Hearing loss may push decline in memory, thinking

Older Americans who have hearing loss have an accelerated decline in thinking and memory abilities, compared to those with normal hearing, according to a study published in JAMA Archives of Internal Medicine.

Those with hearing loss experience a 30% to 40% greater decline in thinking abilities compared to their counterparts without hearing loss, according to the findings published Monday.
Hearing loss is common among old older adults, affecting about two-thirds of adults 70 and older, and about one-third of adults younger than 60, according to lead study author Dr. Frank R. Lin of Johns Hopkins University.  A large number of people with hearing loss are untreated, Lin explained, because they associate hearing loss with the stigma of getting older.
About two years ago Lin and his associates published a paper showing that hearing loss was associated with greater risk for developing dementia. “Fortunately most of us will never develop dementia, but most of us will experience some kind of cognitive decline over time,” explained Lin.
Rather than looking at hearing loss and dementia, the researchers studied people with normal cognitive function to determine whether people with hearing loss had different rates of memory and thinking decline compared to people with normal hearing. Dementia rates are projected to rise as the world's population ages, the study noted; identifying factors that may contribute to cognitive decline and dementia in older adults may lead to ways to slow and treat brain decline.
The researchers studied about 2,000 older adults enrolled in a long-term study which began in 1997. All subjects included in the study had no dementia or cognitive impairment.  Each subject went through an audiometric assessment performed in a sound-treated booth, which Lin described as “the gold standard” for hearing testing. Their memory, thinking abilities and decision-making were also tested. Both tests were repeated at three, five and six years, and researchers looked at average decline in memory and thinking abilities, comparing people with normal hearing to those with reduced hearing.
“We found that people with hearing loss had a faster rate of mental decline compared to people with normal hearing. ... And the greater the rate of hearing loss, the faster the decline of memory and thinking. It was dose dependent,” said Lin. People with hearing loss took 7.7 years to have a five-point drop in their thinking skills, compared to 10.9 years for people with normal hearing.
Why does this happen? Lin said there’s no definite explanation, noting that various explanations may apply. When people suffer from hearing loss, it’s not that they can’t hear. It’s that the cochlea, the part of the inner ear that converts a complex sound to a precise signal that goes to the brain for decoding, isn’t doing a good job converting, so people hear a garbled signal. Lin described it like a bad cell phone connection.
One theory is that "if the brain is dedicating extra resources to try and hear what’s going on, it's probably taking away from other brain resources like thinking and memory, “ explained Lin.
A second explanation, using the cell phone example, is that people experiencing lousy reception end up tuning out, because it’s so labor intensive to try to hear the call. This explanation plays into the idea of social isolation, which has been shown to have negative health effects including increased illness, death rates, and increased cognitive decline and dementia.
A third possible explanation is that some mechanism in the brain is affecting both hearing and brain function. Lin said it's likely that the hearing loss and brain decline are explained by all three factors. He also acknowledged that while his study tried to adjust for other factors affecting hearing and cognitive abilities, they did not account for factors including something in the inflammatory process or the age of mitochondria, the energy factories of cells.
Lin thinks the big public health question is whether treating hearing loss will have an impact on brain function and memory decline.

Hearing loss may push decline in memory, thinking

Don't judge that generic pill by its color

It's not the color, but what's inside that counts when it comes to medication. However, doctors suspect that's not exactly how patients see it.

