2023 SENIOR LIVING IN ALASKA

Alaska Relay Speech-to-Speech

Speech-to-Speech (STS) service allows people with a speech disability to make and receive phone calls. The STS operators are specially trained to understand speech patterns to ensure you are understood. 711 or 866-355-6198

alaskarelay.com/sts

C all with Confidence and Ease

To use STS, dial 711 or 866-355-6198 and provide the telephone number of the person you want to call. Instruct the STS operator to:

l repeat your words upon request

l re-voice your side of the conversation

Alaska Relay STS offers the following options:

l Telecommunications Relay Service (TRS) Customer Profile

l Speech-to-Speech (STS) Call Setup

To learn more about the call processing options, visit alaskarelay.com/sts.

For more information or to request training, workshop, or presentations, contact:

– 907-563-2599

– akrelay@atlaak.org

– alaskarelay.com/outreach

alaskarelay.com

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15 Why are Women More Likely to Develop Alzheimer’s Disease?

18 Do

21 Add Resistance Training to Your Exercise Routine

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RetiRees getting back to woRk

LateLY, tHeRe’s been an uptick in tHe peRcentage of foLks wHo “unRetiRe.” in maY 2022, 3.4% of peopLe wHo said tHeY weRe RetiRed a YeaR eaRLieR Had RetuRned to woRk, accoRding to tHe indeed HiRing Lab, wHicH pRovides ReseaRcH on tHe LaboR maRket.

What’s behind the trend? A tight labor market is one factor. In the spring, there were nearly two available jobs for every unemployed person. Employers are dangling incentives such as higher starting wages and signing bonuses to draw qualified candidates. And although ageism can still be an issue, employers are looking at older, experienced workers more favorably than they did in the past, says Chris Farrell, author of “Purpose and a Paycheck: Finding Meaning, Money, and Happiness in the Second Half of Life.” Rather than wonder when older workers are going to retire, managers are more inclined to think about how to keep them on the job, he says.

High inflation and a rocky stock market may also be luring some retirees back to work or encouraging pre-retirees to work longer. When your dollars don’t stretch as far, adding income can help cover expenses more comfortably. “Filling up part of your income need with some part-time work can be a really good thing at this time, especially if you enjoy doing it,” says Jason Hamilton, a certified financial planner in Orange, Calif.

Earning a paycheck can also help retirees delay withdrawals from their retirement and investment accounts. That’s especially helpful if the stock market is down in your early retirement years. Pulling money from your portfolio while it’s losing value in a market swoon presents what’s known as sequence-of-returns risk. If your account balance shrinks significantly, you have fewer assets to create returns during market recoveries, posing the threat that you’ll run out of money in a retirement that could last decades.

“Going back to work or continuing to work is one of the most effective ways of mitigating longevity risk,” says Jeffrey Levine, a CFP in St. Louis. As restrictions related to the COVID-19 pandemic lift and vaccines protect against severe illness, those who dropped out of the workforce to avoid contracting the virus may feel more at ease returning to the office or picking up a retail job. But if you’d rather avoid in-person contact, the rising prevalence of remote work provides greater opportunity to stay home and collect a paycheck.

Lisa Gerstner is a contributing editor at Kiplinger’s Personal Finance magazine. For more on this and similar money topics, visit Kiplinger.com.

Lisa gerstner, kiplinger’s personal finance, kiplinger’s money power

How tax Rules cHange as you age

YouR Life cHanges in manY waYs wHen You get oLdeR. but tHeRe’s sometHing eLse tHat cHanges as You age tHat You migHt not Have consideRed befoRe — YouR taxes.

There are different tax breaks that you can claim when you’re older, and the types of income you’re likely to receive are taxed differently than wages.

HeRe’s a quick Rundown.

YouR 50s: When you hit 50, you can squirrel away even more money as “catch-up” contributions to taxadvantaged retirement accounts. For 2023, you can put an extra $1,000 in your IRAs and an extra $7,500 in a 401(k) plan.

Catch-up contributions are also allowed for health savings accounts. Once you turn 55, you can put an additional $1,000 in an HSA each year.

YouR 60s: Most people retire in their 60s, and that’s when tax changes really kick in.

