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New studies suggest millions with mild cognitive impairment go undiagnosed, often until it’s too late

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/soeren-mattke-1484707">Soeren Mattke</a>, <a href="https://theconversation.com/institutions/university-of-southern-california-1265">University of Southern California</a> and <a href="https://theconversation.com/profiles/ying-liu-1221170">Ying Liu</a>, <a href="https://theconversation.com/institutions/usc-dornsife-college-of-letters-arts-and-sciences-2669">USC Dornsife College of Letters, Arts and Sciences</a> Mild cognitive impairment – an early stage of dementia – is widely underdiagnosed in people 65 and older. That is the key takeaway of two recent studies from our team. In the first study, we used Medicare data for about 40 million beneficiaries age 65 and older from 2015 to 2019 to estimate the prevalence of mild cognitive impairment in that population and to identify what proportion of them had actually been diagnosed. Our <a href="https://doi.org/10.1186/s13195-023-01272-z">finding was sobering</a>: A mere 8% of the number of cases with mild cognitive impairment that we expected based on a statistical model had actually been diagnosed. Scaled up to the general population 65 and older, this means that approximately 7.4 million cases across the country remain undiagnosed. In the second study, we analyzed data for 226,756 primary care clinicians and found that <a href="https://doi.org/10.14283/jpad.2023.131">over 99% of them underdiagnosed mild cognitive impairment</a> in this population. <h2>Why it matters</h2> Mild cognitive impairment is an early symptom of Alzheimer’s disease in <a href="https://doi.org/10.1001/jama.2019.2000">about half of cases</a> and progresses to dementia <a href="https://www.alz.org/alzheimers-dementia/what-is-dementia/related_conditions/mild-cognitive-impairment">at a rate of 10% to 15% per year</a>. It includes symptoms such as losing the ability to remember recent events and appointments, make sound decisions and master complex tasks. Failure to detect it might deprive patients of an opportunity to get treated and to slow down disease progression. Mild cognitive impairment can sometimes be caused by easily addressable factors, such as medication side effects, thyroid dysfunction or <a href="https://theconversation.com/vitamin-b12-deficiency-is-a-common-health-problem-that-can-have-serious-consequences-but-doctors-often-overlook-it-192714">vitamin B12 deficiency</a>. Since mild cognitive impairment has <a href="https://doi.org/10.1016/j.amjopharm.2008.06.004">the same risk factors as cardiovascular disease</a>, such as high blood pressure and cholesterol, medication management of these risks combined with diet and exercise <a href="https://doi.org/10.1016/S0140-6736(15)60461-5">can reduce the risk of progression</a>. In 2023, the Food and Drug Administration <a href="https://www.fda.gov/news-events/press-announcements/fda-converts-novel-alzheimers-disease-treatment-traditional-approval">approved the drug lecanemab</a> as the <a href="https://theconversation.com/what-the-fdas-accelerated-approval-of-a-new-alzheimers-drug-could-mean-for-those-with-the-disease-5-questions-answered-about-lecanemab-197460">first disease-modifying treatment</a> <a href="https://www.nia.nih.gov/health/alzheimers-causes-and-risk-factors/what-happens-brain-alzheimers-disease">for Alzheimer’s disease</a>, the most common cause of mild cognitive impairment. In contrast to previous drugs, which can temporarily improve symptoms of the disease, such as memory loss and agitation, this new treatment addresses the underlying cause of the disease. Lecanemab, a monoclonal antibody, <a href="https://www.news-medical.net/health/What-are-Amyloid-Plaques.aspx">reduces amyloid plaques</a> in the brain, which are toxic protein clumps that are believed to contribute to the progression of the disease. In a large clinical trial, lecanemab was able to <a href="https://doi.org/10.1056/NEJMoa2212948">reduce the progression</a> of early-stage Alzheimer’s disease. A similar drug, donanemab, also <a href="https://doi.org/10.1001/jama.2023.13239">succeeded in a clinical trial</a> and is expected to be <a href="https://www.medicalnewstoday.com/articles/fda-delays-approval-of-alzheimers-drug-donanemab-what-experts-think">approved sometime in 2024</a>. However, these drugs must be used in the early stages of Alzheimer’s disease, ideally when a patient has only mild cognitive impairment, as there is <a href="https://www.alz.org/alzheimers-dementia/treatments/lecanemab-leqembi">no evidence that they are effective in advanced stages</a>. <figure><iframe src="https://www.youtube.com/embed/w3IbAscNjsQ?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe><figcaption>An earlier diagnosis leads to early treatment and better outcomes.</figcaption></figure> <h2>What still isn’t known</h2> Many factors contribute to the <a href="https://doi.org/10.1002/alz.13051">lack of timely detection</a>. But researchers don’t have a good understanding of the relative importance of those individual factors or how to reduce the high rate of underdiagnosis. While distinct, symptoms are subtle and their slow progression means that they can be overlooked or misinterpreted as normal aging. A neurologist in China told our research team that diagnosis rates spike in China after the New Year’s holiday, when children who haven’t seen their parents for a year notice changes that are harder to pick up when interacting with someone daily. Doctors also commonly discount memory concerns as normal aging and doubt that much can be done about it. While cognitive tests to distinguish mild cognitive impairment from pathologic decline do exist, they take about 15 minutes, which can be hard to come by during the limited time of a doctor’s visit and may require a follow-up appointment. <h2>What’s next</h2> People, particularly those in their 60s and beyond, as well as their families and friends need to be vigilant about cognitive decline, bring it up during doctor’s appointments and insist on a formal assessment. The <a href="https://www.medicare.gov/coverage/yearly-wellness-visits">Medicare yearly “wellness” visit</a> is an opportunity to explore such concerns, but only about half of beneficiaries <a href="https://doi.org/10.1377/hlthaff.2019.01795">take advantage of it</a>. Just as physicians ask patients about unexplained weight loss and take those concerns seriously, we believe questions that explore a patient’s cognitive state need to become the norm. The <a href="https://theconversation.com/us/topics/research-brief-83231">Research Brief</a> is a short take on interesting academic work.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/216892/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/soeren-mattke-1484707">Soeren Mattke</a>, Director of the USC Dornsife Brain Health Observatory, <a href="https://theconversation.com/institutions/university-of-southern-california-1265">University of Southern California</a> and <a href="https://theconversation.com/profiles/ying-liu-1221170">Ying Liu</a>, Research Scientist, Center for Economic and Social Research, <a href="https://theconversation.com/institutions/usc-dornsife-college-of-letters-arts-and-sciences-2669">USC Dornsife College of Letters, Arts and Sciences</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/new-studies-suggest-millions-with-mild-cognitive-impairment-go-undiagnosed-often-until-its-too-late-216892">original article</a>. </div>

