If you’re poor, you’ll likely have less success with your hearing aid, a new study finds.

A survey of more than 1 100 Medicare recipients with hearing aids found that 27% of low-income users still had a lot of trouble hearing. That compared with just 11% of the wealthiest users.

The reason, the study authors suggested, is that poorer seniors have insufficient access to ongoing care to keep the devices functioning properly.

Ongoing maintenance and counselling

While 42% of the wealthiest hearing aid patients sought out expert audiology advice each year, only about 30% of the poorest users did so, the study found.

“As Medicare does not cover hearing aids or hearing care services, beneficiaries must therefore pay for them out of pocket,” said study lead author Amber Willink. “The cost of these services is a significant barrier to access, particularly for low-income beneficiaries.”

But even for patients of means, “the value of hearing care services is not widely known or appreciated,” said Willink, an assistant scientist at the Johns Hopkins Bloomberg School of Public Health in Baltimore.

Given the complexity of hearing aid use, hearing care services provide “a necessary value-add”. They offer proper fitting and device customisation as well as ongoing maintenance and counselling to ensure continued use, she explained.

Two-thirds of Americans over the age of 70 have some degree of hearing loss, which affects their quality of life, the researchers noted. But most don’t use hearing aids, often because of the price.

New law

Willink’s team pegs the expense at about $2 000 (±R28 000) for a single unit. But a study published last July placed the overall figure at about $7 000 (±R98 000). That report, led by Dr Michael McKee of the University of Michigan, suggested that high prices (alongside hearing loss shame) keep many seniors from seeking hearing devices.

Some low-income seniors can obtain partial Medicaid coverage, but it’s only available in 28 states, the researchers reported.

The situation might ease somewhat in 2020 when a new law takes effect allowing consumers to buy hearing aids directly from approved manufacturers instead of an audiologist or licensed dispenser.

However, while hearing aids may become more affordable, McKee cautioned that “this may also exacerbate hearing health disparities among those who can’t afford them in the first place, or may not be as technologically savvy as others”.

It will be important for audiologists to help guide consumers on these choices, he said.

Jackie Clark, past president of the American Academy of Audiology, said that getting Medicare to cover costs in full would go a long way to ensuring that those at all income levels get the devices and continuous care they need.

Optimal performance

“It would certainly be a whole new ballgame if Medicare would cover hearing aids,” said Clark, who is also a clinical professor at the University of Texas at Dallas.

Willink and her colleagues also suggested that the federal government expand Medicare and/or Medicaid coverage of hearing care services.

But with or without such a major funding change, Clark said hearing aid users must be educated about the importance of regular consultations.

The audiologist is critical in determining what technology is best, and knowing how to programme the device to ensure optimal performance, she explained.

Study participants were aged 65 and older, and drawn from a 2013 survey pool of nearly 9 100 Medicare recipients.

The report was published in Health Affairs.

^{Image credit: iStock}

Your chances of inheriting genes linked to longevity are highest if you come from a family with many long-lived members, researchers say.

And that includes aunts and uncles, not just parents.

‘Top survivors’

Using databases at the University of Utah and in the Dutch province of Zeeland, investigators analysed the genealogies of nearly 315 000 people from over 20 000 families dating back to 1740.

“We observed … the more long-lived relatives you have, the lower your hazard of dying at any point in life,” said study lead author Niels van den Berg. He is a doctoral student in molecular epidemiology at Leiden University in the Netherlands.

“For example, someone whose parents are both ‘top survivors’ has a 31% lower hazard of dying than someone of the same age without such parents,” van den Berg said in a University of Utah news release.

“Top survivors” refers to people in the top 10% age-wise of a group of people born within a given time period.

“Moreover, that person’s hazard of dying is reduced, even if the parents themselves did not live to be extremely old but aunts and uncles were among the top survivors,” van den Berg said.

Genes associated with longevity

“In long-lived families, parents can therefore pass on longevity genes to their children, even if external factors prohibited them from reaching the top survivors,” he explained.

The findings reinforce the idea that “there really are longevity genes to be discovered in humans”, van den Berg said.

The study was published online in the journal Nature Communications.

Researchers have long searched for genes associated with longevity, but those genes have been much more difficult to pinpoint than genes for disease, said study co-author Eline Slagboom, a professor of molecular epidemiology at Leiden University.

“This research has led us to be far stricter in selecting the people in whom you have to look for those genes,” Slagboom said.

“If you investigate a random group of people aged over 100, however exceptional they may be, it’s highly likely that many of them do not in fact belong to a family in which longevity is heritable,” Slagboom said. “Their age is probably a matter of chance, the result of a healthy lifestyle or healthy circumstances, for example during childhood, and isn’t therefore reflected in their DNA.”