Part of the change is triggered by the different types of income you receive in retirement. For instance, instead of wages, which are 100% taxable, at least 15% of your Social Security benefits are tax-free—and lower-income seniors won’t pay any federal tax on their benefits. Withdrawals from a Roth IRA or Roth 401(k) plan are tax-free as well since you already paid taxes on the funds (distributions from a traditional IRA or 401(k) are taxable). The portion of an annuity payment that represents your principal is tax-free, too. There are also tax breaks that only become available after your 65th birthday. For example, there’s an additional standard deduction for people 65 and older. For 2023, it’s $1,500, or $1,850 if you’re claiming the single or head of household filing status.

Rocky Mengle, Kiplinger’s Personal Finance, Kiplinger’s Money Power

There’s also a tax credit available for lower-income taxpayers who are 65 or older. It’s worth up to $750 if you’re single or $1,125 if married.

Also look for other generally available write-offs that might not come into play until you reach your 60s. For example, if medical bills start growing as you age, you may be able to deduct some of those expenses. You must itemize to claim the medical expense deduction, and then you can only deduct qualifying costs that exceed 7.5% of your adjusted gross income.

And don’t forget about state tax breaks. Many states provide full or partial tax exemptions for Social Security benefits or other common types of retirement income. Often overlooked property tax breaks can also provide huge savings for seniors.

YouR 70s: The biggest tax change for people in their 70s is the start of required minimum distributions (RMDs) from retirement accounts. Your money has been growing in your traditional IRAs and 401(k) accounts for years, and now the IRS wants you to

begin paying taxes on it once you turn 72. (There are no RMDs for Roth IRAs.)

For the year you turn 72, the deadline for taking your first RMD is April 1 of the following year. After that, annual RMDs generally must be taken by Dec. 31.

If you’re at least 70 1/2 years old, donating to charity with a qualified charitable distribution from an IRA can also cut your tax bill because the withdrawn funds aren’t taxed. Plus, money donated through a qualified distribution counts toward your RMD.

Rocky Mengle is tax editor at Kiplinger.com. For more on this and similar money topics, visit Kiplinger.com.

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RetiRement: PRePaRe foR longevity

sandra block, kiplinger’s personal finance, kiplinger’s money power

Follow a local newspaper long enough and you’ll probably come upon a story about a 100-year-old resident who still bowls, goes square dancing twice a week and occasionally enjoys a shot of tequila. About 97,000 Americans are centenarians — 100 or older — and a handful of those are supercentenarians — individuals who have celebrated their 110th birthday.

Maybe you’re convinced that you won’t live that long after seeing reports that average U.S. life expectancy has declined to about 76, the lowest since 1996. But those numbers were skewed by the COVID-19 epidemic and don’t reflect the likelihood that you’ll live much longer than that, says Barbara Selig, senior wealth management adviser at TIAA.

For a 65-year-old couple, there’s a 50% chance that one spouse will live to age 93 and a 25% chance that one will live to 97, according to the Society of Actuaries. And while living into your 90s beats the alternative, it increases the risk that you’ll outlive your savings. “Longevity is the biggest financial risk for retirees,” Selig says.

to invest a significant percentage of your retirement savings in after-tax accounts. While more than 75% of large employers offer Roth 401(k) plans, only about 14% of employees invest in them, according to Fidelity Investments, one of the largest plan providers. You’ll lose the tax deduction in the year you make a contribution, but withdrawals will be tax-free as long as you’re 59 1/2 and have owned the Roth for at least five years.

Although you can’t contribute to a Roth IRA if your income exceeds annual thresholds — $153,000 for singles and $228,000 for married couples in 2023 — there are no income limits on contributions to a Roth 401(k) plan.

Sandra Block is a senior editor at Kiplinger’s Personal Finance magazine. For more on this and similar money topics, visit Kiplinger.com.

It should go without saying that saving early and often is the most important component of longevity planning. In 2023, you can contribute up to $22,500 to your 401(k), 403(b) or 457 plan, plus $7,500 in catch-up contributions if you’re 50 or older, for a total of $30,000. The maximum contribution to a traditional or Roth IRA in 2023 is 6,500. Savers age 50 and older can contribute an extra $1,000 to an IRA, for a total of $7,500.