Mind

Vitamin C deficiency linked to cognitive impairment

A new study has found a link between poor brain function and how much Vitamin C older people have, and that a deficiency could have some serious effects on the brain. Cognitive impairment is common among older, hospitalised patients, and can result in poor memory and concentration, as well as finding decision-making difficult. The team from Flinders University in Adelaide tested the cognitive function and vitamin C level of 160 people over the age of 75 who were admitted to the university’s medical centre. From this, 91 patients were found to have cognitive impairment, and 42 of this group were found to have such low levels of vitamin C - below 11 micromoles per litre - they were at risk of developing scurvy. “Our findings showed that cognitive function scores were significantly lower among patients who were vitamin C deficient, with further analysis suggesting vitamin C deficiency was almost three times more likely to be associated with cognitive impairment after adjustment for other factors,” Associate Professor Yogesh Sharma, the study’s lead author, <a href="https://www.scimex.org/newsfeed/low-vitamin-c-linked-to-cognitive-impairment-in-older-australians" target="_blank" rel="noopener">said</a>. The researchers stressed that the two were associated, not that vitamin C deficiency causes cognitive impairment. They also noted that many of the symptoms of low vitamin C levels - including skin issues, bruising and bleeding - are common in this age group because of a number of conditions. “It may, therefore, be difficult to diagnose vitamin C deficiency solely on looking for these particular symptoms in older hospitalised patients,” Associate Professor Sharma said. “Given we know vitamin C deficiency is common among older hospitalised patients, medical professionals need to remain vigilant for this condition and confirm a patient’s vitamin C status in suspected cases.” With this link, the researchers said they will need to conduct more studies to confirm the link and determine whether replacing a patient’s vitamin C levels could help prevent or reverse cognitive impairment. The study was published in the journal <a href="https://doi.org/10.3390/antiox11030463" target="_blank" rel="noopener">Antibiotics</a>. Image: Getty Images