^{Image credit: iStock}

Asthma Expert

Professor Keertan Dheda has received of several prestigious awards including the 2014 Oppenheimer Award, and has published over 160 peer-reviewed papers and holds 3 patents related to new TB diagnostic or infection control technologies. He serves on the editorial board of the journals PLoS One, the International Journal of Tuberculosis and Lung Disease, American Journal of Respiratory and Critical Medicine, Lancet Respiratory Diseases and Nature Scientific Reports, amongst others.Read his full biography at the University of Cape Town Lung Institute

But youngsters living in poorer areas of England had lower chances of survival, cancer data found.

And you don’t have to be vegan to follow the “planetary health diet”.

Premier League footballers are taking part in a “ground-breaking” new concussion study this season that could lead to pitch-side diagnosis.

The growth of forest trees all over the world is becoming more water-limited as the climate warms, according to new research from an international team that includes University of Arizona scientists.

You may have seen a kid play with a feather, or you may have played with one yourself: Running a hand along a feather’s barbs and watching as the feather unzips and zips, seeming to miraculously pull itself back together.

Coral reefs are made up of massive calcium carbonate skeletons. The present study, published in Science Advances on January 16th 2019, reveals insights into the process of calcification, namely the process that leads to the formation of these skeletons. Elucidating coral calcification is key to a deeper understanding and better predictions of how and why coral reefs respond to environmental changes, such as ocean acidification.

Add another danger that e-cigarettes pose to teenagers: A new study finds second hand exposure to vaping may raise the chances of asthma attacks in adolescents with the respiratory condition.

Middle school and high school students with asthma were 27% more likely to have suffered an asthma attack if they’d been exposed to vapour from someone else’s e-cigarette use, the researchers found.

Not harmless

“While we cannot definitively say these products worsen asthma, I think if I was a parent, I wouldn’t want to risk my kids being around people using these products,” said lead researcher Jennifer Bayly. She is a student at Rutgers Robert Wood Johnson Medical School in New Brunswick, New Jersey.

These findings and others belie the general perception that e-cigarette emissions carry no risk, said Dr Karen Wilson, chief of general paediatrics at the Icahn School of Medicine at Mount Sinai in New York City.

“Contrary to the idea that it’s a harmless water vapour, it actually contains some of the same chemicals that we find in tobacco smoke, along with particulate matter that can be very irritating to people with asthma,” Wilson said.

There is moderate scientific evidence that e-cigarette use causes increased cough and wheeze in teenagers, and an increase in asthma symptoms, according to a recent National Academies of Sciences, Engineering and Medicine report cited by the study authors.

For their research, Bayly and her colleagues gathered data from the 2016 Florida Youth Tobacco Survey. It included about 33 500 high school students and just over 36 000 middle school students, aged 11 to 17. The study focused on 11 830 students who reported having asthma.

Significantly increased risk of asthma attack

Overall, 21% of kids with asthma said they’d had an asthma attack during the previous year, and 33% said they’d been exposed to second hand vapour from an e-cigarette.

This exposure to second hand vapour was tied to a significantly increased risk of an asthma attack, even after researchers accounted for other factors, such as whether the teens used an e-cigarette themselves or had been exposed to tobacco smoke.

The report was published in the journal Chest.

“The authors did a nice job of controlling for other sources” of exposure to lung-irritating substances, said Dr Christy Sadreameli, a paediatric pulmonologist at Johns Hopkins Hospital in Baltimore and a spokeswoman for the American Lung Association.

If anything, the new study probably understated the effect second hand e-cigarette vapour has on kids, Wilson and Sadreameli said.

That’s partly because the study focused on adolescents, Wilson said. “I’d be very worried to think about the impact on small children who can’t escape these second hand aerosols,” she explained.

Inflammation and irritation

It’s also because the survey data is now years old, Sadreameli added, and e-cigarette use has surged even more since the advent of Juul, a leading e-cig brand that is popular with young people.

“We know that uptake of electronic cigarettes is happening at a pretty rapid rate,” Sadreameli said. “If anything, there may be even more students, if they did the study today, who are being exposed to [electronic nicotine delivery systems] or possibly using them.”

E-cigarette vapour contains propylene glycol, vegetable glycerine, nicotine and many different flavouring agents, the researchers noted. Each has been linked to inflammation and irritation in the lungs that could impact asthma sufferers.

Parents should limit kids’ exposure to second hand vapour, particularly if they have asthma, Wilson and Sadreameli said.

But Gregory Conley, president of the American Vaping Association, a non-profit that advocates for sensible regulation of vaping products, took issue with the findings.

“Unfortunately, the authors of this study failed to disclose what percentage of vapour-exposed youth were also exposed to cigarette smoke – despite having that data available to them – therefore making it impossible for a reader to determine whether any effect remains if cigarette smoke exposure is eliminated,” Conley said.

^{Image credit: iStock}