But where you save is almost as important as the amount you sock away. If you invest all of your savings in tax-deferred 401(k)s and traditional IRAs, you could find yourself with a massive “tax bomb” in retirement that could dramatically reduce the amount you will have for your own expenses, says David McClellan, a partner with Forum Financial Management in Austin, Texas.

That’s because every dollar you save in a tax-deferred account will be taxed at your ordinary income tax rate when you take the money out. And even if you don’t need the money, you’ll eventually need to take required minimum distributions — the start date which is gradually rising to age 75 in 2033 — that can set off the tax bomb, McClellan says.

The most effective way to reduce your tax bill in retirement is

With that in mind, you should start planning for longevity well before you retire — in your 50s or, ideally, even before that.

ThE MEdiCiNE CabiNET

wiTh dr. hOward LEwiNE

HeLp foR menopausaL women’s HaiR Loss

q:

since menopause my hair keeps getting thinner. why do older women lose their hair? what treatments are available?

a: Among postmenopausal women, as many as twothirds develop hair thinning or bald spots.

The main type of hair loss in women is the same as it is men. It’s called androgenetic alopecia, or female (or male) pattern hair loss. In women, androgenetic alopecia begins with gradual thinning at the part line, followed by increasing diffuse hair loss radiating from the top of the head. A woman’s hairline rarely recedes, and women rarely become bald.

There are many potential causes of hair loss in women, including medical conditions, medications, and physical or emotional stress. If you notice unusual hair loss of any kind, it’s important to see your primary care provider or a dermatologist, to determine the cause and appropriate treatment.

Almost every woman eventually develops some degree of female pattern hair loss. It can start any time after the onset of puberty, but women tend to first notice it around menopause, when hair loss typically increases. The risk rises with age, and it’s higher for women with a history of hair loss on either side of the family.

Medications that can help with hair loss in women include:

• Topical minoxidil: The FDA originally approved over-the-counter 2% minoxidil to treat hair loss in women. Since then a 5% solution has also become available when a stronger solution is needed for a woman’s hair loss.

While it can produce some new growth of fine hair in some — not all — women, it can’t restore the full density of the lost hair. It’s not a quick fix, either for hair loss in women . You won’t see results until you use the drug for at least two months. The effect often peaks at around four months, but it could take longer, so plan on a trial of six to 12 months. If minoxidil works for you, you’ll need to keep using it to maintain those results. If you stop, you’ll start to lose hair again.

• Anti-androgens: Androgens include testosterone and other “male” hormones, which can accelerate hair loss in women. Some women who don’t respond to minoxidil may benefit from the addition of the anti-androgen drug spironolactone (Aldactone) for treatment of androgenic alopecia. This is especially true for women with polycystic ovary syndrome (PCOS) because they tend to make excess androgens.

• Iron supplements: Iron deficiency could be a cause of hair loss in some women. Your doctor may test your blood iron level. If you do have iron deficiency, you will need to take a supplement and it may stop your hair loss. However, if your iron level is normal, taking extra iron will only cause side effects, such as stomach upset and constipation.

pRostate canceR scReening afteR age 70

q: i just celebrated my 70th birthday and am due for my yearly doctor visit. How does a man decide whether to continue psa testing for prostate cancer?

a: While some guidelines suggest stopping prostate cancer screening after age 70, the decision to continue depends on your general health and life expectancy. The reason: Most prostate cancers are lowgrade and will not shorten a man’s life or diminish his quality of life. On the other hand, diagnosing higher-grade cancer at an earlier stage could lead to treatment to keep the cancer from spreading.

In the past, a man with a high or rising PSA level would have to choose between having an immediate prostate biopsy (to locate any cancer and assess its severity) or living with some uncertainty. Today, other tests can help predict the presence of cancer, especially cancer that is

more likely to spread. Examples include MRI (magnetic resonance imaging), specific subtypes of PSA blood tests, and urine testing for specific genetic markers. For men who do opt for prostate cancer screening but may not want immediate treatment even if cancer is likely, the two main strategies are watchful waiting or active surveillance.

Watchful waiting: Watchful waiting either before or after a biopsy means you don’t get regular PSA tests or other monitoring. Only if symptoms occur would you have further diagnostic testing to determine whether and how to treat the symptoms.