According to a study published Monday in the medical journal Archives of Internal Medicine, changes in pill color significantly increase the odds that a patient will fail to take their medication as prescribed by their doctor.
First, the basics
Generic drugs are approved by the U.S. Food & Drug Administration’s Office of Generic Drugs.  These off-brand alternatives must be “bioequivalent” to the brand-name version, meaning they must be identical in terms of dosage form, strength, route of administration, quality, intended use, and clinical efficacy. But the FDA does not require that the two versions look alike.
Generics are big business worldwide.  In America, they account for more than 70% of prescriptions dispensed, but only 16% of spending. Generic prescriptions are expected to increase even more, as top-selling brand-name medications reach the end of their market  - and profit - exclusivity and go “off patent.”  In the United States, drug patents offer 20 years of protection for the pharmaceutical company, but they are applied for before clinical trials begin, so the effective life of a drug patent tends to be somewhere around 7-12 years.
The study
Dr. Aaron Kesselheim, assistant professor of medicine at Brigham and Women’s Hospital in Boston, wanted to investigate whether switching between brand-name and different generic versions of a drug could lead patients to neglect refilling their prescriptions.
“An estimated 50-75% of patients do not take their medications as prescribed,” says Kesselheim.  When patients don't adhere to prescribed drug regimens, it can can have serious medical, financial, and social consequences.  Kesselheim chose to study antiepileptic drugs, due to the fact that epilepsy is a common disease affecting up to 2% of the general population. Additionally, these types of drugs are prescribed off-label for psychiatric disease, chronic pain and other conditions.
Kesselheim and his team analyzed national data gathered between 2001 and 2006, and subsequently split patients into two groups: those who became “nonpersistent” (defined, in this study, as a failure to fill a prescription within five days of the elapsed days supplied) and those who exhibited no delay in refilling.  The groups were further matched by age, sex, number of refills and the presence of a seizure disorder diagnosis.
Results
Researchers found when patients with epilepsy refilled their prescriptions and received a different color pill than they were used to, they were  53% more likely to take a break from taking their drugs as prescribed.  Twenty-seven percent of patients taking antiepileptic drugs for other reasons also took a break from their prescribed drug regimen.  "Someone who knows it’s so important they take their medication to avoid a seizure is much more in tune with color... and (becomes) more stressed out with any potential switch,” says Kesselheim.
Conclusion
Patients and caregivers frequently remove pills from their original bottles to organize them in daily pill planners.  “Visual cues thus become paramount to identification of pills,” says Kesselheim.  Therefore, changes in appearance may be jarring or confusing, leading patients to delay pill-taking while seeking validation from a physician, pharmacist, or other health care provider.
Perhaps even more interesting, a pill’s physical attributes have been linked to expectations of efficacy of both placebos and prescription drugs.  Kesselheim says, “changes in appearance may not only deprive patients of these expectations of efficacy, but potentially even have the opposite effect."  It's something that's called the "nocebo" effect, a belief that the newly-substituted pill will be less effective than the previous dose.
Lastly, it’s important to note that a filled prescription does not necessarily indicate that the patient actually took his or her medication, and vice-versa. Additionally, says Kesselheim, “what we observed as nonpersistence may have been physician-directed changes in medication dosing frequency.”
What's next
As more widely used brand-name drugs face generic competition, the study’s authors suggest physicians warn their patients about the possibility of a change in pill color, and that pharmacists take greater care to alert patients when changes in suppliers might lead to new pill characteristics.
In the United States, the FDA has recently started rejecting generic drugs that are larger in size than their brand-name counterparts, citing safety and efficacy concerns, such as increased risk of choking and patient dissatisfaction.
“Based on our results,” says Kesselheim, “the FDA would be justified in taking a similar posture about new generic drugs that differ in color.”
“At a minimum,” Kesselheim says, “our results should clarify that manufacturers cannot protect their drugs’ physical characteristics through the principle of ‘trade dress,'" - physical attributes such as color, shape, size, texture, aroma, and flavor.  By definition, trade dress attributes legally cannot affect the impact of a drug on a consumer. But this study concludes that's exactly what's happening.

Cancer can't stop teen singer's music

Like many aspiring singers on YouTube, 17-year-old Carley Allison has uploaded several videos of herself belting out covers and original songs.

But her most popular YouTube video, which was later posted on CNN iReport, was shot just after doctors sliced a hole in her neck. A golf-ball-sized tumor -- what turned out to be an extremely rare cancer -- was causing her to have difficulty breathing, and she needed an emergency tracheotomy.

Even after the tracheotomy, she could still sing.

"Music has been my passion ever since I was young," the Toronto resident wrote on her blog.

"I started taking guitar lessons when I was 11 years old, and I've been singing for as long as I can remember."

Allison hopes that, despite the tumor, she'll still be able to pursue singing as a career.