Body

Air pollution may impair cognitive function

<div> <div class="copy"> A joint China-US research team has found that exposure to even short-term air pollution may impair cognitive function. Air pollution is a growing cause of sickness and death globally, with a <a href="https://cosmosmagazine.com/climate/air-pollution-pandemic-warning/" target="_blank" rel="noreferrer noopener">recent study</a> estimating that it caused an extra 8.8 million premature deaths in 2015, surpassing the 7.2 million caused by tobacco smoking. It has well-established effects on the lungs and the heart – it has been linked with spikes in <a href="http://jaha.ahajournals.org/content/5/5/e002742" target="_blank" rel="noreferrer noopener">heart attacks, strokes</a> and <a href="http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0180522" target="_blank" rel="noreferrer noopener">asthma</a>, and is a carcinogen known to cause lung cancer. Increasingly, research is also associating air pollution with other health impacts including <a href="https://cosmosmagazine.com/biology/kidney-disease-linked-to-air-pollution/" target="_blank" rel="noreferrer noopener">kidney disease</a>, <a href="https://cosmosmagazine.com/climate/could-air-pollution-contribute-to-psychiatric-illness/" target="_blank" rel="noreferrer noopener">psychiatric illness</a> and <a href="https://cosmosmagazine.com/biology/air-pollution-link-to-alzheimer-s-mooted/" target="_blank" rel="noreferrer noopener">Alzheimer’s</a>. What causes air pollution? <ul> <li>Air pollution is the release of pollutants into the air that have detrimental effects on human or planetary health.</li> <li>It can have natural sources, such as desert dust or bushfire smoke, but is increasingly created by humans, primarily from burning fossil fuels.</li> <li>There are two main types: smog occurs when emissions from burning fossil fuels react with sunlight, while soot is made up of tiny particles made up of smoke, soil, dust, allergens or chemicals. Anything that combusts fossil fuels can cause this, including vehicle exhaust, power plants, incinerators and more.</li> </ul> Now, in a new study <a href="https://doi.org/10.1038/s43587-021-00060-4" target="_blank" rel="noreferrer noopener">published</a> in the journal Nature Ageing, researchers have linked poor air quality with decreased brain health. The team studied a sample of 954 Caucasian males (with an average age of 70) from the Boston area in the US, who were participants in the Veterans Affairs Normative Aging Study. Their cognitive function was measured by a series of assessments to test their attention, learning and memory, as well as an screening to help detect early signs of dementia. This was compared to the average levels of fine particulate matter (PM2.5, smaller than 2.5 micrometres in size) in the area, both on the day of each test and in the 28 days prior. The team found the participants tended to score lower when levels of PM2.5 were higher in the month before the tests – even when levels were still below what is considered as “hazardous”. “The findings were quite startling,” write cognitive health researchers Joanne Ryan and Alice J. Owen, in an <a href="https://dx.doi.org/10.1038/s43587-021-00062-2" target="_blank" rel="noreferrer noopener">accompanying article</a>. “Even relatively small increases in the levels of PM2.5 in the 3–4 weeks prior to testing were associated with consistently worse cognitive performance.” Ryan and Owen, both from Monash University in Australia and both not involved in the study, point out that Boston “has by no means the worst air quality in the USA or the world, and yet significant detrimental effects of air pollution on cognitive function were observed”. While a decline in brain function in older adults is common, it can be exacerbated – and accelerated – by environmental factors. Evidence is <a href="https://doi.org/10.3233/jad-180631" target="_blank" rel="noreferrer noopener">mounting</a> that air pollution could be a risk factor for dementia and could, over the long term, be <a href="https://dx.doi.org/10.1016%2Fj.neuro.2016.06.004" target="_blank" rel="noreferrer noopener">associated</a> with cognitive declines. “The results of the current study are especially important because they provide some of the first evidence that even relatively low-level, short-term increases in PM2.5 are detrimental for thinking and memory, as well as global cognition in older adults,” Ryan and Owen write. The results may point to a general trend in the larger population, given that air pollution <a href="https://www.unicef.org/environment/files/Danger_in_the_Air.pdf" target="_blank" rel="noreferrer noopener">affects brain development</a> in kids, and women seem to be <a href="https://doi.org/10.1289/ehp.0900994" target="_blank" rel="noreferrer noopener">more strongly affected</a> than men. Interestingly, the researchers also found that the participants who were prescribed NSAIDs (nonsteroidal anti-inflammatory drugs, such as aspirin) were less adversely affected. This may be because the health impacts of air pollution tend to involve activating the body’s inflammatory response. But caution is warranted; there may be many other differences between participants who do and don’t use NSAIDs. This study also had a relatively small sample size and focused on a certain geographical area, so further research is needed to solidify the link between air pollution and cognitive function. However, Ryan and Owen emphasise the importance of the results. “The implications for public health, and consequent health, societal and economic costs of air pollution, are immense,” they write. “This should be a further wake-up call about the urgent need for action. “It has been estimated that 90% of the world’s population breathe polluted air. Breathing clean air is fundamental to our health but represents a global challenge and one of substantial inequity, disproportionally affecting the most vulnerable.” Image credits: Getty Images  <img id="cosmos-post-tracker" style="opacity: 0; height: 1px!important; width: 1px!important; border: 0!important; position: absolute!important; z-index: -1!important;" src="https://syndication.cosmosmagazine.com/?id=149918&title=Air+pollution+may+impair+cognitive+function" width="1" height="1" data-spai-target="src" data-spai-orig="" data-spai-exclude="nocdn" /> </div> <div id="contributors"> This article was originally published on <a href="https://cosmosmagazine.com/health/air-pollution-may-impair-cognitive-function/" target="_blank" rel="noopener">cosmosmagazine.com</a> and was written by Lauren Fuge. </div> </div>