Active surveillance: An active surveillance strategy requires a prostate biopsy first to identify the cancer’s size and probability of spreading. High-grade and many intermediate-grade prostate cancers don’t qualify for active surveillance because treatment usually begins right away. However, this strategy is an option for men who would be comfortable with close monitoring for low-grade cancer. Active surveillance involves more frequent PSA testing (to look for any rise in the level over time) and likely periodic prostate biopsies. Your doctor might order an MRI or a urine test for genetic markers to determine when a repeat biopsy is needed. If and when evidence arises that the cancer has become more active, then treatment would begin.

Studies comparing men with low-grade prostate cancer who choose active surveillance rather than immediate surgery or radiation show similar outcomes and life expectancy. By choosing active surveillance, a man can delay or even avoid treatment side effects, such as erectile dysfunction and incontinence. The downside is the small risk of delaying treatment of a cancer that grows faster than expected.

expected memoRY Lapses oR eaRLY dementia?

q: when should a person start worrying about becoming more forgetful? How can you tell if it’s normal memory loss, or something more serious?

a: For many of us, memory blips become more common as we get older. Our brains are forming fewer connections now, so our memory is not as strong as it used to be. It may take us longer to remember basic information, such as names, dates or where we left our car keys. As we get older, the processing speed of our brain slows down, so we can’t recall information as quickly as we used to.

Memory lapses are unsettling, but they don’t necessarily herald impending dementia. The key is in how often these slips occur. You really need to figure out the pattern. Is it happening several times a week or is it happening once or

twice a month? Is it a change compared to five or 10 years ago? Is it getting gradually worse?

Forgetfulness can be a normal part of growing older. Memory lapses can also stem from several other conditions, including lack of sleep, stress, medications, alcohol or depression.

Any of these conditions can be treated. For example, you can adjust your sleep schedule, try deep breathing or other techniques to reduce stress, change the dose or type of medications you take, cut down on your drinking or get treated for depression.

Don’t be alarmed by everyday forgetfulness. The time to call your doctor is when you have more persistent or worsening memory loss that’s interfering with your daily activities and routine and starting to affect your daily functioning.

There are three things you can start doing right now to preserve mental function as you age:

1. Exercise: Exercise promotes the release of a powerful molecule called brain-derived neurotrophic factor, which repairs brain cells, strengthens their connections, promotes new brain cell growth, and enlarges the size of your hippocampus (a part of the brain involved in the storage and retrieval of memories). Exercise also increases blood flow to your brain and may protect the brain’s system for flushing out toxins.

2. Eat a healthy diet: To protect yourself, generally avoid processed and sugary foods and animal fats (other than from fish): they’re associated with poor cardiovascular health. Opt instead for a Mediterranean-style diet, which is tied to lower risks for cardiovascular disease and cognitive decline. The

diet is rich in fruits, vegetables, beans, whole grains, nuts, seeds, olive oil, and fish, as well as moderate amounts of poultry and dairy.

3. Get more sleep: We should aim for seven to eight hours of sleep each night to help the body rest and the brain conduct important duties. During sleep, the brain’s glymphatic system flushes out waste produced by the brain, including Alzheimer’s disease–related toxins (such as the protein amyloid-beta).

Howard LeWine, M.D., is an internist at Brigham and Women’s Hospital in Boston and assistant professor at Harvard Medical School. For additional consumer health information, please visit www.health.harvard.edu.

TinniTus:

Ringing oR Humming in youR eaRs? sound tHeRaPy is one oPtion

matthew solan, Harvard Health blog, premium Health news service

That recurring sound that you hear but nobody else does? It’s not all in your head. Well, not exactly.

You may be one of the estimated 50 million-plus people who suffer from tinnitus. The mysterious condition causes a sound in the head with no external source. For many it’s a high-pitched ringing, while for others it’s whistling, whooshing, buzzing, chirping, hissing, humming, roaring or even shrieking.

The sound may seem to come from one ear or both, from inside the head, or from a distance. It may be constant or intermittent, steady or pulsating. One approach to managing this condition is different forms of sound therapy intended to help people tune out the internal soundtrack of tinnitus.

What causes tinnitus?

