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More and more research points to a connection between hearing loss and dementia later in life. For people experiencing hearing loss, that connection leads to an obvious question: “Am I going to get dementia?”
That question does not have an easy answer. Just because a person is experiencing hearing loss does not mean they will develop dementia. But learning more about the connection as well as the causes of hearing loss is important. 
Here’s a closer look at what we know about the connection between hearing loss and dementia, and here are some practical steps people can take at any age to protect their hearing and reduce their risk of hearing loss. 
What does the research say about hearing loss and dementia? 
Hearing loss and dementia are both more likely to affect older people. So, it makes sense that researchers see more older adults with both hearing loss and dementia. But research suggests that among aging populations the connection is stronger than we would expect by random chance. 
It’s important to note that this connection does not necessarily mean that hearing loss causes dementia. However, researchers are finding that the presence of hearing loss appears to accelerate dementia that already exists or is already developing. 
Researchers think the reason is because hearing loss, particularly severe hearing loss, can lead to a person becoming more withdrawn and socially isolated. That isolation may increase the risk of developing dementia. In fact, vision loss has a similar connection to dementia, suggesting that changes in senses in general can lead to changes in behavior and accelerate dementia. 
Additional studies have found that correcting hearing loss can slow dementia’s rate of progression. All of this research makes a strong case for people to protect their hearing and take steps to address hearing loss they may have developed. 
What Causes Hearing Loss?
Hearing loss falls into two broad categories: Conductive hearing loss and sensorineural hearing loss. Conductive hearing loss occurs when something blocks sound from reaching the sensory structures in the inner ear, such as wax or fluid. 
With sensorineural hearing loss, sound reaches the inner ear but cannot be effectively translated into nerve impulses. Conductive hearing loss can often be treated by removing whatever is blocking the sound, whereas sensory hearing loss generally cannot be reversed. Noise and aging are both common causes of sensorineural hearing loss. 
How Does Someone Know They Have Hearing Loss?
There are certain kinds of hearing loss that are cause for immediate concern. Hearing loss in only one ear, or hearing loss that comes with neurologic abnormalities like numbness, loss of balance, or difficulty chewing or speaking warrants seeing a doctor immediately. 
For hearing loss that develops gradually, many people struggle to admit they are experiencing it. Their first response is often “other people need to speak up.” People often first notice difficulty hearing when trying to follow a conversation in noisy situations.
If someone thinks they’re experiencing hearing loss, it’s good to see their primary care physician, an audiologist or an otolaryngologist (ENT). These professionals will likely do a hearing test to establish a baseline hearing level. 
How Can People Treat Hearing Loss?
Many causes of hearing loss have no cure, and treatment involves compensating for the hearing loss with hearing aids and various other assistive strategies and technologies. Hearing aids are a life-changing solution for many people, and the over-the-counter models can be a great option. There are many impressive advancements in hearing aid technology. Newer models are more discreet, and some models now use AI tools to help reduce background noise. 
At any time and at any age, people can stop behaviors that lead to hearing loss and can take hearing protection seriously. That means using earplugs at loud events or work environments. It also means keeping headphones at a safe volume.
Headphones can also be a useful tool in protecting your hearing. Some models have helpful noise cancellation features, and in some instances, they can be used similarly to hearing aids to help make sounds louder. Others, when connected to an app, can actually conduct hearing tests. 
How Should People Talk to Their Doctor About the Connection Between Hearing Loss and Dementia?
Even though research points to a connection between hearing loss and dementia, each is a distinct condition requiring its own treatment and approaches. An audiologist can address hearing loss, but any cognitive decline requires a visit to a neurologist for a full evaluation. 
Addressing hearing loss can improve relationships with loved ones and enhance quality of life now and into the future. It’s an important step to take in overall health. 
To learn more about hearing loss, visit the Manuals page or the Quick Facts on the topic.