The diagnosis

Music wasn't always the primary focus of Allison's life. She initially hoped to become a competitive figure skater, training six days a week for more than five years. The intense training was something she learned from her mother, who was an Olympic marathon runner in 1996.

It was through skating that Allison first suspected something might be wrong. "Her skating coach noticed that just walking up a flight of stairs, she'd breathe hard," said her mother, May Allison. It seemed unusual that such a young athlete might have trouble breathing.

Allison and her family went for a year believing -- as doctors told them -- that she had asthma. But a CT scan in February revealed a clear cell sarcoma near the trachea.

Allison knew her skating career would be put on hold.

Teen with cancer blogs her bucket list

A rediscovered passion

Without skating to fill her time, Allison turned her efforts to singing. She has uploaded seven videos to YouTube in the past year, where she has nearly 50,000 views.

"Everything happens for a reason," she said of her condition. "It was an easy switch to put music as the biggest thing in my life right now ... and my music has taken off, which is nice."

In April, her videos received the notice of actress and pop star Selena Gomez. Gomez tweeted, "Carley Allison you are so strong girl. Love you! And praying for you. Keep singing."

The words echo many of the comments on Allison's YouTube and Twitter pages -- and helped her singing videos take off online.

She has certainly followed Gomez's advice, too. Singing is "therapeutic for her in a way," said her mother.

May Allison believes this is the best way her daughter has found to deal with the fact that she has a hole in her trachea and her hair has been shaved down, and it's how she has chosen to express herself.

Her daughter put it this way: "Before February 4, my biggest problem was trying to find a prom dress."

May Allison added, "She wants to make something of (her condition) instead of moping around."

Allison's focus on singing isn't unusual for a patient, said Dr. Michael E. Kupferman of the MD Anderson Cancer Center in Houston. He has seen others with cancer turn to creative outlets.

"Any kind of devastating medical situation will make people more introspective," he explained. "Artists' careers have sometimes evolved having gone through cancer. I've seen patients find that creativity to express themselves whether in music or in art. We've seen that for millennia. It changes the tenor of their art and productivity."

What the future holds

Will Allison still be able to belt out her songs in the same way if her cancer needs to be surgically removed?

Luckily, "her vocal cords are not involved with the tumor," according to her mother.

Teen beating the odds after brain injury

However, she added, "The one side that the tumor's on, the vocal cord nerve may be affected by the tumor. It's very difficult to tell on the CT scan. We're hoping the chemotherapy will help the situation."

Allison herself maintains a positive attitude.

"There is a smaller chance there may be some permanent damage, but I try not to think about that," she said.

Early on, there were some fears as well.

Allison admitted that she was originally scared by her diagnosis after searching online. She has since mostly stayed away from searching for information on her illness.

When the family learned about the tumor, May Allison said she and her husband got choked up.

"(Carley) turned to us in a calm voice and said she was glad it was her and not anyone else in the family, because she knew she could handle it."

Despite being told there was a 5% chance that chemotherapy would affect a tumor in the trachea, the tumor has become softer since treatment and has moved away from the thyroid gland, which makes it easier to remove surgically.

No matter what happens, Allison still plans to pursue her passions. She's still thinking about a possible singing career, despite the fact that she had to cancel an audition for Boston's Berklee College of Music a few days after she was diagnosed. She looks forward to getting back on the ice one day as well.

It's that unstoppable attitude that has been the most inspirational to witness, her mother said.

"From an early age, Carley always knew what she wanted and had no fear trying to get it," she said.

"For her, every day presents a new opportunity to take a step closer. The interesting thing about Carley is that she actually enjoys the journey as much as achieving her goals. When things don't go according to plan, she rallies quickly and moves on. She has the ability to make anything fun and finds it very difficult to sit still."

"She's been able to touch people," May Allison added. "Her public school raised $5,000 in a fundraiser for (Toronto's) Sick Kids Hospital where she's having her chemotherapy. There are thousands of dollars coming into Princess Margaret Hospital where she has the link on her blog. She's very proud of that."

In the meantime, Allison continues to inspire people on social media with her positive attitude.