There are many possible causes of tinnitus. Long-term exposure to loud noises is often blamed. But other sources include middle ear problems like an infection, a tumor or cyst pinching nerves in the ear, or something as simple as earwax buildup. Tinnitus also can be a symptom of Meniere’s disease, a disorder of the balance mechanism in the inner ear.

Even old-fashioned aging can lead to tinnitus, which is common in people older than age 55. As people get older,

the auditory nerve connecting the ear to the brain starts to fray, diminishing normal sounds.

“Neurons (nerve cells) in areas of the brain that process sound make up for this loss of input by increasing their sensitivity,” says Daniel Polley, director of the Lauer Tinnitus Research Center at Harvard-affiliated Massachusetts Eye and Ear. “The sensitivity knobs are turned up so high that neurons begin to respond to the activity of other nearby neurons. This creates the perception of a sound that does not exist in the physical environment. It’s a classic example of a feedback loop, similar to the squeal of a microphone when it is too close to a speaker.”

At times, everyone experiences the perception of a phantom sound. If it only lasts for a few seconds or minutes, it’s nothing to worry about. However, if it pulsates in sync with your heart rate, it’s definitely something to get checked out by a physician, says Polley. If it’s a relatively continuous sound, you should see an audiologist or otolaryngologist (ears, nose, throat specialist).

can sound therapy help tune out tinnitus?

There is no cure for tinnitus, but it can become less noticeable over time. Still, there are ways to ease symptoms and help tune out the noise and minimize its impact. Treatments are a trial-and-error approach, as they work for some people but not others.

One often-suggested strategy is sound therapy. It uses external noise to alter your perception of or reaction to tinnitus. Research suggests sound therapy can effectively suppress tinnitus in some people. Two common types of sound therapy are masking and habituation.

• Masking: This exposes a person to background noise, like white noise, nature sounds, or ambient sounds, to mask tinnitus noise or distract attention away from it. Listening to sound machines or music through headphones or other devices can offer temporary breaks from the perception of tinnitus. Household items like electric fans, radios and TVs also can help. Many people with tinnitus also have some degree of hearing loss. Hearing aids can be used to mask tinnitus by turning up the volume on outside noises. This works especially well when hearing loss and tinnitus occur within the same frequency range, according to the American Tinnitus Association.

• Habituation: Also known as tinnitus retraining therapy, this process trains your brain to become more accustomed to tinnitus. Here, you listen to noise similar to your tinnitus sound for long periods. Eventually your brain ignores the tone, along with the tinnitus sound. It’s similar to how you eventually don’t think about how glasses feel on your nose. The therapy is done with guidance from a specialist and the time frame varies per person, usually anywhere from 12 to 24 months.

additional approaches may help With tinnitus

Depending on your diagnosis, your doctor also may recommend addressing issues that could contribute to your tinnitus.

• Musculoskeletal factors: Jaw clenching, tooth grinding, prior injury or muscle tension in the neck can sometimes make tinnitus more noticeable. If tight muscles are part of the problem, massage therapy may help relieve it.

• Underlying health conditions: You may be able to reduce the impact of tinnitus by treating conditions like depression, anxiety and insomnia.

• Negative thinking: Adopting cognitive behavioral therapy and hypnosis to redirect negative thoughts and emotions linked to tinnitus may also help ease symptoms.

• Medication: Tinnitus can be a side effect of many medications, especially when taken at higher doses, like aspirin and other nonsteroidal anti-inflammatory drugs and certain antidepressants. The problem often goes away when the drug is reduced or discontinued.

Matthew Solan is executive editor at Harvard Men’s Health Watch.

why arE wOMEN

LikELy TO dEvELOp aLzhEiMEr’S diSEaSE?

Andrew E. Budson, M.D., Harvard Health Blog, Premium Health News Service

Did you know that of the 6.2 million people with Alzheimer’s disease who are age 65 or older in this country, almost two-thirds are women? This means that Alzheimer’s disease is almost twice as common in women compared to men. Why is Alzheimer’s disease more common in women?

women Live LongeR

The first and most important reason is that women tend to live longer than men. If you look at actuarial life tables, you can see that a baby girl born in 2019 is likely to live five years longer than a baby boy: 81 versus 76 years.

