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Health Matters: How to manage hearing loss, prevent hip fractures

Health Matters: How to manage hearing loss, prevent hip fractures

Q: As I’ve entered my “golden years,” I’m having more trouble hearing and understanding those speaking around me. There is nothing golden about that! Suggestions?

A: Isn’t that the truth! Your experience isn’t unique — the frequency of hearing loss doubles during each decade of life. Half of folks in their 60s have significant hearing loss, as do four out of five of those in their mid-80s.

In a minority of cases, there are problems in the outer ear canal or the middle ear that can cause hearing loss, and most of these cases can be treated effectively, for example by removing impacted wax in the ear canal.

Most hearing loss, however, is due to damage to the inner ear or the nerves that connect the ear to the brain (called sensorineural hearing loss). Treatment of sensorineural hearing loss is more difficult and depends on the cause.

The most common causes of this condition are age-related degeneration of the hearing system, prior noise exposure, and genetic abnormalities; however, chronic problems such as cigarette smoking, obesity, and diabetes also are associated with hearing loss for unclear reasons. Thus, prevention is perhaps the most important way to “treat” hearing loss.

And while there is no way to prevent the effects of aging, wearing appropriate hearing-protective devices in high-noise areas, not smoking and controlling diabetes and other cardiovascular risk factors reduce the risk of hearing loss.

In fact, all things being equal, the frequency of hearing loss in any age group in the United States has decreased over time, probably because prevention works. But treatment can help those who do have hearing loss despite preventive measures.

Hearing aids are used by some, but they can be expensive, uncomfortable and may be considered unattractive. Perhaps as a consequence, most adults with hearing loss don’t use a hearing aid. For them (especially those with more severe hearing loss), surgery with the use of an implanted device may be helpful.

Q: Is there a role for supplemental calcium or vitamin D to help prevent hip or other fractures seen in seniors?

A: Many of the hip and spine fractures seen in the elderly are related to osteoporosis, a condition where bones become thin, brittle and more susceptible to fractures (especially after injuries like a fall). Some practice guidelines and health providers recommend calcium or vitamin D supplements (or both) for such patients at risk, but the evidence to date doesn’t really support their use.

A large review recently was released that looked at the potential benefit of calcium or vitamin D supplements (or both together) in 33 clinical trials performed over the past decade in over 50,000 subjects.

None of the studies’ subjects were residents of nursing homes or residential care facilities; we know that such individuals are at higher risk of fractures. Nevertheless, the disappointing conclusion of the analysis was that neither of the supplements (even when taken together) had a significant impact on reducing the number of subsequent hip fractures in individuals who were older than 50 years of age and living in the community.

Wynne is vice president for health affairs at UND, dean of the School of Medicine and Health Sciences, and a professor of medicine. He is a cardiologist by training.

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