"For me to be able to reach out to other people throughout all this has been great," she said. "People want to hear from me and hear my music right now so it keeps me happy. I cherish every moment. I have a different perspective on everything now. In the end, I think it will make me a better person."

Thousands of kids hurt yearly on amusement rides

From carousels to roller coasters, part of summer fun for many kids is a trip to the local carnival or a nearby amusement park. But experts are warning parents their children need to be supervised on rides because of the risk of injuries.

Researchers from Nationwide Children's Hospital in Columbus, Ohio, looked at Consumer Product Safety Commission information on youngsters who were taken to emergency rooms for amusement ride injuries during a 20-year period.  Their study, published in the May issue of the journal Clinical Pediatrics, looked at fixed-site rides, such as those at major amusement parks, as well as mobile rides, which included rides at local carnivals, state fairs and mall rides like those found in shopping mall arcades.

The rides "included anything from coin-operated rides to Ferris wheels, carousels, bumper cars, roller coasters, and any type of ride like that," said Tracy Mehan, lead researcher of the study.

The researchers looked at data on 92,885 children under the age of 18 who were treated for amusement park type of injures in emergency rooms from 1990 to 2010.  More than 70% of the problems occurred during the summer months, when amusement parks are open and state fairs are being held.  That averages out to 4,423 injuries each year and 20 injuries daily from May through September.

The injuries ranged from head and neck problems to injuries to the face, arms and legs. Soft tissue injuries - damage to ligaments, muscles and tendons - were the most common. Serious injuries comprised only a very small percentage.

"Many of the injuries of these rides are over hard floors, and children are falling on a hard floor and are ending up with head injuries," noted Mehan.

Authors of the study say more regulations need to be in place to make these rides safer.   Scott Wolfson, spokesperson for the Consumer Product Safety Commission, said that’s easier said than done.

“Back in the early eighties, our authority to oversee fixed-site rides was taken away from us," he said. "We do deal with mobile rides, like those at local carnivals, but we are a small agency and it’s tough to oversee every fair that sets up for a short period of time."

“Although the U.S. Consumer Product Safety Commission has jurisdiction over mobile rides, regulation of fixed-site rides is currently left to state or local governments, leading to a fragmented system,” said Dr. Gary Smith, the study's senior author and director of the Center for Injury Research and Policy of Nationwide Children’s Hospital. “A coordinated national system would help us prevent amusement ride-related injuries through better injury surveillance and more consistent enforcement of standards."

Authors noted  parents can also do their part to help keep children safe by following a few simple guidelines.

– Always follow all posted height, age, weight and health restrictions.

– Make sure to follow any special seating order and/or loading instructions.

– Always use safety equipment such as seat belts and safety bars.

– Make sure children keep hands and feet inside the ride at all times.

– Know your child. If you don’t think he/she will be able to follow the rules, keep him/her off the ride.

– Trust your instincts. If you are worried about the safety of the ride, choose a different activity.

– Avoid “mall rides” if they are over a hard, unpadded surface or if they don’t have a child restraint such as a seat belt.

Study authors say this is the first study to look at the national rate of child ER injuries involving amusement rides in the United States.