The greatest risk factor for Alzheimer’s disease is age: the older you are, the more likely you are to develop Alzheimer’s disease. For example, out of 1,000 people, the incidence (the number who develop Alzheimer’s each year) depends on age:

4 out of 1,000 people ages 65 to 74 develop Alzheimer’s each year

32 out of 1,000 people ages 75 to 84 develop Alzheimer’s each year

76 out of 1,000 people ages 85 and older develop Alzheimer’s each year.

So, one reason that there are more women with Alzheimer’s disease than men is simply that there are more older women than older men living in our society — 5.7 million more of them — and the older you are, the more likely you are to develop Alzheimer’s disease.

But that’s not the whole answer.

tHe incidence of aLzHeimeR’s is gReateR in women

Your chances of developing Alzheimer’s disease late in life are somewhat greater if you are a woman than a man. One study followed 16,926 people in Sweden and found that, beginning around age 80, women were more likely to be diagnosed with Alzheimer’s disease than men of the same age. Similarly, a study based in Taiwan found that one’s chances of developing Alzheimer’s disease over seven years was greater in women compared to men. And a meta-analysis examining the incidence of Alzheimer’s disease in Europe found that approximately 13 women out of 1,000 developed Alzheimer’s each year, compared to only seven men.

So, women living longer than men cannot be the whole answer as to why women are more likely than men to develop Alzheimer’s disease, because even among individuals who are living and the same age, women are more likely to be diagnosed with Alzheimer’s than men. The incidence of non-Alzheimer’s dementia is not greater in women.

One clue to the answer to this puzzle is that your chances of developing dementia from a cause other than Alzheimer’s disease is not greater if you are a woman. For example, the study examining dementia rates in Sweden found that both women and men were equally likely to develop a non-Alzheimer’s dementia as they aged. That rates of Alzheimer’s disease differ by gender, whereas rates of non-Alzheimer’s dementias do not, suggests that there must be a specific interaction between Alzheimer’s disease and gender.

amYLoid deposition in aLzHeimeR’s maY be figHting infections

Another clue to this puzzle comes from the work of Harvard researchers, who have suggested that amyloid, one component of Alzheimer’s disease pathology, may be deposited in order to fight off infections in the brain. If their suggestion turns out to be correct, we might think of Alzheimer’s disease as a byproduct of our brain’s immune system.

autoimmune disoRdeRs aRe moRe common in women

The last piece of the puzzle is that women are about twice as likely to have an autoimmune disease compared to men. The reason for this difference is not entirely clear, but it is clear that the immune system is generally stronger in women than men, and many autoimmune diseases are more common during pregnancy. It may be that women’s stronger immune system developed through evolution to protect the fetus from infections. So, as part of their stronger immune systems, women may end up having more amyloid plaques than men.

putting tHe pieces togetHeR

By combining all of this information, one possible explanation as to why women’s risk of Alzheimer’s disease is greater than men’s — in addition to women living longer — is:

• The amyloid plaques that cause Alzheimer’s disease may be part of the brain’s immune system to fight against infections.

• Women have stronger immune systems than men.

• As part of their stronger immune systems, women may end up having more amyloid plaques than men.

• Because they may have more amyloid plaques than men, this theory may explain why women end up having a greater risk of developing Alzheimer’s disease.

Please note the italicized words “may” that I have used. Although the ideas I have presented here are logical, coherent, and form the basis of a good theory, they have not yet been proven to be correct. More research is needed!

tHe bottom Line

You are more likely to develop Alzheimer’s disease over your lifetime if you are a woman, because women live longer than men and, possibly, because women have stronger immune systems compared to men.

Does that mean that if you’re a woman, you’re more likely to develop Alzheimer’s disease and there’s nothing you can do about it? Not at all! You can do many things to reduce your risk of Alzheimer’s today.

• Engage in aerobic exercise such as brisk walking, jogging, biking, swimming or aerobic classes at least 30 minutes per day, five days per week.

• Eat a Mediterranean menu of foods including fish, olive oil, avocados, fruits, vegetables, nuts, beans, whole grains and poultry. Eat other foods sparingly.

• Sleep well — and clean those Alzheimer’s plaques out of your brain.

• Participate in social activities and novel, cognitively stimulating activities.

Andrew E. Budson, M.D., is a contributor to Harvard Health Publications.

Do you pass the hearing test?

Many older men have some degree of age-related hearing loss, but don’t know it.