What is the Connection Between Hearing Loss and Dementia? Answering Common Patient Questions

More and more research points to a connection between hearing lossand dementialater in life. For people experiencing hearing loss, that connection leads to an obvious question: “Am I going to...

Many Americans are turning to AI tools for medical information, but there are conflicting views about the trustworthiness of the results. More than three in five (62%) Americans have used AI tools like medical chatbots, ChatGPT, Google Assistant, Siri, or Google Gemini for medical information, according to a recent poll conducted online by The Harris Poll on behalf of Merck Manuals among 2,057 U.S. adults. About a third of Americans (32%) say they do not trust the medical information provided by AI tools. Nine in 10 who’ve used AI for medical info say they take steps to check the legitimacy of information provided by AI. 
“Artificial intelligence is a powerful tool for accessing and organizing information across all sorts of tasks, and finding health information is no exception,” said Dr. Sandy Falk, M.D., Merck Manuals Editor-in-Chief. “One of AI’s great capabilities is as a search engine that finds not only links to medical content but also puts together information from a variety of sources. The challenge is making sure the information is accurate and reliable and provided in the right context. At the Merck Manuals, we’re committed to empowering people to use trusted medical information to make the best choices for their health, whether that’s through our own AI search tool or by powering other AI applications. Our mission is to provide resources patients and health care professionals can use to ensure AI results are correct or to follow up an AI answer with a deeper dive.”
The Merck Manuals/Harris Poll survey found Americans use AI tools to access medical information in a variety of ways, with the most common being:

    Getting information about a specific condition or disease (33%)
    Getting more information about symptoms they are experiencing (29%)
    Getting advice about nutrition, lifestyle habits, and physical activity (26%)
    Asking about medication side effects or dosage (26%)

Among Americans who use AI tools for medical information, some common actions they take when using include:

    Entering a list of symptoms to get a diagnosis (54%)
    Entering detailed prompts into AI that include things such as vitals, medical history or other important personal health data (44%)
    Using an AI tool specifically designed to focus on health and medical topics (39%)

Among those who use AI for medical information, nearly 9 in 10 (88%) say they trust the information, but only 14% say they trust it completely. This trust among people who use AI for medical information was relatively consistent across generations (87% each of Gen Z ages 18-29 and Millennials ages 30-45, 90% of Gen X ages 46-61, 88% of Baby Boomers ages 62-80). 
Nine in 10 Americans who use AI tools for medical information (90%) say they do take steps to check the legitimacy of the information provided by AI. The most common tactics include:

    Talk to a healthcare professional for confirmation or clarification (41%)
    Cross-reference with other reputable AI or online information platforms (e.g., search engines, websites) (39%)
    Check the sources provided within the AI response for accuracy and/or authority (37%)
    Use academic and medical databases for deeper research (32%)

Different demographics are more likely to use AI for medical information. Gen Z and Millennials are more likely to use AI for medical information than Gen X and Baby Boomers, while Baby Boomers are the least likely to do so (77% each Gen Z and Millennials, 58% Gen X, 40% Baby Boomers). Parents with children under 18 are more likely to use AI for medical information, with more than 8 in 10 (83%) saying they use it compared to just 52% of those who are not parents with children under 18. The most common uses among parents of minors are to get information about a specific condition or disease (46%) and to get more information about symptoms they were experiencing (41%). 
 
Consumer Survey Methodology
This survey was conducted online within the United States by The Harris Poll on behalf of Merck Manuals from February 26-March 2, 2026, among 2,057 U.S. adults ages 18 and older, among whom 1,285 use AI for medical information. The sampling precision of Harris online polls is measured by using a Bayesian credible interval.  For this study, the sample data is accurate to within +/- 2.7 percentage points using a 95% confidence level. This credible interval will be wider among subsets of the surveyed population of interest. For complete survey methodology, including weighting variables and subgroup sample sizes, please contact kmiller@gobraithwaite.com.