Mind

Why background music “significantly impairs” your creativity

Psychologists from the University of Central Lancashire, University of Gävle in Sweden and Lancaster University have asked people to complete verbal problems that are believed to stimulate creativity. This is to test whether or not background music stifles creativity. Participants were presented with three words and were asked to find a single word that when combined, make a common word or phrase. For example, if you chose the word “sun”, the combined word could be “sundress”, “sunflower” and “sundial”. Participants then performed the task while listening to music with unfamiliar lyrics, music with familiar lyrics or instrumental lyrics. The researchers also tested the effect of silence and quiet background noise from a library. Dr Neil McLatchie from Lancaster University explained that music stifles creativity. He told the<a href="https://www.abc.net.au/classic/read-and-watch/news/music-impairs-creativity/10912466"> ABC</a> that the team “found strong evidence of impaired performance when playing background music in comparison to quiet background conditions." This means that even though you’re listening to your favourite song, it’s still impairing your creativity. Even music that participants liked or made them feel good still stifled their creative juices. The research results suggest that music disrupts verbal working memory. However, there was no difference found between quiet background noise and silence. McLatchie believes that this was because of the steady state of background noise that doesn’t disrupt verbal processes. For those of you who want to listen to music whilst you’re working away, classical music that makes listeners feel happy has been found to stimulate creative thinking. Do you listen to music whilst working? Let us know in the comments.

Music

The new innovation that allows visually impaired people to "see"

For a local Sydney woman, she loves reading anything she can get her hands on. At first, she might sound like a bookworm. However, she loves reading simply because she was born completely blind and had no idea what it was like to read junk mail and trawl through the adverts looking for a decent bargain. This changed last September, when she received a small device that clips onto a pair of glasses. The device uses artificial intelligence to recognise faces and read text for her. The device, OrCam MyEye 2.0, has completely changed her life. Lisa Hayes explained to <a href="https://www.news.com.au/technology/gadgets/wearables/the-breakthrough-of-the-21st-century-how-this-product-changed-a-blind-womans-life/news-story/74f9881ed0f6f87a8797842bd982d1da">news.com.au</a>: “It has got be the breakthrough of the 21st century as far as I’m concerned.” “It’s one of the best things I’ve ever had.” The tech is designed by an Israeli company called OrCam and the device is designed for the blind and visually impaired. <img style="width: 0px; height: 0px; display: block; margin-left: auto; margin-right: auto;" src="https://oversixtydev.blob.core.windows.net/media/7824337/picture1.png" alt="" data-udi="umb://media/ca47348ee3fc4a22aecf5e25c10ac6fb" /> What the device looks like. Photo credit: OrCam On the front of the device, there’s a small camera with real time visual recognition technology. On the back of the device is a small speaker that relays the information into the ear of the user. It’s available in 23 languages. Miss Hayes is overjoyed with the device. “Being totally blind since birth, I’ve never been able to read a print book,” she said. “I can now actually read. I can read medication boxes, I can pick up junk mail. “I feel like I’m part of the real world.” The device has gotten attention around the globe, with Prince William being shown the technology on a historic visit to Israel. <blockquote style="background: #FFF; border: 0; border-radius: 3px; box-shadow: 0 0 1px 0 rgba(0,0,0,0.5),0 1px 10px 0 rgba(0,0,0,0.15); margin: 1px; max-width: 540px; min-width: 326px; padding: 0; width: calc(100% - 2px);" class="instagram-media" data-instgrm-captioned="" data-instgrm-permalink="https://www.instagram.com/p/BkkFGF3n-9v/?utm_source=ig_embed&utm_medium=loading" data-instgrm-version="12"> <div style="padding: 16px;"> <div style="display: flex; flex-direction: row; align-items: center;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 40px; margin-right: 14px; width: 40px;"></div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 100px;"></div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 60px;"></div> </div> </div> <div style="padding: 19% 0;"></div> <div style="display: block; height: 50px; margin: 0 auto 12px; width: 50px;"></div> <div style="padding-top: 8px;"> <div style="color: #3897f0; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: 550; line-height: 18px;">View this post on Instagram</div> </div> <a style="color: #000; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: normal; line-height: 17px; text-decoration: none; word-wrap: break-word;" rel="noopener" href="https://www.instagram.com/p/BkkFGF3n-9v/?utm_source=ig_embed&utm_medium=loading" target="_blank">#princewilliam made a historic visit to Israel, meeting with 4 top technology companies. He met with OrCam Technologies and used OrCam MyEye 2, the most advanced assistive wearable technology, that reads text, recognizes faces, and identifies products for the blind, visually impaired, and people with reading difficulties. #assistivetechnology #blindness #lowvision #OrCam #assistivetech #visuallyimpaired #partiallysighted #blind #lifechanging #visualimpairment #wearabletech</a> <p style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; line-height: 17px; margin-bottom: 0; margin-top: 8px; overflow: hidden; padding: 8px 0 7px; text-align: center; text-overflow: ellipsis; white-space: nowrap;">A post shared by <a style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: normal; line-height: 17px;" rel="noopener" href="https://www.instagram.com/orcam_technologies/?utm_source=ig_embed&utm_medium=loading" target="_blank"> OrCam</a> (@orcam_technologies) on Jun 28, 2018 at 2:43am PDT </div> </blockquote> The royal was thrilled with the technology, <a href="https://www.orcam.com/gb/article/prince-william-experiences-life-changing-device-for-blind-people/">saying</a>: “Wow. That is absolutely incredible. “That will help many people I am sure. What brilliant tech.” Would you use this device? Let us know in the comments.