Approximately one in three people ages 65 to 74 has hearing loss. Nearly half of those older than 75 have difficulty hearing.

While many people can function with some degree of hearing loss, especially if they have a spouse or family member who can repeat any information they may miss, ignoring hearing decline can profoundly affect one’s health.

Growing evidence shows that age-related hearing loss is associated with a higher risk of cognitive decline. Research suggests that hearing loss impairs new nerve cell creation in the hippocampus, the brain’s memory region. Hearing loss also is linked with increased risks for depression, social isolation and being less active.

“It is often challenging to differentiate the cause of one’s hearing loss and its severity without an evaluation,” says Dr. James Naples, assistant professor of otolaryngologyhead and neck surgery at Harvard-affiliated Beth Israel Deaconess Medical Center. “This is why older men need to get their hearing checked by a certified audiologist before any potential hearing loss worsens.”

HeaRing about pRobLems

There is no single cause of age-related hearing loss, also known as presbycusis. The most common reason is changes in the inner ear, which can alter nerve pathways from the ear to the brain.

Over time, the cells in the inner ear grow old, die and are not replaced. When these cells - called hair cells - die, the electrical messages of sound waves don’t travel to the

Matthew Solan, Harvard Men’s Health Watch

brain as well as they should. This causes many people to eventually experience some degree of presbycusis, although the severity varies. Another contributor to hearing loss is long-term noise exposure, like from power tools, loud music, gunfire or careers in loud environments, such as construction and manufacturing.

getting tested

Hearing tests measure how loud a sound needs to be before you clearly hear it. People with normal hearing can identify sounds of less than 25 decibels (dB). Mild hearing loss means you require sounds to be in the 26 to 40 dB range, and moderate hearing loss, your minimum hearing in the 41 to 55 dB range. Ranges higher than this are considered moderately severe to severe and profound.

According to the CDC, a person with mild hearing loss may hear most speech sounds, but soft sounds don’t get through. Someone with moderate hearing loss may hear almost no speech at normal levels.

Age-related hearing loss and noise-induced hearing loss tend to affect both ears equally. If hearing loss occurs in one ear but not the other, or is accompanied by ear pain, vertigo or ringing in the ear, it could signal any of a variety of conditions that require further medical evaluation.

You may be fitted for a hearing aid based on your hearing test results. An audiologist configures hearing aids to a person’s specific hearing loss, similar to the way prescription glasses are fitted. Despite their name, hearing aids don’t directly improve hearing, but instead work as amplifiers. Still, hearing aids can be literal life-changers. Research has shown that people with age-related hearing loss who wear hearing aids improve their working memory, concentration, processing speed and attention.

Other studies have found that wearing hearing aids can lower the risk of being diagnosed with dementia and protect against fall-related injuries. “On a personal level, hearing aids can also improve your relationships with your partner, friends, and family,” says Dr. Naples.

Less expensive options

The main downside to hearing aids has always been cost. The average price of one hearing aid is about $2,000 (although this can vary), and most people need one for each ear. Hearing aids are not usually covered by Medicare, although some Medicare Advantage plans and other commercial health insurance plans do cover them.

Why are hearing aids traditionally so expensive? Only a handful of companies produce most of the country’s hearing aids, which are sold through audiology practices. This lack of competition drives up prices and keeps them high. However, in October 2022 the FDA approved the over-thecounter sale of hearing aids suitable for mild to moderate hearing loss. This new category means more competition among manufacturers that, in turn, should lower average

prices. Some estimates suggest that a pair of over-thecounter hearing aids could drop to less than $1,000 (although the exact savings is unknown).

It’s still being determined which styles will be available over the counter, according to Dr. Naples. He speculates they will range from traditional behind-the-ear devices to ones that fit into the ear canal.

Be mindful that there are some limitations to the over-thecounter devices. For instance, they are only for mild to moderate hearing loss; people with severe hearing loss would likely need a prescription hearing aid. Also, whereas a prescription hearing aid can be individually fine-tuned and fitted, over-the-counter aids come in generic sizes that can’t be altered. It also still needs to be clarified how repairs, warranties and replacements will work.

