Gill Livingston: “When a person cannot hear, or hears poorly, their brain shrinks”

Gill Livingston is an expert psychiatrist from the Department of Mental Health at University College London, a group that has launched programs to modify the main risk factors that promote dementia. Her initiatives have influenced health policies in the US, ‘US National plan’, the United Kingdom, ‘UK midlife check’ or the guidelines of the World Health Organization (WHO). Professor Livingston has participated in the Cycle of Lectures and Debates in Sciences of the Ramón Areces Foundation and Springer-Nature. Can dementia be prevented? Some factors are modifiable; They are those that make people more prone. And if we reduce and address these risk factors, we can prevent or delay the onset of dementia. Which is it? You may be surprised to know that we are seeing loss in hearing ability being the most important. So are education and smoking. All three are modifiable. Related News Standard oxytocin No The love hormone holds the key to better memory R. Ibarra Specific oxytocin neurons are identified in the mouse brain that modulate object recognition memory Can you explain the relationship between hearing loss and Alzheimer’s? Hearing is one of the main ways we stimulate our brain. The brain is like a muscle that, if you stimulate it, becomes stronger. For example, now we are talking and you are thinking about what I am saying and I, myself, am thinking about what you are observing. Thus, without making too much effort we are stimulating our minds. But when a person cannot hear, or hears poorly, his or her brain shrinks. The temporal lobe, where memory resides, is reduced. And thus they have a less resilient brain. which increases your chances of developing dementia. We know that it is key to maintain a resilient brain and brain reserve; and that is achieved through hearing, which allows you to interact with people and think and be part of society. There is increasing evidence showing that the use of hearing aids mitigates this risk. Furthermore, it has been found that a person with hearing problems tends to become depressed and isolated. In my group we have observed people up to 15 years before the development of dementia and we have seen that those with impaired hearing were at much higher risk of dementia. But if they use headphones, they decrease. And the other two? Education also increases cognitive reserve and being cognitively active makes you less likely to develop dementia. Those people who have had no education, but who carry out cognitively stimulating jobs throughout their lives, can compensate for this risk, but not as much as those with a high level of education and with cognitively stimulating jobs, whose risk is much lower. What people want is to have no symptoms. They don’t care as much about what’s going on in their brains. In dementia, in Alzheimer’s, plaques and tangles form in the brain. But we know that if you have a greater cognitive reserve, symptoms can be delayed. Good hearing and education and physical exercise preserve cognitive reserve and, therefore, even if these plaques are forming in the brain, it is possible not to have symptoms. And what people want is to not have symptoms. They don’t care so much what’s going on in their brains. A recent study published in the journal ‘BMJ Global Health’ announced that millions of young people are potentially at risk of hearing loss due to the use of headphones or exposure to noise levels above recommended levels. Does this mean there will be an increase in dementia in the future? It is possible, although it depends on the volume at which you listen to the music. Many people, especially young people, use headphones daily, which could increase the risk of hearing loss and thus increase dementia. There is more and more data about the impact of hearing aids on our health. What do you think? For years there has been a stigma about its use. Many people have hesitated to use hearing aids but not to wear glasses. Things may be changing, at the end of the day, it’s swapping headphones for headphones. While the former isolate you from social life, the latter encourage interactions with other people. And, as he said, hearing is related to the development of dementia. Are high noise levels a reason why there are more cases of dementia in cities? Really if. If you live in a very noisy environment that damages your hearing, you are at risk for dementia and isolation. So we should think about our environment. There are more and more studies that link dementia with the heart. It’s not my area of ​​research, but we know that smoking, high blood pressure, and high cholesterol increase the risk of heart disease, so it’s likely that if you reduce these and other factors that reduce the risk of heart disease, you also decrease the risk of heart disease. risk of dementia. They are not the definitive answer, but they are the beginning of an answer, the beginning of seeing something that makes a difference. In a short period of time, three new drugs have appeared that could open a new scenario in the treatment of Alzheimer’s disease; However, they have generated many controversies. What is your opinion? I think it is a great advance since they are the first drugs that have worked in terms of modifying the disease. It is true that some have many side effects and people’s brains have been seen to shrink from them. We also don’t know what the long-term effect is. Of course they are not the definitive answer, but they are the beginning of an answer, the beginning of seeing something that makes a difference. Related News standard No Can you train your erection capacity like in the gym? Rafael Ibarra Swedish researchers suggest a possible connection between the frequency of erections and the prevention of erectile dysfunction. What do you think of the rejection that these drugs have caused in part of the medical community? Patients must have the opportunity to decide. If it is administered and the patient says “I feel better and, although it may kill me to make me worse, it may also slow the progression.” It is a risk that many people and family members are willing to take. If it kills me, it kills me. But what I don’t want is this progressive reduction in my capacity. But the patient must always be informed in detail of the positive and negative effects; and in this case the risk is much greater than that of most other medications. But I can understand why someone might take it. One of my colleagues who is a professor has Alzheimer’s and talked about this with him and his wife. His response was: “We have a good quality of life right now and if we opt for treatment, it could kill us; So why take it? However, other people have different views: “Well, if it kills me, it kills me. But what I don’t want is this progressive reduction of my capabilities. You also work with caregivers and have developed a specific program for them. Can you give any advice to cope with this scenario? One of the things that is important to keep in mind is that most caregivers try to solve the problem; but dementia has no solution. So they become depressed and anxious because they are caring for someone they love and they see them deteriorate. And often, the sick person isn’t even grateful because he doesn’t realize it. That is why it is important to take care of the mental state of the caregivers, otherwise they will not be able to move forward. We are working on strategies that could help them and that do not end up blaming the person with dementia. We have a START program (STRAtegies for RelaTives) in place for family caregivers, which has demonstrated long-lasting beneficial effects on symptoms of depression and anxiety, has increased quality of life, and has proven that it could lead to financial savings in the management of these diseases. . . So I think these coping strategies really make a difference because people try so hard.