Technology

Caring for someone who is vision impaired

Marissa Sandler is the CEO and co-founder of <a href="http://www.careseekers.com.au/" target="_blank">Careseekers</a>. Previously a social justice lawyer and researcher for over 15 years, Marissa is passionate about helping people live with dignity and finding innovative solutions to problems. There are over 575,000 people who are blind or vision impaired currently living in Australia, with more than 70 per cent over the age of 65 and over 66,000 people who are blind. With stats like this it is highly possible that you may find yourself caring for a loved one whose vision starts to decrease and may unfortunately become legally blind. Here is some information that you will help you care for a person with vision loss from the beginning stages of their diagnosis. Look for the symptoms of deteriorating eyesight It is quite common that a person will hide their poor eyesight from loved ones, they may be embarrassed, in denial or are scared of losing their independence. Look out for physical symptoms including: <ul> <li>Constant red eyes</li> <li>Pain in the eyes</li> <li>Blurring vision</li> <li>Sudden temporary loss of vision</li> <li>Floaters</li> </ul> Other symptoms could be a sign of vision problems including <ul> <li>Depression and anxiety</li> <li>Not wanting to go out, especially at night</li> <li>Nervous behavior in public or crowded places</li> </ul> Start with a conversation about sight As soon as you think a loved one is having problems seeing it is very important that you start to talk about it. You need to have conversations about their sight often as it will be constantly changing. Make sure you are aware of what they can and cannot see. Check in with them every few months to see what has changed. Make the living environment as safe as possible Use the <a href="http://careseekers.respond.ontraport.net/safetychecklist" target="_blank">Careseekers Home Safety Checklist</a> and do an audit on each room in the house. Specific things you should do in a home for someone with poor eyesight include: <ul> <li>Making sure the home is free of clutter and unnecessary items, especially in thoroughfares.</li> <li>Make sure lighting is good throughout the house, especially on staircases.</li> <li>Light switches are at the top and bottom of the staircases.</li> <li>There are night lights, as well as easy to reach bedside lights in bedrooms.</li> <li>Arrangement of furniture and large items is consistent throughout the home, so that the layout is always familiar. The same for regularly used items in every room in the home.</li> </ul> A few more helpful tips <a href="http://www.visionaustralia.org/" target="_blank">Vision Australia</a> is the go to organization for information for anyone suffering vision loss. Here are some general tips from them for day to day interactions with people with vision loss. <ul> <li>Address people who are blind or have low vision by their names so they know you are speaking to them. </li> <li>When entering a room let the person who is blind or have low vision know that you have arrived. </li> <li>Do not walk away from a person who is blind or have low vision without indicating that you are doing so - it is embarrassing and frustrating to talk to thin air. </li> <li>In dangerous situations say "STOP" rather than "LOOK OUT"</li> <li>Do not fill glasses or cups to the brim. </li> <li>When directing people use ordinary language and when describing be specific. Do not point, or say "over there". Direct people who are blind or have low vision to their left and right, not yours. </li> <li>When talking, don’t be embarrassed to use the words "look" and "see"; they are part of everyone's vocabulary.</li> <li>Describe the surroundings and obstacles in a person's pathway (remember to look up as well as down). Warn of the presence of over-hangs, such as kitchen cupboards, jutting side mirrors of cars, or trees. </li> <li>When seating people who are blind or have low vision, put their hands on the back of the chair and they will then be able to seat themselves.</li> </ul>

