Dear Doctor: Our grandfather won’t use his hearing aid because he doesn’t like how it makes things sound. However, I recently read that using a hearing aid reduces the risk of dementia. How can we get him to use one?

Dear Reader: Your grandfather isn’t alone in his reluctance to use a hearing aid. Many people with hearing loss wait as long as 10 years before finally agreeing to seek help. Meanwhile, poor hearing hinders their ability to communicate and interact with family, friends and the world at large. This leads to isolation and depression, and as a growing body of research shows, also increases the risk of cognitive decline.

A study published in the Journal of the American Geriatrics Society last fall found that when older adults with hearing loss used a hearing aid within three years of their diagnosis, they had measurably better outcomes in several important health categories than those who didn’t correct their hearing. Those who used a hearing aid had lower rates of dementia and depression, as well as fewer injuries due to falls.

The researchers examined eight years of insurance data for almost 115,000 women and men over age 66 who were diagnosed with hearing loss. They found that the risk of a dementia diagnosis, including Alzheimer’s disease, was 18% lower among the hearing aid users. The risk of becoming injured in a fall dropped 11%, and the risk of depression was also 11% lower. Their findings are consistent with previous research that established a clear connection between even mild uncorrected hearing loss and an increased risk of dementia and depression.

The next step in the research is to pinpoint how and why uncorrected hearing loss is tied to dementia and cognitive decline. One theory is that hearing loss leads to structural changes in the brain, which in turn affect memory. Another ties it to the profound social isolation that hearing loss can cause.

Meanwhile, your efforts to persuade your grandfather to use a hearing aid aren’t unusual. The insurance data used in the study revealed that, among those diagnosed with hearing loss, an average of only 12% went on to get hearing aids.

We think it’s encouraging that your grandfather already owns a device. He has shown himself to be open to improving his hearing and may just need a bit of help to get on the right track. Try talking to him about what, specifically, he doesn’t like about his current hearing aid. Then if you have the time, do some research about the current technology and offer to help find a replacement.

Shopping for a hearing aid can be confusing and, with hearing loss, daunting. There are several types, with different fits and placements. Be sure your grandfather is using a reputable audiologist who can help him to find the perfect device. It’s possible that with ongoing support, your grandfather may be willing to give hearing aids another try.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10880 Wilshire Blvd., Suite 1450, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)

Dear Doctor: What’s the difference between a cold and the flu, and how do you know which one you’ve got? Why can’t antibiotics help?

Dear Reader: Whether it’s a cold or the flu, the reason you are feeling awful is because you’ve been infected by a virus. More than 200 different types of viruses can cause a cold, and the most common is the rhinovirus, the culprit behind up to half of all colds. The flu, as its name suggests, is caused by the influenza virus. Of the four known types of influenza virus, labeled A, B, C and D, the seasonal epidemics we prepare for each winter are caused by influenzas A or B.

When the immune system senses that a cold or flu virus has entered the body, it goes to war. This includes using every weapon at its disposal to attack and destroy the intruders. Unfortunately, this causes the physical symptoms that make having a cold or the flu so miserable. These include sore throat, runny nose, chest congestion, coughing, sneezing, fever, headache, body aches and fatigue. Some people may also experience diarrhea or vomiting.

The symptoms of a cold and the flu are often similar, but the potential outcomes are different. A cold is a milder illness that rarely leads to serious health problems. The flu, by contrast, is more severe than a cold. It can also lead to serious complications, some of them life-threatening. These include viral or bacterial pneumonia, inflammation of the heart or the brain, and sepsis, a response to infection that is so extreme, it can lead to death. The flu can also worsen chronic medical conditions, such as asthma, diabetes and heart disease.

The only reliable way to differentiate between a cold and the flu is with a special test performed on cells and fluids swiped from the inside of the nose or the back of the throat. Two quick tests can be performed in the doctor’s office. These are the rapid influenza diagnostic test, or RIDT, which detects proteins associated with the influenza virus, and the rapid molecular assay, which identifies viral genetic material. Each test takes about 15 minutes, but neither is infallible. More accurate tests, which can return results in several hours, must be performed in specialized labs.

There is no cure for either the cold or the flu at this time. Antibiotics don’t work against them because they kill bacteria, and as we discussed, both the flu and a cold are caused by viruses. Your doctor may offer to treat you with a class of drugs known as antivirals, including Tamiflu, Relenza, Flumadine and Xofluza, a newer drug approved by the Food and Drug Administration in 2018. Antivirals won’t cure you, but when taken soon enough after infection -- about two days -- they may lessen the severity of symptoms and shorten the duration of illness by a few days.

As always, we recommend getting the flu vaccine every year. It’s not too late!

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10880 Wilshire Blvd., Suite 1450, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)

Dear Doctor: After knitting, I sometimes get tingles in my right hand, and my doctor thinks it might be the start of carpal tunnel syndrome. What can I do to prevent it?

Dear Reader: Carpal tunnel syndrome is a common and often painful condition that occurs when the median nerve, which plays a role in movement and feeling in part of the hand, becomes squeezed or compressed. This happens as the nerve passes from the forearm to the palm via a narrow passageway in the wrist, known as the carpal tunnel. Formed in part by small wrist bones known as carpals, it’s hard and rigid and measures roughly an inch across. In addition to the median nerve, the carpal tunnel guides the nine flexor tendons that bend the thumb and fingers.

Injury, anatomy and certain health problems can contribute to developing carpal tunnel syndrome. People with metabolic disorders such as diabetes, inflammatory conditions such as rheumatoid arthritis, and those who are obese are at greater risk. Heredity can also affect the size of the carpal tunnel, and there is evidence the syndrome runs in families. The condition is three times more common in women than in men, and also is more common in older adults. Repetitive hand and wrist motions, like those used in knitting, sewing, assembly line work, playing an instrument and typing, also play a role. Performed over time, these actions can irritate the tissues around the flexor tendons and cause them to swell. When this happens, the carpal tunnel becomes crowded, which puts pressure on the median nerve.

Symptoms include tingling; numbness; weakness; pain; and a burning sensation in the hand, particularly in the palm, thumb, and second and third fingers. Sometimes, the pain can extend along the arm. In more severe cases, it’s possible for carpal tunnel syndrome to weaken grip strength, and to affect the ability to distinguish between cold and heat.

When the onset of carpal tunnel syndrome arises due to the health problems mentioned earlier, those should be addressed first. If the condition begins to develop due to overuse of the hands and wrists, lifestyle changes can be helpful.

Pay attention to wrist position while knitting and during the day. Keep your wrists in a neutral position and avoid extreme bending. You may have to change how you perform certain tasks, including your knitting technique. Some people find it helpful to wear wrist splints, which promote optimal hand position and minimize pressure on the median nerve. Take frequent breaks during any activities that involve the hands and wrists. Never rest wrists on hard or sharp surfaces, like the edge of a desk or a table. When using a keyboard or mouse, adjust seat height so wrists don’t have to flex. Gentle stretching and gentle massage, the use of cold to reduce swelling, and over-the-counter pain relievers can help. Recent studies have shown acupuncture to be clinically effective in reducing physical symptoms and improving grip strength. If your symptoms continue or become worse, please see your doctor.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10880 Wilshire Blvd., Suite 1450, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)