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Byline: Ariyanachi. Kaliappan, Archana. Gaur, Varatharajan. Sakthivadivel, Yuvaraj. Balan, Lakshmi. Tadi, Raja. Sundaramurthy The current pandemic has affected almost everyone worldwide. Although the majority of people survive the illness, bad [...]

As the proportion of older adults in the world's total population continues to grow, the adverse health outcomes of age-related hearing loss are becoming increasingly recognized. While research has shown that age-related hearing loss is the single greatest modifiable risk factor for dementia, use of hearing aids remains low worldwide, even in many middle- and high-income countries. Reasons for poor uptake of hearing aids are likely to involve a combination of factors, ranging from increasing costs of hearing aid technology to a widespread lack of insurance coverage. This article aims to identify the current state of access to hearing aids, focusing on eight middle- and high-income countries. We discuss how to facilitate greater access to hearing aids for patients by addressing changes in how devices are regulated, technological advancements in hearing devices, the need to adjust reimbursement schemes and the importance of adaptation among the community workforce for hearing-care. Alors que la proportion de personnes agees au sein de la population mondiale totale continue a croitre, les effets nefastes sur la sante de la perte de l'acuite auditive liee a l'age sont de plus en plus reconnus. Bien que la recherche ait demontre que la perte de l'acuite auditive liee a l'age est le principal facteur de risque modifiable de la demence, l'utilisation de protheses auditives reste limitee a l'echelle mondiale, y compris dans de nombreux pays a revenu intermediate et eleve. Les raisons de ce recours limite aux protheses auditives tiennent probablement a une combinaison de facteurs qui vont des couts croissants de la technologie des appareils auditifs a un manque generalise de couverture medicale. Cet article vise a determiner l'etat actuel de l'acces aux protheses auditives en se concentrant sur huit pays a revenu intermediate et eleve. Nous etudions comment permettre aux patients d'acceder plus facilement aux protheses auditives en tenant compte de la reglementation applicable aux appareils, des progres technologiques relatifs aux appareils auditifs, de la necessite d'ajuster les systemes de remboursement et de l'importance de l'adaptation au sein de la main-d'reuvre locale pour les soins auditifs. A medida que la proporcion de adultos mayores en la poblacion total del mundo continua creciendo, los resultados adversos para la salud de la perdida de audicion relacionada con la edad son cada vez mas reconocidos. Aunque las investigaciones han demostrado que la perdida de audicion relacionada con la edad es el mayor factor de riesgo modificable para la demencia, el uso de audifonos sigue siendo bajo en todo el mundo, incluso en muchos paises de ingresos medios y altos. Las causas de la escasa aceptacion de los audifonos pueden ser una combinacion de factores, que van desde el aumento de los costes de la tecnologia de los audifonos hasta la falta generalizada de cobertura de seguro. Este articulo pretende identificar el estado actual del acceso a los audifonos, centrandose en ocho paises de ingresos medios y altos. Discutimos como facilitar un mayor acceso a los audifonos para los pacientes abordando los cambios en como se regulan los dispositivos, los avances tecnologicos en los audifonos, la necesidad de ajustar los esquemas de reembolso y la importancia de la adaptacion entre los trabajadores de la comunidad para el cuidado de la audicion., Introduction Policies around the world to address hearing loss have followed an advancing scientific understanding of the impact of hearing loss on health. Since the 1990s, worldwide efforts to screen [...]

Background Several epidemiological studies have suggested that vitamin D status is associated with risk of dementia in general populations. However, due to the synergistic effect between diabetic pathology and neuroinflammation, and the prothrombotic profile in patients with diabetes, whether vitamin D is associated with risk of dementia among patients with diabetes is unclear. This study aimed to investigate the associations of circulating vitamin D levels with risks of all-cause dementia, Alzheimer disease (AD), and vascular dementia (VD) among adults with type 2 diabetes (T2D). Methods and findings This study included 13,486 individuals ([greater than or equal to]60 years) with T2D and free of dementia at recruitment (2006-2010) from the UK Biobank study. Serum 25-hydroxyvitamin D (25[OH]D) concentrations were measured using the chemiluminescent immunoassay method at recruitment. Serum 25(OH)D [greater than or equal to] 75 nmol/L was considered sufficient, according to the Endocrine Society Clinical Practice Guidelines. Incidence of all-cause dementia, AD, and VD cases was ascertained using electronic health records (EHRs). Each participant's person-years at risk were calculated from the date of recruitment to the date that dementia was reported, date of death, date of loss to follow-up, or 28 February 2018, whichever occurred first. Among the 13,486 individuals with T2D (mean age, 64.6 years; men, 64.3%), 38.3% had vitamin D [greater than or equal to] 50 nmol/L and only 9.1% had vitamin D [greater than or equal to] 75 nmol/L. During a mean follow-up of 8.5 years, we observed 283 cases of all-cause dementia, including 101 AD and 97 VD cases. Restricted cubic spline analysis demonstrated a nonlinear relationship between serum 25(OH)D and risk of all-cause dementia (P.sub.nonlinearity < 0.001) and VD (P.sub.nonlinearity = 0.007), and the nonlinear association reached borderline significance for AD (P.sub.nonlinearity = 0.06), with a threshold at around a serum 25(OH)D value of 50 nmol/L for all the outcomes. Higher serum levels of 25(OH)D were significantly associated with a lower risk of all-cause dementia, AD, and VD. The multivariate hazard ratios and 95% confidence intervals for participants who had serum 25(OH)D [greater than or equal to] 50 nmol/L, compared with those who were severely deficient (25[OH]D < 25 nmol/L), were 0.41 (0.29-0.60) for all-cause dementia (P.sub.trend < 0.001), 0.50 (0.27-0.92) for AD (P.sub.trend = 0.06), and 0.41 (0.22-0.77) for VD (P.sub.trend = 0.01). The main limitation of the current analysis was the potential underreporting of dementia cases, as the cases were identified via EHRs. Conclusions In this study, we observed that higher concentrations of serum 25(OH)D were significantly associated with a lower risk of all-cause dementia, AD, and VD among individuals with T2D. Our findings, if confirmed by replication, may have relevance for dementia prevention strategies that target improving or maintaining serum vitamin D concentrations among patients with T2D., Author(s): Tingting Geng 1,2, Qi Lu 1, Zhenzhen Wan 1, Jingyu Guo 1, Liegang Liu 1, An Pan 2, Gang Liu 1,* Introduction Type 2 diabetes (T2D) is a serious [...]