Impendulo emfushane
I-Lancet Commission yango-2024 ibala ukulahlekelwa ukuzwa njengesinye sezinto ezinkulu kunazo zonke ezibeka engozini ye-dementia ezingashintshwa. Esivivinyweni se-ACHIEVE, izinsiza zokuzwa azizange zenze ukwehla kwamakhono okucabanga kube kancane ngokwesilinganiso, nakuba iqembu elisengozini enkulu laba nokwehla okuncane. Izinsiza zokuzwa zisiza ingxoxo nempilo yansuku zonke noma kunjalo. Hlolisani ukuzwa, nicabange ngezinsiza ezinesiqondiso sodokotela noma ezithengwa esitolo, futhi nikhulume nodokotela.
- I-Lancet Commission ilinganisa ukuthi ukulahlekelwa ukuzwa kuyingxenye engaba yi-7% ye-dementia emhlabeni wonke, isabelo esikhulu kunazo zonke (ngokulingana) phakathi kwezinto ezingu-14.
- Esivivinyweni se-ACHIEVE sabantu asebekhulile abangu-977, izinsiza zokuzwa azishintshanga ukwehla kwamakhono okucabanga kweminyaka emithathu ngokwesilinganiso.
- Eqenjini elincane, elisengozini enkulu ngaphakathi kwe-ACHIEVE, ukwehla kwamakhono okucabanga kwaba kancane ngo-48% ngezinsiza zokuzwa; lokhu kudinga ukuqinisekiswa.
- Kusukela ngo-Okthoba 2022, abantu abadala base-US abazibona benokulahlekelwa ukuzwa okuncane kuya kokumaphakathi bangathenga izinsiza zokuzwa ezilawulwa yi-FDA esitolo ngaphandle kwesiqondiso.
- Ukulahlekelwa ukubona okungelashiwe kwengezwa njengento ebeka engozini ye-dementia ngo-2024, ngakho nokuhlolwa kwamehlo kubalulekile.
Kuleli khasi (izingxenye ezingu-7)
Ukulahlekelwa ukuzwa kuvamile ekuhlaleni kwemva, futhi abacwaningi bakubheka njengento ebalulekile ebeka engozini ye-dementia. Lokho akwenzi izinsiza zokuzwa zibe indlela efakazelwe yokuvimbela i-dementia; isivivinyo esingcono kakhulu kuze kube manje sinemiphumela exubile. Leli khasi lichaza ukuthi ucwaningo lubonisani, indlela yokuhlolisa ukuzwa, ukuthi yini izinsiza zokuzwa ezithengwa esitolo e-US, nokuthi ningayenza kanjani ingxoxo ibe lula.
Kungani ukuzwa kubalulekile empilweni yobuchopho?
Ukulahlekelwa ukuzwa kuhlobene nobungozi obuphezulu be-dementia. I-Lancet Commission yango-2024 ilinganisa ukuthi iyingxenye engaba ngu-7% ye-dementia emhlabeni wonke. Lokho kuyenza ilingane ne-LDL cholesterol ephezulu ekubeni nesabelo esikhulu kunazo zonke phakathi kwezinto ezingu-14 ezibeka engozini ezingashintshwa kumodeli ye-Commission, ngokwe-ngqikithi ye-UCL yalo mbiko.
Okutholwe i-Commission:
- Ubungozi obuphezulu uma kunokulahlekelwa ukuzwa. Ekuhlaziyweni kwayo okuhlanganisiwe kocwaningo oluyisithupha olusezingeni eliphezulu, abantu abalahlekelwe ukuzwa babenobungozi obungaba ngu-37% obuphezulu be-dementia kunabantu abanokuzwa okujwayelekile.
- Ukulahlekelwa okukhulu, ubungozi obukhulu. Ucwaningo olubheke ubukhulu bokulahlekelwa lwathola ukuthi ubungozi bukhuphuka njengoba ukuzwa kubi kakhulu.
- Izizathu ezingaba khona, kungakabi kufakazelwe. Imibono ihlanganisa ukuzizwa uyedwa nokuhoxa, ukudabuka, ukuvuselelwa kancane kobuchopho, nomzamo owengeziwe wengqondo odingwa ukulalela.