Sugar, not just salt, linked to high blood pressure

Eating too much sodium can push your blood pressure into the danger zone. Now, researchers are reporting that eating too many sweets--or drinking too much soda--may have a similar effect.
People who consume a diet high in fructose, a type of sugar and a key ingredient in high-fructose corn syrup, are more likely to have high blood pressure (hypertension), according to a new study.
Drinking 2.5 cans or more of non-diet soda per day--or consuming an equivalent amount of fructose from other foods--increases your risk of hypertension by at least 30 percent, the study found. What's more, the increased risk appears to be independent of other dietary habits, including sodium, carbohydrate and overall calorie intake.
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The study, which appears in the Journal of the American Society of Nephrology, focused on foods containing high-fructose corn syrup and other added sugars, such as soda, fruit punch, cookies, candy and chocolate. (Although fructose occurs naturally in fruits, the researchers excluded them because they contain other nutrients that are difficult to measure.)
"High-fructose corn syrup is very prevalent," says Dr. Michel Chonchol, M.D., the senior author of the study and a blood pressure specialist at the University of Colorado, Anschutz Medical Campus, in Aurora. "If you go to grocery stores, it's everywhere."
Chonchol and his colleagues analyzed the diet and blood pressure readings of more than 4,500 U.S. adults with no history of hypertension. The data used in the study was collected in nationwide surveys over a four-year period by the Centers for Disease Control and Prevention, and also included information on health measures such as physical activity and body mass index.
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The researchers estimated each person's fructose intake using detailed diet questionnaires and nutrition information from the U.S. Department of Agriculture. The average fructose intake was 74 grams a day, an amount roughly equivalent to that found in 2.5 cans of soda.
People who consumed more than the average amount were more likely to have high blood pressure than people who consumed less, the researchers found. Above-average fructose intake increased the likelihood of having blood pressure above 140/90 and 160/100 mmHg by 30 percent and 77 percent, respectively. (Normal blood pressure is 120/80 or below, while anything above 140/90 is considered high.)
Hypertension can affect the health of blood vessels and is a leading risk factor for heart disease, kidney disease, and other ailments.
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The findings don't prove that fructose actually causes hypertension, however. Although the researchers took various health factors and dietary habits besides fructose intake into account, it's always possible that other, unknown factors explain the apparent link between fructose and hypertension, says Dr. Cheryl Laffer, M.D., an associate professor of internal medicine at Texas A&M Health Science Center College of Medicine, in Temple.
The study "doesn't tell us anything about causation," she says. "People who have high blood pressure may eat more fructose. It can go either way."
One important drawback of the study is that the participants reported their own diets based on memory, which makes the estimates of fructose intake less accurate.
But the study's limitations don't mean that people should feel free to go on sugar binges, Laffer says. "I wouldn't discourage people from eating less fructose, because we have evidence that high fructose [consumption] is not particularly good for you," she says.
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Animal studies have linked fructose consumption to higher blood pressure, for instance, and a study published earlier this year in the journal "Circulation" suggested that cutting back on sugar-sweetened beverages may lower blood pressure.
In a statement, the Corn Refiners Association, a trade group representing manufacturers of high-fructose corn syrup, said that Chonchol and his colleagues were drawing "inaccurate conclusions about fructose." The association challenged the authors' estimate that 2.5 cans of soda contain about 74 grams of fructose, and also highlighted the inaccuracies of diet surveys that rely on memory.
"The risk of hypertension from fructose is not a matter of concern for the overwhelming majority of Americans," the association stated.
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Chonchol and his colleagues acknowledge that more research is needed to confirm a link between fructose and hypertension.

It's still unclear how fructose might affect blood pressure, for instance. One theory is that fructose might make the body absorb sodium more readily, Chonchol says. Fructose intake may also increase levels of uric acid, which has been shown to contribute to high blood pressure.

Is your diet good for your skin?