Also, don’t confuse over-the-counter hearing aids with personal sound amplification products (PSAPs) sold at most drugstores. “PSAPs are not specifically intended for people with hearing loss,” says Dr. Naples. They are a great alternative for people who only experience some hearing difficulties in specific situations, like listening to the TV.”

add rESiSTaNCE TraiNiNg TO yOur ExErCiSE rOuTiNE

q:For a person in his 70s who never did resistance training, what’s a good way to get started?

a:Old-fashioned resistance training — lifting heavy weights multiple times — is the best way for men to slow and even reverse age-related muscle loss, known as sarcopenia. It can also increase your strength, protect against falls and help you live a more independent life.

Resistance training (also known as strength training) consists of doing upper- and lower-body exercises using free weights (like dumbbells, kettlebells or barbells), weight machines, resistance bands or just your own body weight.

The constant challenge with resistance training is finding the Goldilocks zone between doing too little and too much. You want to stress your muscles enough to see and feel a difference, but not overdo it, where you risk injury.

Ideally, see a certified trainer before you embark on a resistance training program. It’s worth the time and investment, as he or she can create a routine unique to your needs, and more importantly, teach you proper form and speed.

However, if you want to get started on your own, here are some resistance exercise basics:

tYpe: Do one to two multi-joint exercises per major muscle group. There are six main muscle groups: chest, back, arms, shoulders, legs and calves. So this means six to 12 exercises per workout.

weigHt: Use enough weight or resistance so you can perform 10 reps with good form. The last two should be tough to complete. Alternatively, start with 70% of your maximum one rep. Maximum one rep is the amount of weight you can safely lift just once.

Reps: Do anywhere from six to 12 reps per exercise. I suggest beginning with 10 to 12 reps. Then as you progress, you should aim for six to eight reps with increased weight or resistance.

sets: Start with two sets per exercise. Always rest in between each set for 30 to 60 seconds to help you recover.

fRequencY: More is not always better when it comes to resistance training. Two or three workouts per week can produce the desired muscle tone and strength.

Keep in mind that it can take time to see increased muscle mass and feel stronger. Consistency is essential, but if you don’t notice changes after about eight weeks, you are not training hard enough and need to mix up your routine by increasing your weight or sets or the number of exercises.

Howard LeWine, M.D., is an internist at Brigham and Women’s Hospital in Boston and assistant professor at Harvard Medical School. For additional consumer health information, please visit www.health.harvard.edu.

Howard Lewine, m.d., Harvard Health publishing, the medicine cabinet

eatingWell: this sWeet tReat is peRfect foR kiDs anD aDults alike

carolyn casner, eatingWell, entrée

Lightly sweetened Greek yogurt gets studded with fresh strawberries and chocolate chips then frozen so you can break it into chunks just like chocolate bark (but healthier!). Use full-fat yogurt to ensure the creamiest bark possible.

Strawberry & Chocolate Frozen Yogurt Bark

Makes 32 pieces

active time: 10 minutes

totaL time: 3 hours, 10 minutes

3 cups whole-milk plain Greek yogurt

1/4 cup pure maple syrup or honey

1 teaspoon vanilla extract

1 1/2 cups sliced strawberries

1/4 cup mini chocolate chips

1. Line a rimmed baking sheet with parchment paper.

2. Stir yogurt, maple syrup (or honey) and vanilla in a medium bowl. Spread on the prepared baking sheet into a 10-by-15-inch rectangle. Scatter the strawberries on top and sprinkle with chocolate chips.

3. Freeze until very firm, at least 3 hours. To serve, cut or break into 32 pieces.

to make aHead: Freeze airtight between sheets of parchment for up to one month; let stand at room temperature for 15 minutes before serving.

Recipe nutRition peR seRving: 39

Calories, Total Fat: 2 g, Saturated Fat: 1 g, Cholesterol: 3 mg, Carbohydrates: 4 g, Fiber: 0 g, Total Sugars: 4 g, Added Sugars: 2 g, Protein: 2 g, Sodium: 9 mg, Potassium: 56 mg,

Phosphorus: 36 mg, Iron: 0 mg, Folate: 3 mcg, Calcium: 28 mg, Vitamin A: 5 IU, Vitamin C: 28 mg, Vitamin D: 0 IU.

EatingWell is a magazine and website devoted to healthy eating as a way of life. Online at www.eatingwell.com.

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