Ukulahlekelwa ukuzwa kuvamile. I-National Institute on Aging (NIA) ithi cishe ingxenye eyodwa kwezintathu yabantu asebekhulile inakho, futhi amathuba akhuphuka ngeminyaka.
Isivivinyo sezinsiza zokuzwa se-ACHIEVE sathola ini?
I-ACHIEVE kwaba yisivivinyo sokuqala esikhethwe ngenhlanhla (randomized) sezinsiza zokuzwa nokwehla kwamakhono okucabanga. Imiphumela yaso ivame ukubikwa kabi, ngakho nansi imininingwane evela embikweni wesivivinyo osushicilelwe.
- Ababambe iqhaza: abantu abadala abangu-977 abaneminyaka engu-70 kuya ku-84 abanokulahlekelwa ukuzwa okungelashiwe futhi abangenazo izinkinga ezinkulu zokucabanga, ezindaweni ezine zomphakathi e-US.
- Okwaqhathaniswa: Ingxenye eyodwa yathola izinsiza zokuzwa kanye nezikhathi zokululekwa ne-audiologist. Enye ingxenye yathola uhlelo lwemfundo yezempilo ngokuguga okunempilo.
- Umphumela oyinhloko: Ngemva kweminyaka emithathu, kwakungekho mehluko ekwehleni kwamakhono okucabanga phakathi kwamaqembu womabili ngokwesilinganiso.
- Umphumela weqembu elincane: Ababambe iqhaza bavela ezindaweni ezimbili. Abantu abangu-238 bavela ocwaningweni lwempilo yenhliziyo lwesikhathi eside (ARIC), futhi njengeqembu babesengozini enkulu yokwehla kwamakhono okucabanga. Kuleli qembu, ukwehla kwaba ngu-48% ngokuhamba kancane ngezinsiza zokuzwa. Phakathi kwabazinikele bomphakathi abangu-739 abaphilile, kwakungekho mphumela ocacile.
Indlela yokufunda lokhu ngokwethembeka:
- Impendulo ngokwesilinganiso kwaba ukuthi akukho mphumela.
- Okutholwe eqenjini elincane bekuhlelwe kusengaphambili, kodwa kwavela ekuhlaziyweni kwesibili kweqembu elincane. Kudinga ukuqinisekiswa kwezinye izifundo.
- Ababambe iqhaza babazi ukuthi bahlelweni luphi, okungathinta imiphumela.
- I-Lancet Commission ibuchaza ubufakazi ngokuthi izinsiza zokuzwa zibonakala zisiza kakhulu abantu abanokulahlekelwa ukuzwa kanye nezinye izinto ezibeka engozini ye-dementia.
Isiphetho siwukuthi izinsiza zokuzwa azikhona indlela efakazelwe yokuvimbela i-dementia. Zisiza abantu ukuzwa, ukubamba iqhaza ezingxoxweni nokuhlala behlangene, okuyisizathu esanele sokuzicabangela.
Ngingazi kanjani ukuthi ukuzwa kufanele kuhlolwe?
I-NIA iphakamisa ukubona udokotela uma wena noma umuntu omnakekelayo:
- Kunzima ukuqonda abantu ocingweni
- Kunzima ukulandela izingxoxo uma abantu ababili noma ngaphezulu bekhuluma
- Kuvame ukucelwa ukuthi abantu baphinde kaningi
- I-TV ikhuphulwa ngokuphakeme kangangokuthi abanye bayakhononda
- Kunzima ukuqonda inkulumo uma kunomsindo ngemuva
- Kubonakala sengathi abanye abantu bakhuluma ngokungacacile
Qalani nodokotela wokunakekela kokuqala, ongase anithumele ku-audiologist (uchwepheshe wokuzwa) noma kudokotela wezindlebe, impumulo nomphimbo. Ukuqongelela kwe-earwax (ukungcola kwendlebe) kungenye imbangela evamile yokulahlekelwa ukuzwa udokotela angayihlola. Ukulahlekelwa ukuzwa ngokuzumayo kuyisimo esiphuthumayo sezokwelapha, futhi i-NIA iluleka ukubona udokotela ngokushesha.