Survey Shows More Than 3 in 5 Americans Use AI Tools for Medical Information, but Most Take Steps to Check Sources and Information

Many Americans are turning to AI tools for medical information, but there are conflicting views about the trustworthiness of the results. More than three in five (62%) Americans have used AI...

Kawasaki disease is an autoimmune condition that causes inflammation of blood vessels throughout the body. It most often occurs in children who are under 5 years old. It is rare, but without prompt treatment it can lead to serious complications. Parents should know the signs and symptoms of Kawasaki disease and when to contact a doctor. Here are answers to some of the most common questions pediatricians get about Kawasaki disease.
Who is at risk for Kawasaki disease?
Most children with Kawasaki disease are under 5 years of age. Rarely, infants under 4 months of age, adolescents, and adults can develop the disease. Boys are affected slightly more often than girls.
The cause of Kawasaki disease is not known. Probably, there are a number of triggers, including viral infections, that lead the body to create a very intense short-term inflammatory state. Like other autoimmune conditions, genetics are likely a component, but the exact role they play is unknown. 
What are the signs of Kawasaki disease?
Kawasaki disease has several specific symptoms. In some cases, these symptoms can be confused with other more common conditions, such as measles or scarlet fever. For a typical case in a child between the ages of 2 and 6 years, most will have a fever greater than 100.4° F (38° C) for five or more days, and at least four of the following five symptoms:

    Red eyes with no discharge
    Reddened, dry, cracked lips and a red strawberry tongue
    Swelling, redness or dark purple color, and, eventually peeling of the hands and feet
    Red, purplish, or reddish-brown, patchy rash over the trunk
    Swollen, tender lymph nodes in the neck

Extreme irritability is often considered a sixth symptom doctors will watch for. When children are very difficult to console, even when given support like a bottle, being held, or a distraction, it can be a sign of Kawasaki disease, if in the presence of the above symptoms. 
In children under 6 months of age, the only symptom may be prolonged fever, or infants may have just one or two of the most common signs. At the same time, it’s important to note that there are many more common causes of fever in children than Kawasaki disease, so not all fevers mean that a child has Kawasaki disease.
Why is prompt treatment so important?
The inflammation that defines Kawasaki disease can be especially dangerous if it affects blood vessels around the heart. In fact, Kawasaki disease is the most common cause of acquired coronary artery disease in children. Prompt treatment substantially reduces the risk of coronary artery disease.
If children are not treated, heart problems may develop, usually beginning 1 to 4 weeks after the illness starts. A few children develop the most serious heart problem, a bulge in the wall of a coronary artery (coronary artery aneurysm). These aneurysms can rupture or cause a blood clot, leading to a heart attack and sudden death. Treatment greatly reduces the risk of heart complications.
The standard treatment for Kawasaki disease is pooled immune globulin given intravenously. Often, patients feel better and the fever reduces after a single infusion. Doctors will also focus on treating the fever and other symptoms and preventing coronary artery aneurysms. 
When should I call a doctor?
Anytime a child has a fever, it’s important to be vigilant. If the fever has lasted for 5 days, calling the child’s pediatrician is a good next step. At this point, a viral infection is still the more likely cause (remember Kawasaki disease is rare and typically has other more distinguishing symptoms). But after 5 days of fever, in most cases, the doctor will recommend having the child seen by a healthcare professional. In general, pediatricians are very familiar with Kawasaki disease. They’ll know what symptoms to look for and be able to recommend the right next steps. 
To learn more about Kawasaki disease, visit the Manuals page. 

What Parents Need to Know About Kawasaki Disease

Kawasaki disease is an autoimmune condition that causes inflammation of blood vessels throughout the body. It most often occurs in children who are under 5 years old. It is rare, but without...