Caring

Bringing Sydney’s Vivid Festival to the visually-impaired

Vivid might be Sydney’s time to shine, but it’s not only those of us lucky enough to have decent vision who get to enjoy the sights and sounds of this incredible festival of light – the visually-impaired can experience it, too. The festival has enlisted the help of commentator Emma Bedford, who two nights ago took a group of 50 visually-impaired visitors around the city, describing the exhibits to them in great detail. “Behind these pink, bent over tentacles that could reach all the way to the top but they flop forward, the sails are a greenish-blue,” she narrated. It might not sound like much, but for the attendees, it’s the difference between immersing themselves in the city’s most colourful festival and missing out. “I’m very short sighted and have no night sight,” festivalgoer Jaci Armstrong told <a href="http://mobile.abc.net.au/news/2017-06-13/vivid-sydney-brings-light-festival-to-blind-people/8613170" target="_blank">the ABC</a>. “But I can occasionally see a little bit of colour." “Without the audio description and the detail that’s provided I wouldn’t be able to tell what’s happening on the sails, and I wouldn’t be able to enjoy the experience of Vivid as others can.” But Vivid isn’t all about the lights. Most exhibits feature strong audio components, and some have even included tactile elements. In fact, the visually-impaired attendees were even given models and tiles from the iconic Sydney Opera House to pass around and get a feel (literally) for the structure. “When we started doing this and passing around the models of the Opera House, people were for the first time saying, ‘Now I know what the Opera House feels like,’” explained the venue’s Accessibility Manager, Jenny Spinak. “It’s really about everyone coming together, feeling part of the community and accessing the arts which otherwise they wouldn't be able to do.” Have you been to this year’s Vivid yet? It runs until June 17, so get in quick if you can!

Art

Safety tips for the hearing impaired

If you or a family member suffers from hearing loss, one issue you may not have thought to address is that of safety. For instance, for those people who generally wear hearing aids and remove them before bed, one of the biggest issues is that they may not wake up in the night if a fire alarm sounds. You may think an alarm would be loud enough to hear without the hearing aid, but in fact most use a sound with a frequency between 3,000 to 4,000 Hertz, which is often not heard by those with hearing loss. You can buy some safety products that are made for the hearing impaired, such as a special smoke detector. This will send out a low frequency (520 Hz) square wave tone, which can be heard by most people with hearing problems. There are also alarms that include flashing lights or vibrations that can be felt in your mattress, which are ideal for people who are completely deaf or can’t hear at all without a hearing aid. But what about other sounds, like someone breaking in or a person knocking on your door in the night? Some people overcome this by installing induction loops in their house. This helps improve the performance of hearing aids by raising the volume of sound heard. Even modern telephones tend to be compatible with hearing aids and cochlear implants. Other phones offer a speakerphone with very loud volumes for the hearing impaired, voice activation, and accessories such as vibrating wristbands to inform you of an incoming call. Have you ever found yourself in a vulnerable situation due to hearing loss? We would love to hear your story in the comments. Related links: <a href="/health/hearing/2016/06/tips-for-going-to-movies-with-hearing-loss/">How to enjoy going to the movies with hearing loss</a> <a href="/health/hearing/2016/06/understanding-long-term-hearing-damage/">Understanding long-term hearing damage</a> <a href="/health/hearing/2016/06/the-dangers-of-single-sided-deafness/">The dangers of single sided deafness</a>

Hearing

Facebook will help describe photos for the blind

Facebook is training its computers to become seeing-eye guides for the blind and visually impaired. The feature, rolling out this week on Facebook's iPhone app, interprets what's in a picture using a form of artificial intelligence that recognises faces and objects. The iPhone's built-in screen reader, VoiceOver, must be turned on for Facebook's photo descriptions to be read. For now, the feature will only be available in English. The descriptions initially will be confined to a vocabulary of 100 words in a restriction that will prevent the computer from providing a lot of details. For instance, the automated voice may only tell a user that a photo features three people smiling outdoors without adding that the trio also has drinks in their hands. Or it may say the photo is of pizza without adding that there's pepperoni and olives on top of it. Facebook is being careful with the technology, called "automatic alternative text", in an attempt to avoid making a mistake that offends its audience. Google learned the risks of technology last year when an image recognition feature in its Photos app labelled a black couple as gorillas, prompting the company to issue an apology. Eventually, though, Facebook hopes to refine the technology so it provides more precise descriptions and even answers questions that a user might pose about a picture. Facebook also plans to turn on the technology for its Android app and make it available through web browsers visiting its site. The Menlo Park, California, company is trying to ensure the world's nearly 300 million blind and visually impaired people remain interested in its social network as a steadily increasing number of photos appear on its service. On an average day, Facebook says more than 2 billion photos are posted on its social network and other apps that it owns, a list that includes Messenger, Instagram and WhatsApp. Until now, people relying on screen readers on Facebook would only hear that a person had shared a photo without any elaboration. The vocabulary of Facebook's photo-recognition program includes "car", "sky", "dessert", "baby", "shoes", and, of course, "selfie". Tell us: What other changes do you think Facebook should implement to help make it easier for people with disabilities? Written by Michael Liedtke. First appeared on <a href="http://www.stuff.co.nz/" target="_blank">Stuff.co.nz</a>. Related links: <a href="/entertainment/technology/2016/05/tips-to-prolong-your-smartphones-battery-life/">Tips to prolong your smartphone's battery life</a> <a href="/entertainment/technology/2016/05/how-to-avoid-facebook-scams/">How to avoid Facebook scams</a> <a href="/entertainment/technology/2016/03/how-to-make-your-wifi-faster/">4 ways to make your wifi faster</a>

