Q: You said in a column last month that poor hearing is linked to the risk of dementia. Could you explain why this should be so?
Howard Ashton Blackwood, South Wales.
Dr Martin Scurr responds: Thank you for asking this valuable question that will be of interest and concern to many.
Dementia is a brain disorder that affects memory and other key functions, such as the way people use language and communicate, spatial awareness (the ability to judge distances, for example), and the processes that allow us to plan. , paying attention and juggling tasks. .
About 40 percent of dementia cases could be prevented or delayed by addressing 12 key risk factors, including: high blood pressure; obesity; diabetes; depression; physical inactivity; of smoking; social isolation and hearing (according to a 2020 report on dementia prevention from the Lancet Commission).
Several major studies have confirmed the link between hearing loss and dementia. One involved almost 2,000 people who started out with no signs of cognitive decline: they were then monitored for 11 years, and those who had hearing loss at the start of the study had higher levels of cognitive decline at the end.
Some experts believe that social isolation caused by hearing loss contributes to a person developing dementia, but we currently don’t know enough about the mechanisms involved to be sure. There are other potential mechanisms, including central auditory processing dysfunction, where people find it difficult to understand speech in noisy environments, a problem that may become more common with age. The person knows that they are being spoken to, but cannot understand what they are saying. This may be an early sign of Alzheimer’s disease.
Dementia is a brain disorder that affects memory and other key functions, such as the way people use language and communicate, spatial awareness, and the processes that allow us to plan, pay attention, and juggle tasks.
The question is which comes first: hearing problems that affect the brain or brain changes that affect hearing.
It is also unclear whether hearing aid use can reduce the rate of cognitive decline. There is limited evidence; For example, a study published last year in the journal Lancet Public Health suggested this might be the case, but it has since been retracted. So the jury is still out.
It seems likely that working on known risk factors from middle age onwards, if one sticks to it resolutely, should go a long way toward preventing the decline in brain function that is dementia.
But to answer your exact question, I’m afraid the answer is: more research is needed.
The 12 steps that could help you avoid it…
- Sleep at least seven hours a night.
- Regularly challenging the brain
- Caring for mental well-being
- Stay socially active
- Taking care of your audience
- To eat a balanced diet
- Stay physically active
- Give up smoking
- Drink responsibly
- Maintain a healthy cholesterol level
- Maintain healthy blood pressure
- Manage diabetes as best as possible
Q: I play badminton two or three times a week. In a recent game I felt and heard a pop in the upper rear muscle of my left leg, just below my buttock. It can be painful, especially at night. Will it repair itself soon so I can play again?
Tim Fuller, via email.
Dr Martin Scurr responds: What you’ve described is a hamstring injury, a tear that affects the tendons or large muscles in the back of the thigh. The hamstrings are actually a group of three muscles (they basically allow you to bend your knee), while the tendons attach these muscles to the bones of the knee and the top of the femur.
A sudden movement can cause a tear, which is very painful. The popping sensation he noticed may be a sign that this was a fairly serious injury: the “pop” is caused by the sudden snapping of a tendon (rather than separating the muscle). If the tendon has completely torn, you will find it difficult to walk or fully extend your knee and it may take a while to heal; It may be several months before he can resume active exercise such as badminton. In the meantime, gentle exercise like walking is sensible, but you should let the pain be your guide in terms of how much you do.
However, increased nighttime pain raises a question. Could it be that you have actually torn one of the three muscles that make up the hamstrings from where they attach to the pelvic bones? Night pain is a sign of this and you may need an ultrasound or MRI to confirm this. I highly recommend discussing this with your GP.
In my opinion… there is an awworrying lack of anesthetists
My father was an anesthetist (at one time for King George VI, when he had surgery at Buckingham Palace to try to save him from lung cancer). So are my brother and my son.
Sometimes I wonder if I could have been too, although, realistically, I lack the necessary nerves of steel. Keeping a patient alive but sedated during surgery is a tightrope act that requires supreme skill, expert judgment, and a thorough knowledge of medications and their dosages.
It is therefore deeply worrying to hear that the Royal College of Anesthetists is now warning that the shortage of anesthetists has become so severe that it is preventing some patients from having surgery at a time when the NHS waiting list exceeds 9 million .
However, curiously there is no shortage. What is missing is adequate government funding. Currently only around 400 places a year are funded in the further training required to become a consultant anesthetist, for around 650 applicants each year.
The 250 who lose have to retrain in a different medical specialty, or emigrate, or abandon medicine altogether. Without money for more training places, this crisis will only get worse.