Ukulahlekelwa ukuzwa kungadidaniswa nokudideka. I-NIA ithi abantu asebekhulile abangezwa kahle ngezinye izikhathi bacatshangwa ngephutha ukuthi badidekile, abaphenduli noma abalaleli. Uma umuntu omthandayo ebonakala ethi cwaka noma engakuzwa okushiwo, ukuhlolwa kokuzwa kuyisinyathelo esihle sokuqala.
Yini izinsiza zokuzwa ezithengwa esitolo?
Kusukela ngo-17 Okthoba 2022, i-FDA e-United States ivumele uhlobo lwezinsiza zokuzwa ezithengwa esitolo ngaphandle kwesiqondiso (OTC). Nansi indlela eziqhathaniswa ngayo nezinsiza ezinesiqondiso:
| Isici | Izinsiza ze-OTC | Izinsiza ezinesiqondiso |
|---|---|---|
| Ngubani ozifanele | Abantu abadala abaneminyaka engu-18 nangaphezulu abazibona benokulahlekelwa ukuzwa okuncane kuya kokumaphakathi | Noma yiliphi izinga lokulahlekelwa ukuzwa, noma yiliphi iminyaka |
| Zitholakala kuphi | Ezitolo noma ku-inthanethi, akukho kuhlolwa noma isiqondiso esidingekayo | Ngochwepheshe bokuzwa abanelayisense |
| Ukuzilungisa | Nina nilungisa izilungiselelo, kaningi nge-app | Uchwepheshe uzihlela ngokuzwa kwenu |
I-FDA ithi izinsiza ze-OTC azenzelwe ukulahlekelwa ukuzwa okukhulu noma okujulile. Iluleka ukubona udokotela, kungaba kuhle udokotela wezindlebe, impumulo nomphimbo, ngaphambi kokuthenga uma kukhona lokhu:
- Ubuhlungu noma ukungakhululeki endlebeni
- Uketshezi, i-pus noma igazi eliphuma endlebeni ezinyangeni eziyisithupha ezedlule
- Ushintsho oluzumayo noma olungazinzile ekuzweni
- Ukuzwa kubi kakhulu endlebeni eyodwa, noma umsindo okhalayo endlebeni eyodwa kuphela
- Isiyezi noma i-vertigo
- I-earwax eningi
Ukujwayela izinsiza zokuzwa kudinga ukuzijwayeza, ngakho hlolani inqubomgomo yokubuyisa ngaphambi kokuthenga, njengoba i-FDA iphakamisa. I-NIA iphakamisa ukubuza ukuthi umshwalense wenu umboza ingxenye yezindleko yini. Kumuntu ophila ne-dementia, i-audiologist ingasiza ukunquma ukuthi yiluphi uhlobo lwensiza nokulungiswa okuzoba lula kakhulu ukukuphatha usuku nosuku.
Ngingakhuluma kanjani kalula nomuntu onokulahlekelwa ukuzwa?
I-NIA iphakamisa:
- Bhekanani nomuntu futhi nigcine ukubhekana kwamehlo, ekukhanyeni okuhle, ukuze akwazi ukubona izindebe zenu nokubukeka kobuso.
- Tholani indawo ethulile. Vala i-TV noma nisuke emsindweni.
- Khulumani ngomsindo ophakeme kancane, kodwa ningememeli. Khulumani ngokwemvelo futhi ngesivinini esifanele.
- Gcinani umlomo ucacile. Ningadli, ningahlafuni i-chewing gum noma nimboze umlomo ngenkathi nikhuluma.
- Shintshani amazwi kunokuphinda uma okuthile kungezwakalanga.
- Umuntu oyedwa ngesikhathi. Eqenjini, qinisekisani ukuthi umuntu uhlanganyele.
- Yibani nesineke futhi nibuze ukuthi ningasiza kanjani.
Lezi zeluleko zisebenza kahle nezeluleko zethu zokuxhumana nomuntu one-dementia. Imisebenzi esekelwe ezithombeni nayo ikhulula ingcindezi yokulalela. Amapheya ezithombe no-Amakhadi engxoxo kusebenza ngalokho okubonwayo, futhi Qeda isisho ikuvumela ukuthi ukhombise isiphetho esikhundleni sokusho. Ngezingcingo, bhekani ucingo nezingcingo zevidiyo.