Technology

10 commandments the hard of hearing wish you’d follow

For all those people who have a loved one who has a hearing impairment, these are the commandments they wish you’d follow. 1. Thou shalt not speak to the listener from another room. 2. Thou shalt not speak with your back toward the listener or while the listener’s back is toward you. 3. Thou shalt not speak as you walk away. 4. Thou shalt not turn your face away from the listener while continuing to talk. 5. Thou shalt not speak while background noise (water running, radio or TV playing, people talking, etc) is as loud or louder than your voice. 6. Thou shalt not start to speak before getting the listener’s attention and while the listener is reading, engrossed in a TV program, or otherwise preoccupied. 7. Thou shalt not speak while your face is hidden in shadow. 8. Thou shalt not obstruct a view of your mouth while speaking. 9. Thou shalt not speak rapidly or by shouting. 10. Thou shalt be patient, supportive and loving when the listener appears to have difficulty comprehending what has been said. Source:<a href="https://www.pinterest.com/pin/335658978453894345/" target="_blank"> Pinterest</a><a href="https://www.pinterest.com/pin/335658978453894345/"> </a> Related links: <a href="/health/hearing/2015/06/hearing-impaired-suffer-in-silence/">People with hearing loss suffer in silence</a> <a href="/health/hearing/2015/07/how-hearing-is-tested/">What happens when your hearing is tested?</a> <a href="/health/hearing/2015/05/partner-wont-acknowledge-hearing-loss/">What to do when your partner won’t acknowledge their hearing loss</a>

Hearing

13-year-old blind boy gets Australia to finally introduce “tactile banknotes” to help visually impaired

Thirteen-year-old Connor McLeod campaign to get the Reserve Bank of Australia (RBA) to print tactile banknotes has finally paid off.The legally blind boy began his campaign last year after he received money for Christmas but felt embarrassed because he could not tell how much it was.“I received some notes at Christmas time and I kept having to ask Mum what they had given me,” said Connor, continuing, “I didn't touch notes because it was really annoying and embarrassing that I couldn't differentiate between them, but I could differentiate coins so I used to go around with only coins in my wallet getting stuff from the canteen with them.“And then it just sort of hit me that my life isn’t going to be all coins, so I thought I’d better make things a little easier, and easier for others as well.”The teenager started a petition, and backed by the Human Rights Commission and Vision Australia, Connor’s campaign received 57,000 signatures. Last November, Connor himself had a meeting with the RBA where he argued passionately and articulately that tactile banknotes were needed for the 300,000 visually impaired people in Australia.This week the RBA announced they will add a tactile feature to their bank notes to help visually impaired people tell the difference between the notes.Vision Australia advocacy general manager Maryanne Diamond said Connor should be proud of himself for making such a big difference in many people’s lives.“What we found in Vision Australia in a recent survey is that 50 per cent of people who are totally blind are telling us that they feel that at times they have been short-changed, or given the wrong change when they’ve purchased something, simply because they can't quickly and easily and effectively distinguish notes,” Ms Diamond said.Image credit: ABC TVRelated link: <a href="http://oversixty.com.au/news/news/2015/02/adelaide-fringe-for-vision-impaired/" target="_blank">Adelaide Fringe festival caters to the vision-impaired</a><a href="http://oversixty.com.au/health/eye-care/2014/11/what-your-family-history-says-about-your-eyesight/" target="_blank">What your family history says about your eyesight</a> <a href="http://oversixty.com.au/health/eye-care/2014/09/six-ways-to-keep-your-eyes-healthy/" target="_blank">Six ways to keep your eyes healthy</a>