Sure, your diet keeps your body slim and healthy, but its impact doesn't stop there.
The food you eat -- from wrinkle-fighting antioxidants in fruits and vegetables to hydrating healthy fats in fish -- may matter to your skin almost as much as it does to your waistline.
Is your way of noshing helping or hurting your complexion? We asked top docs for their take on the face-friendliness of six popular diets.
Read on to see if yours passes the beauty test, and find out how you can alter what you eat for A-plus skin.
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Mediterranean
(such as The Mediterranean Diet and The Mediterranean Prescription)
The lowdown: Fish, leafy greens, olive oil, and fruit are the stars of this heart-healthy, waist-whittling diet. But the benefits don't end there -- eating Mediterranean may also protect against melanoma, the deadliest form of skin cancer, a recent Italian study suggests.
On the cosmetic front, omega-3 fatty acids in fish help keep skin-cell membranes strong and elastic. And antioxidants in leafy greens and olive oil may protect against ultraviolet light and other environmental assaults that can break down collagen and elastin, the structural supports that keep skin plump and smooth. Result: less sagging and fewer wrinkles later.
Olive oil, tomatoes, and red wine also have antioxidants that help block the chemical reactions that lead to sun damage, explains Leslie Baumann, M.D., chief executive officer of the Baumann Cosmetic and Research Institute in Miami Beach, Florida.
Skin Rx: Red wine contains resveratrol, an antioxidant that's great for skin -- but sip in moderation. Overdoing it can dehydrate you, leaving skin dry. Too much alcohol can also generate free radicals, which can break down collagen, leading to wrinkles, Baumann says.
Health.com: 7 ways you're aging your skin
Vegetarian/vegan
(such as "The New Becoming Vegetarian" and "Skinny Bitch")
The lowdown: Whether you skip meat and other animal products for your health, ethical reasons, or both, you probably eat more fresh produce and whole grains as a result -- good news for your skin. The antioxidants in these eats neutralize the free radicals that contribute to wrinkles, brown spots, and other signs of aging.
Plant-based protein sources may also have super skin benefits. For example, beans contain zit-battling zinc and decrease inflammation, a culprit behind redness, pimples, and premature wrinkles, says Nicholas Perricone, M.D., author of "Forever Young: The Science of Nutrigenomics for Glowing, Wrinkle-Free Skin and Radiant Health at Every Age." On the other hand, some studies suggest that dairy contributes to acne, Dr. Baumann says; consider other protein sources if breakouts are a problem.
Skin Rx: Veggie diets tend to be low in fat, so incorporate ground flaxseeds and olive and safflower oils to help your skin retain water, making it more supple, Baumann says.
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High-protein, low-carb
(such as South Beach Diet and Atkins)
The lowdown: First, the good news: Cutting back on white bread, pasta, and refined sugar in order to fight flab can also lower the secretion of the stress hormone cortisol and minimize breakouts, says Manhattan dermatologist Francesca Fusco, M.D. Moderate plans that swap in whole grains, fresh produce, and lean meats also up antioxidants, blemish-busting zinc, and collagen-building protein.
But beware of more meat-heavy plans: Getting some cholesterol from red meat will shore up skin cells' protective lipid layer, but "eating too much animal fat can result in an increased production of free radicals, which are thought to interfere with normal cellular processing," says New York City--based aesthetic dermatologist Lisa Airan, M.D. "This may cause premature cell death," which can lead to sagging skin.
Skin Rx: Drink lots of water to keep skin hydrated. Choose fish and other lean proteins -- not just saturated fat-laden red meat. Eat antioxidant-rich leafy greens daily.
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Low-fat
(such as "Eat More, Weigh Less")
The lowdown: Cutting down on saturated fat -- found in red meat and whole milk -- is great for your heart and waistline. A diet low in animal fat also stems the production of free radicals that can prematurely age skin, Airan says.
Still, your skin needs some fat, especially the good kind found in nuts and olive oil. Fat helps your body absorb complexion-friendly antioxidants and fat-soluble vitamins, and strengthens cell membranes -- and ultimately your epidermis -- for a dewier, more supple face.
Skin Rx: Eat a little fat. "Get at least 20 percent of your calories from fat, mainly the unsaturated kind," says New York City dermatologist Cheryl Karcher, M.D. Sauté veggies in olive oil, toss nuts into salads, and keep omega-3-rich salmon, flaxseeds, and the occasional fortified egg in your diet. Linoleic acid, found in vegetable oils, is "crucial for bolstering the skin barrier, which keeps moisture in and irritants out of your skin," Dr. Baumann says.
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Raw
(such as "Raw Food Life Force Energy")
The lowdown: Raw-foodists -- who nosh mainly on produce, nuts, and sprouted beans and grains -- believe that not cooking food preserves its natural enzymes, aiding digestion, energy, and weight loss. Though these claims aren't universally accepted by doctors, there's no denying that these foods make for a happy complexion.
What's more, the healthy oils in nuts, avocados, and olive oil keep skin cell membranes strong and pliant. The downside: "When you eat very little meat, it's challenging to get enough of the building blocks for collagen," Airan says.
Skin Rx: Sneak in sprouted beans, sushi, soy, and other raw proteins for collagen, and incorporate healthy fat sources like almonds, flaxseeds, and olive oil to help build firm skin cells.