and different underlying causes. So if people with heart failure are curious about fish oil, he said, they should talk to their doctor about whether a prescription is right for them.

Source:


Today’s Comic

High Levels of Two Hormones in the Blood Raise Prostate Cancer Risk

Men with higher levels of ‘free’ testosterone and a growth hormone in their blood are more likely to be diagnosed with prostate cancer, according to research presented at the 2019 NCRI Cancer Conference.

Other factors such as older age, ethnicity and a family history of the disease are already known to increase a man’s risk of developing prostate cancer.

However, the new study of more than 200,000 men is one of the first to show strong evidence of two factors that could possibly be modified to reduce prostate cancer risk.

The research was led by Dr Ruth Travis, an Associate Professor, and Ellie Watts, a Research Fellow, both based at the University of Oxford, UK. Dr Travis said: “Prostate cancer is the second most commonly diagnosed cancer in men worldwide after lung cancer and a leading cause of cancer death. But there is no evidence-based advice that we can give to men to reduce their risk.

“We were interested in studying the levels of two hormones circulating in the blood because previous research suggests they could be linked with prostate cancer and because these are factors that could potentially be altered in an attempt to reduce prostate cancer risk.”

The researchers studied 200,452 men who are part of the UK Biobank project. All were free of cancer when they joined the study and were not taking any hormone therapy.

The men gave blood samples that were tested for their levels of testosterone and a growth hormone called insulin-like growth factor-I (IGF-I). The researchers calculated levels of free testosterone – testosterone that is circulating in the blood and not bound to any other molecule and can therefore have an effect in the body. A subset of 9,000 of men gave a second blood sample at a later date, to help the researchers account for natural fluctuations in hormone levels.

The men were followed for an average of six to seven years to see if they went on to develop prostate cancer. Within the group, there were 5,412 cases and 296 deaths from the disease.

The researchers found that men with higher concentrations of the two hormones in their blood were more likely to be diagnosed with prostate cancer. For every increase of five nanomoles in the concentration of IGF-I per litre of blood (5 nmol/L), men were 9% more likely to develop prostate cancer. For every increase of 50 picomoles of ‘free’ testosterone per litre of blood (50 pmol/L), there was a 10% increase in prostate cancer risk.

Looking at the population as a whole, the researchers say their findings correspond to a 25% greater risk in men who have the highest levels of IGF-I, compared to those with the lowest. Men with the highest ‘free’ testosterone levels face a 18% greater risk of prostate cancer, compared to those with the lowest levels.

The researchers say that because the blood tests were taken some years before the prostate cancer developed, it is likely that the hormone levels are leading to the increased risk of prostate cancer, as opposed to the cancers leading to higher levels of the hormones. Thanks to the large size of the study, the researchers were also able to take account of other factors that can influence cancer risk, including body size, socioeconomic status and diabetes.

Dr Travis said: “This type of study can’t tell us why these factors are linked, but we know that testosterone plays a role in the normal growth and function of the prostate and that IGF-I has a role in stimulating the growth of cells in our bodies.”

“What this research does tell us is that these two hormones could be a mechanism that links things like diet, lifestyle and body size with the risk of prostate cancer. This takes us a step closer to strategies for preventing the disease.”

Dr Travis and Ms Watts will continue examining the data from this study to confirm their findings. In the future, they also plan to home in on risk factors for the most aggressive types of prostate cancer.

Professor Hashim Ahmed, chair of NCRI’s prostate group and Professor of Urology at Imperial College London, who was not involved in the research said: “These results are important because they show that there are at least some factors that influence prostate cancer risk that can potentially be altered. In the longer term, it could mean that we can give men better advice on how to take steps to reduce their own risk.

“This study also shows the importance of carrying out very large studies, which are only possible thanks to the thousands of men who agreed to take part.”

Source: National Cancer Research Institute


Today’s Comic

Heart Disease and Cancer Risk May be Linked

Heart attack survivors may have an increased risk of developing cancer compared to people without cardiovascular disease, according to research to be presented at the American Heart Association’s Scientific Sessions 2019 — November 16-18 in Philadelphia. The Association’s Scientific Sessions is an annual, premier global exchange of the latest advances in cardiovascular science for researchers and clinicians.

People with more risk factors for cardiovascular diseases were also at higher risk for developing cancer compared to people with lower cardiovascular disease risk.

“It’s a double whammy. Heart disease and cancer are the two leading causes of death in the United States. We now recognize that they are intimately linked. This tells us that we, as physicians, should be aggressive in trying to reduce cardiovascular risk factors not only to prevent heart disease, but also to consider cancer risk at the same time,” said study lead author Emily Lau, M.D., a cardiology fellow at Massachusetts General Hospital in Boston.

Using data from the Framingham Heart Study, researchers evaluated data from 12,712 participants (average age 51) without cardiovascular disease or cancer at the start of the study. The American Heart Association/American College of Cardiology’s Atherosclerotic Cardiovascular Disease (ASCVD) Risk Estimator and biomarkers (substances released into the bloodstream when the heart is damaged) were used to measure cardiovascular risk. The ASCVD risk estimator is a tool to help predict a person’s risk of developing heart disease within ten years.

During the study period of nearly 15 years, 1,670 cancer cases occurred (19% gastrointestinal; 18% breast; 16% prostate; 11% lung). The researchers found:

Cardiovascular risk factors, including age, sex, high blood pressure and smoking status, were independently associated with cancer.

Those with a 10-year ASCVD risk of 20% or higher were more than three times as likely as those with 10-year ASCVD risk of 5% or lower to develop any type of cancer.

People who developed cardiovascular disease (a heart attack, heart failure or atrial fibrillation) during the study period had more than a sevenfold increased risk for subsequent cancer compared to those who did not experience any cardiac event.

Similarly, those with high levels of BNP, a biomarker frequently elevated in heart failure, were more likely to get cancer during the 15-year follow-up period than participants with low levels of BNP.

“I think it’s interesting that BNP, a cardiac marker linked to heart failure risk, was associated with the risk of cancer in the future. Currently we use BNP to determine if a person has developed heart failure from chemotherapy drugs used to treat cancer,” said Tochi M. Okwuosa, D.O., Vice Chair, American Heart Association Council on Clinical Cardiology and Genomics and Precision Medicine Cardio-Oncology Subcommittee and associate professor at Rush University, Chicago. “This is the first study that has shown that BNP that’s elevated at baseline is associated with the future risk of cancer.”

“Cancer and cardiovascular disease share many of the same risk factors, such as tobacco use, poor nutrition and lack of physical activity. The next step is to identify the biological mechanisms driving the link between cardiovascular disease and cancer,” said Lau.

Many of the same lifestyle habits that reduce the risk of heart disease also reduce the risk of some kinds of cancer; so following the American Heart Association Life’s Simple 7 may help prevent both diseases. Life’s Simple Seven includes recommendations to eat a healthy diet (more fruits and vegetables, whole grains and lean protein), be physically active; avoid all tobacco/nicotine products and attain and maintain a healthy body weight, cholesterol, glucose and blood pressure,” said Eduardo Sanchez, M.D., M.P.H., chief medical officer for prevention for the American Heart Association.

Lau said this was an observational study, so it doesn’t prove cause and effect, but it does shed light on the connection between heart disease and cancer.

Source: American Heart Association


Today’s Comic