News

Great apps for the hearing impaired

These great apps for smartphones specifically designed to help people with hearing loss will make your life a little bit easier.<a href="https://itunes.apple.com/au/app/uhear/id309811822?mt=8" target="_blank">uHear, free</a> uHear lets you test your hearing at a push of a button. You can take three tests – hearing sensitivity, speech in noise and a questionnaire – to determine if your hearing is within the normal range or if you have potential hearing loss.<a href="https://itunes.apple.com/au/app/tooloud-pro/id425137981?mt=8" target="_blank">TooLoud?, $1.29</a> This nifty app analyses the sound of any given space and provides a live graph of the decibel level. It will also notify you if you are putting your ears at risk!<a href="/health/hearing/2015/01/sounds-that-damage-hearing/" target="_blank">Related link - Everyday sounds that could be damaging your hearing</a><a href="https://itunes.apple.com/au/app/hearing-loss-simulator/id398352094?mt=8" target="_blank">Hearing Loss Simulator, $2.49</a>It’s hard to explain hearing loss to a loved one so let this app do it for you. The Hearing Loss Simulator allows you to choose a specific hearing loss configuration and then listen to sounds as though you have that particular hearing loss. It also includes graphics to show where the common sounds, speech, and individual speech sounds are located for loudness and frequency.<a href="https://itunes.apple.com/au/app/soundamp-r/id318126109?mt=8" target="_blank">SoundAMP, $6.49</a>Use your smartphone like a hearing aid with SoundAMP. It processed sounds from the microphone and delivers it to you amplified over headphones in real time. There is also the function to adjust the tone to your liking, helping those who have hearing loss in specific tonal areas.<a href="https://itunes.apple.com/au/app/tap-tap/id369747181?mt=8" target="_blank">Tap Tap, $3.79</a>TapTap helps the hearing impaired respond to their audio environment. It will flash and vibrate when there are nearby noises such as a knocking door, honking car or a home phone ringing.Related link:<a href="/health/hearing/2015/02/communicating-with-people-with-hearing-problems/" target="_blank">How you can help someone with hearing loss </a><a href="/health/hearing/2015/02/communicating-with-people-with-hearing-problems/" target="_blank">The different types of hearing loss explained</a><a href="/health/hearing/2015/01/different-types-of-hearing-loss/" target="_blank">5 reasons to cherish your sense of hearing </a>

Hearing

Adelaide Fringe festival caters to the vision-impaired

For the first time ever, vision-impaired and blind people had the chance to touch and feel the floats and costumes before the Adelaide Fringe Festival parade last night.  The parade, which kicked off the festival, consisted of 80 colourful floats and flocks of performers. It’s a spectacle that vision-impaired people had not been able to be part of but organisers hope that the “touch tour” would help the vision-impaired visualise the parade when they listened to it.“It's really important because otherwise you wouldn't see anything or know what's happening,” Gloria, a vision-impaired student, told the ABC.“It's better to have a feel because then you know what it's like instead of just hearing music,” added her friend Courtney.Both student said that the touch tour helped them have a better idea of the parade.“The majority of people who have a vision impairment lose their sight, so they've had sight before,” said Gaelle Mellis from Access2Arts who helped organise the touch tour.“They might have really enjoyed going to the theatre or the Fringe parade, for example, and they think that they can't do that anymore, that that's closed off.“What audio description does, because it's actually describing the visual elements it actually opens that experience up again.”Image credit: Adelaide Fringe Facebook Related links:<a href="/health/eye-care/2014/11/7-habits-that-can-prematurely-age-your-eyes/" target="_blank">7 habits that can prematurely age your eyes</a><a href="/health/eye-care/2015/01/signs-of-eye-floaters/" target="_blank">Why you need to be wary of eye floaters</a><a href="/health/eye-care/2014/11/what-your-family-history-says-about-your-eyesight/" target="_blank">What your family history says about your eyesight</a>

News

Alcohol consumption impairs night-vision

A swig or two (or more) of any alcoholic beverage can do strange things to our minds and body, but now a new study from the University of Granada in Spain has proven that drinking alcohol also impairs night-vision. The study published in the international Journal of Ophthalmology tested the retina-image quality and night-vision performance of 67 subjects after they had consumed alcohol. They were then all breath tested with an evidential breath-alcohol analyser used by traffic police in Spain.Researchers found that alcohol consumptions increased a person’s perception of halos – luminous circles – and other visual disturbances at night, while the image quality produced by the eye deteriorated. The ethanol from alcoholic beverages disturbs the tear-film that covers the surface of the eye which can make it difficult for drivers at night to see pedestrians crossing the road, read traffic signs or might even be “dazzled” by oncoming traffic headlights.Unsurprisingly, the scientists found that this deterioration of vision is significantly greater in subjects with a blood alcohol content higher than the legal limit for driving, which like in Australia is 0.05 per cent.Principal study author and lecturer at the university José Juan Castro said this research shows that people need to be aware of the different condition of night-time driving.“Alcohol consumption and low-illumination conditions are factors present in many traffic accidents, hence people must to be made aware of the effects of alcohol consumption, especially on vision,” he said.

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