Ukubona nakho kubalulekile
Ngo-2024 i-Lancet Commission yengeza ukulahlekelwa ukubona okungelashiwe njengento entsha ebeka engozini. Ingqikithi ye-UCL iyibeka cishe ku-2% yamacala e-dementia, futhi i-Commission incoma ukwenza ukuhlolwa nokwelashwa kwezinkinga zokubona kutholakale kubo bonke. I-NIA iluleka ukuhlolwa kwamehlo (dilated eye exam) minyaka yonke noma emibili ngemva kweminyaka engu-60, nokuhlola nokuthi izibuko zamehlo ziyafaneleka. Ngisho nezinguquko ezincane ekubonweni zingakhuphula ubungozi bokuwa.
Khulumani nodokotela
Buzani udokotela ngokuhlolwa kokuzwa nokubona uma nibona noma yiziphi izimpawu ezingenhla. Funani ukunakekelwa ngokushesha ngokulahlekelwa ukuzwa ngokuzumayo, ubuhlungu bendlebe, noma uketshezi oluphuma endlebeni. Uma nimnakekela umuntu ophila ne-dementia, tshelani udokotela wakhe ngezinguquko ekuzweni noma ekubonweni, ezingathinta isimo sengqondo, ukuphepha nokuthi umuntu angahlanganyela kahle kangakanani.
Leli khasi liwulwazi jikelele, hhayi iseluleko sezokwelapha. Bhekani isaziso sethu sezempilo. Funda kabanzi ngokuxhumana nabantu nempilo yobuchopho.
Imibuzo evamile
Ingabe izinsiza zokuzwa zivimbela i-dementia?
Lokho akukaboniswa. Isivivinyo se-ACHIEVE asitholanga umphumela ngokwesilinganiso ekwehleni kwamakhono okucabanga eminyakeni emithathu, nakuba iqembu elisengozini enkulu lenze kangcono. Izinsiza zokuzwa zisafanele ukucatshangelwa ngoba zenza ingxoxo, ukuphepha nempilo yansuku zonke kube lula.
Ubani ongathenga izinsiza zokuzwa ezithengwa esitolo?
I-FDA ivumela abantu abadala abaneminyaka engu-18 nangaphezulu abazibona benokulahlekelwa ukuzwa okuncane kuya kokumaphakathi ukuthi bathenge izinsiza zokuzwa ze-OTC ezitolo noma ku-inthanethi ngaphandle kwesiqondiso sodokotela. Azenzelwe ukulahlekelwa ukuzwa okukhulu. Noma ubani onobuhlungu bendlebe, uketshezi oluphuma endlebeni, isiyezi noma ushintsho oluzumayo ekuzweni kufanele abone udokotela kuqala.
Ingabe ukulahlekelwa ukuzwa kungabukeka njenge-dementia?
Ngezinye izikhathi. I-National Institute on Aging ithi abantu asebekhulile abangezwa kahle ngezinye izikhathi bacatshangwa ngephutha ukuthi badidekile noma abalaleli. Ukuhlolwa kokuzwa kuyisinyathelo esifanele uma umuntu ebonakala ethi cwaka noma engakuzwa lokho okushiwo.
Abantu asebekhulile kufanele bahlolwe amehlo kangakanani?
I-National Institute on Aging iluleka ukuhlolwa kwamehlo (dilated eye exam) minyaka yonke noma emibili ngemva kweminyaka engu-60, noma njengoba uchwepheshe wamehlo ekweluleka. Abantu abane-diabetes noma ingcindezi yegazi ephezulu bavame ukudinga okungenani kanye ngonyaka.
Imithombo
Sixhumanisa nezinhlangano nezifundo leli khasi eliklanyelwe kuzo. Lunye lwahlolwa lapho leli khasi libuyekezwa.
- Dementia prevention, intervention, and care: 2024 report of the Lancet standing Commission · The Lancet
- Nearly half of dementia cases could be prevented or delayed by tackling 14 risk factors · University College London
- Hearing intervention versus health education control to reduce cognitive decline in older adults with hearing loss in the USA (ACHIEVE): a multicentre, randomised controlled trial · The Lancet (author manuscript in PubMed Central)
- OTC Hearing Aids: What You Should Know · U.S. Food and Drug Administration
- Hearing Loss: A Common Problem for Older Adults · National Institute on Aging
- Aging and Your Eyes · National Institute on Aging