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Wednesday, December 8, 2021

Stanke, Fu-Berman: Hearing Aids That Make No Doubt About Alzheimer’s.

The FDA recently made two important decisions – one bad, one good – that will affect people with cognitive impairments.

Endorsement of Aduhelm (aducanumab), The costly and controversial drug for Alzheimer’s has received harsh and deserved criticism, and the manufacturer’s close relationship with the FDA has been questioned.

Approval of the sale of over-the-counter hearing aids, on the other hand, everyone who cares about dementia and cognitive decline should be applauded.

Friends and family may confuse hearing loss with cognitive decline; Of course, hearing difficulties while speaking can cause misunderstandings, impair social interaction, and contribute to anxiety and frustration.

However, it turns out that hearing loss can actually cause cognitive decline. While most of the causes of cognitive decline are irreversible, here is one: Evidence suggests that hearing aids protect people from further cognitive decline.

Hearing aids are now prohibitively expensive and require multiple visits. A lost or broken hearing aid can cause serious financial damage. The FDA’s decision to authorize the sale of hearing aids without a prescription will lower price barriers and increase their availability to populations in need.

Ironically, no Alzheimer’s group has publicly advocated hearing aids, and no group has announced a recent FDA decision. In contrast, the Alzheimer’s Association, which receives money from Biogen and many other pharmaceutical companies, has actively campaigned for the endorsement of Aduhelm, even announcing the approval on its website.

Harry Jones, president of the Alzheimer’s Association, said “This endorsement is a win for people living with Alzheimer’s and their families,” and called Aduhelm “the first FDA-approved drug to delay the decline of Alzheimer’s.” The Alzheimer’s Treatment Section lists Aduhelma first and never mentions hearing aids.

It’s hard not to link the massive donations from Biogen and other pharmaceutical companies to the laser targeting of Alzheimer’s groups to drug-driven approaches. Alzheimer’s research has focused on expensive drugs targeting plaque amyloid, a biomarker of uncertain importance. The presence of plaque in the brain does not correlate with symptoms of dementia, and in half of older adults without cognitive impairment, plaque and other signs of Alzheimer’s are found on autopsy.

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In addition, no plaque-reducing drug, including Aduhelm, can reverse dementia. The industry’s overwhelming focus on plaque amyloid as the cause of Alzheimer’s has limited research into any theories or treatments that do not focus on amyloid.

A set of hearing aids will cost less than a tenth of what Aduhelm will cost one year. Perhaps research funding could be redirected towards improving hearing aids, improving their performance, comfort, durability, affordability, and ways to prevent loss.

Hearing aids improve communication, social interaction, and cognitive stimulation. They improve the quality of life of many older adults, and even more so for patients with cognitive decline or dementia. The FDA’s decision to authorize the sale of hearing aids without a prescription will lower price barriers and significantly expand the hearing aid market, stimulating further research and development to improve the efficiency and usability of these devices.

After hearing aids, the most effective interventions to prevent cognitive decline are exercise, quitting smoking, eliminating excessive alcohol use, and treating depression, hypertension, and diabetes. Improving patients’ lives depends on treating risk factors, changing the environment, maintaining meaningful social bonds, and using hearing aids.

A public education campaign is needed to encourage testing and treatment for hearing loss in all with cognitive impairments. If only Alzheimer’s groups would spearhead this campaign, as they did with Aduhelm’s approval. Desperation for an elusive cure may explain the Alzheimer’s infatuation with Aduhelm, but false hope does not help patients.

Alzheimer’s groups must return to their roots by helping patients and their families. They will help many more people by promoting hearing aids and healthy lifestyles, and providing support groups and temporary care for families.

Adrian Fug-Berman is professor in the Department of Pharmacology and Physiology at Georgetown University Medical Center. Dave Stanke is a Research Fellow at PharmedOut. They wrote this column for the Chicago Tribune.

World Nation News Deskhttps://www.worldnationnews.com
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