Winter storms can bring extreme cold, ice, snow, and power outages that create serious health and safety risks. According to emergency preparedness experts, injuries and deaths during winter weather are often preventable with proper planning and awareness.
When a winter storm is forecast, preparing ahead of time—and understanding the risks that come with cold weather—can make a critical difference. Ready.gov and public health experts recommend staying informed, limiting travel, and taking precautions to protect your health and safety.
Here’s a closer look at some of the risks and best practices for protecting yourself and those around you when winter storms hit. 
Hypothermia, Frostbite, and Cold Exposure
Cold exposure occurs when the body loses heat faster than it can produce it. Prolonged exposure to cold temperatures—especially with wind, wet clothing, or inadequate shelter—can lead to hypothermia or frostbite.
Hypothermia happens when the body’s core temperature drops too low, usually below 95° F (35° C). Early symptoms may include shivering, confusion, slurred speech, clumsiness, and fatigue. Hypothermia is life-threatening and requires immediate medical attention.
Frostbite occurs when skin and underlying tissues freeze, most often affecting fingers, toes, ears, and the nose. Skin can become numb, white, swollen, blistered, or black and leathery. Don’t not rub frostbitten areas as it might damage the skin and tissue. It is best to warm up frostbitten areas in warm water. 
To reduce risk:

    Dress in layers, including hats and gloves.
    Keep clothing dry and change wet clothes immediately.
    Limit time outdoors during extreme cold.
    Check on older adults, children, and anyone without adequate heat.

Seek medical care promptly if hypothermia or frostbite is suspected.
 
Carbon Monoxide Poisoning
Power outages during winter storms increase the risk of carbon monoxide (CO) poisoning, a serious and potentially fatal condition. Carbon monoxide is a colorless, odorless gas produced by burning fuel. If improperly vented, automobiles, furnaces, fireplaces, hot water heaters, gas heaters, kerosene heaters, and stoves (including wood stoves and stoves with charcoal briquettes) can cause carbon monoxide poisoning. For example, when the exhaust pipe of a running car is blocked by piled-up snow or another object, carbon monoxide levels inside the car rise rapidly.
Symptoms of carbon monoxide poisoning may include headache, dizziness, weakness, nausea, confusion, and loss of consciousness.
To prevent carbon monoxide poisoning, keep vents and chimneys clear of snow and debris. Install battery-powered or battery-backup carbon monoxide detectors in your home. If carbon monoxide poisoning is suspected, get fresh air immediately and seek emergency care.
Snow Shoveling and Overexertion
Snow shoveling is a common cause of winter-related injuries and medical emergencies. The combination of cold temperatures and physical exertion increases strain on the heart, particularly for people with underlying heart disease or risk factors. Overexertion while shoveling can trigger heart attacks, chest pain, shortness of breath, and muscle and back injuries.
To reduce risk:

    Pace yourself and take frequent breaks.
    Push snow instead of lifting when possible.
    Use a smaller shovel load.
    Stop immediately if you experience chest pain, dizziness, or shortness of breath.

People with heart disease or who are not used to strenuous activity should ask for help or use snow removal services.
Emergency Water Storage and Drowning Risks
Filling a bathtub with water before a winter storm can provide an emergency water supply in case of power outages or frozen pipes. However, this precaution comes with important safety considerations. Bathtubs filled with water pose a drowning risk, especially for young children, pets, or individuals with mobility or cognitive impairments. Because infants and young children can drown in only a few inches of water, even water-filled containers are hazardous. 
Never leave infants or children unattended around standing water and keep bathroom doors closed or use safety latches. Drain the tub as soon as emergency water is no longer needed. Even small amounts of water can be dangerous if supervision lapses.
Sledding, Vehicle, and Recreational Accidents
Snow and ice increase the risk of high-speed injuries from sledding, snowmobiles, ATVs, and motor vehicles. Collisions and falls can result in head injuries, spinal injuries, and internal trauma. The common risks for accidents include sledding near roads, trees, or fences, riding without helmets or protective gear, not wearing seat belts, or driving too fast for icy conditions. 
It is very important to wear helmets when sledding, skiing, or riding snowmobiles or ATVs. Also, choose designated sledding areas away from traffic and obstacles like trees. Drive slowly, increase following distance, and avoid unnecessary travel. And always avoid alcohol before winter recreational activities.
Head and spinal injuries can be serious even when symptoms are mild—seek medical evaluation after significant impacts.
Slips and Falls on Ice
Icy sidewalks, driveways, and stairs significantly increase the risk of slips and falls, especially among older adults. Falls can result in concussions, fractures, and hip injuries that may have long-term consequences.
Prevention tips:

    Wear shoes or boots with good traction.
    Use handrails and walk carefully on icy surfaces.
    Apply ice melt or sand to walkways.
    Encourage older adults to stay indoors during icy conditions when possible.

After a fall, seek medical attention if there is head impact, severe pain, confusion, or difficulty walking.
Staying Safe Through the Storm
Winter storms bring unique hazards that extend beyond cold temperatures. Understanding the risks—and taking simple preventive steps—can help protect you, your family, and your community.
Stay informed through weather alerts, prepare your home and emergency supplies, and prioritize safety during and after the storm. When in doubt, seek medical care—early treatment can save lives and prevent serious complications.
Preparation today can make all the difference when winter weather strikes.

Staying Safe During Winter Storms and Cold-Weather Hazards

Winter storms can bring extreme cold, ice, snow, and power outages that create serious health and safety risks. According to emergency preparedness experts, injuries and deaths during winter...

It’s something we all fear, especially this time of year: You or a family member might have been exposed to the “stomach bug.” Maybe it’s a note from school or daycare, a message from a coworker, or a text from a friend you just visited.
In these instances, the “stomach bug” could be referring to a number of stomach illnesses or gastroenteritis. Gastroenteritis refers to an inflammation of your stomach and intestines, sometimes leading to nausea, vomiting, and diarrhea. Often, the stomach bug that causes the gastroenteritis is norovirus, a highly contagious RNA virus. 
Norovirus causes an average of 19 to 21 million illnesses a year in the United States alone. Anyone can get norovirus, but children under the age of 5 and adults aged 65 or older are especially at risk. Most infections occur in the colder months of the year. It’s important to understand some specifics about the virus to help minimize its impact and its spread to others. Here’s what patients and parents need to know. 
Norovirus is highly contagious
Norovirus is very contagious. Most infections are transmitted by person-to-person contact, particularly through direct or indirect contact with infected stool or vomit. 
It takes a remarkably small amount of the virus to infect many people, which is why it is so contagious. It’s also why it can easily cause outbreaks in contained areas, such as cruise ships, daycare centers, and restaurants. Each year, there are about 2,500 reported norovirus outbreaks in the United States.
Norovirus does not cause flu-like symptoms
People sometimes call norovirus the “stomach flu,” but that’s not accurate. Norovirus typically causes vomiting, abdominal cramps, and diarrhea. Children tend to have more vomiting than diarrhea, whereas adults tend to have more diarrhea. Vomiting and diarrhea can lead to dehydration, which may be severe. Symptoms start 1 to 2 days after infection and last 1 to 3 days. People are most contagious immediately after they develop symptoms, and they continue to be most contagious for about 48 hours after symptoms resolve. When returning to school or work, follow all policies and wash your hands thoroughly and regularly. 
People will sometimes have fever, headache, and body aches, but not to the same degree typically seen with the flu. What’s more, the flu vaccine will not protect individuals from norovirus. Symptoms like a cough and a high fever may indicate the condition is something other than norovirus. 
Norovirus can be life-threatening
On average, norovirus causes 900 deaths in the United States each year, mostly among adults aged 65 and older. Parents should pay close attention to symptoms in children, particularly infants, because dehydration can occur more quickly in them. Anyone whose immune system is compromised should also be careful. 
Usually, the only treatment needed for norovirus gastroenteritis is getting bed rest and drinking adequate amounts of fluid. Even a person who is vomiting should drink as much as can be tolerated. Taking small, frequent sips is helpful. It’s best to drink fluids other than water. Drinks with electrolytes or chicken broth work well. Sports drinks often contain more sugar than salt-containing rehydration solutions, so they’re not ideal. If you or someone in your family starts to experience symptoms of dehydration (dark yellow urine, parched inside of mouth), seek medical attention right away. 
Many people won’t see a doctor for norovirus. Because it’s a virus, antibiotics are not needed. Antidiarrheal medications can help, but people should talk to their doctor before taking them. 
Washing your hands is the best defense
Washing your hands thoroughly with soap and warm water is the most important step you can take to prevent the spread of norovirus. Hand sanitizers do not kill norovirus. Washing your hands can help keep you from getting sick with norovirus. If you’re already sick, washing your hands (especially after using the bathroom and before preparing food) can help prevent the spread to others.
If you or someone else in your house has norovirus, maintain distance as much as possible, wash soiled clothing and sheets thoroughly, and use chlorine- or bleach-based cleaners on countertops.
There are other important steps to take to prevent the spread of norovirus. Practice good food hygiene, including washing hands before touching food, washing knives and cutting boards used to cut raw meat before contact with other food, cooking meat and eggs thoroughly, and refrigerating leftovers promptly after cooking. It’s also important to avoid questionable foods, particularly oysters and other raw seafood. Finally, pay attention to food recalls for purchases you may need to throw away. 
To learn more about norovirus, visit the Manuals page.

Wash Your Hands! What Patients and Parents Need to Know About Norovirus

It’s something we all fear, especially this time of year: You or a family member might have been exposed to the “stomach bug.” Maybe it’s a note from school or daycare, a message from a coworker...

For many, travel is an essential part of holiday celebrations. It’s how we gather with family. It’s how we get away with friends. It’s how we make the most of our time off from work. An estimated 119 million Americans traveled at least 50 miles during the holidays last year. A similar number are expected to hit the open road or take to the skies this holiday season.
To ensure a successful trip, it’s important to take steps to stay healthy while traveling – especially during the holidays. Several conditions may occur even among healthy people while in transit. Here’s a closer look at some of the health concerns that can creep up during holiday travel – and how to make sure you reach your destination healthy and ready to celebrate. 
Before the trip
Travel disrupts routines, puts people in unexpected or stressful situations, and can be uncomfortable. It’s not uncommon for some people to get nervous before a trip or while traveling. Anxiety affects many people who travel. Fear of flying, fear of confined spaces, and worries about medical conditions worsening during flight are common sources of anxiety. Anxiety can also cause insomnia, making jet lag worse. People may hyperventilate, often with symptoms such as chest pain, trouble breathing, muscle spasms, and tingling in the arms and hands, as well as around the mouth. The company of a seasoned traveler or caregiver may help relieve anxiety.
Some medical conditions require additional considerations when planning travel and embarking on the trip. Individuals with heart disease, lung disease, diabetes, and certain other conditions should talk to their doctor before significant trips, especially when they involve high altitudes or other stressful conditions. Pregnant women should also take precautions and check with a doctor before major trips, especially close to their due date. All travelers should make sure they have what they need to stay healthy at their destination and for the duration of their trip. 
During the trip
There are several conditions to be aware of during travel during the holidays and all year long. Motion sickness, triggered by vibration and movement, can affect individuals traveling by car, train, airplane, or boat. Symptoms are nausea, vomiting, sweating, and dizziness. Preventive measures include moderating intake of food, fluids, and alcohol, focusing on a stationary object or on the horizon, lying down and keeping the eyes closed, and getting some fresh air. Certain medications can help but may cause side effects. 
Blood clots are another health concern for people who sit for long periods during air, rail, bus, or car travel. Blood clots form in leg or pelvic veins and occasionally dislodge and travel to the lungs (called pulmonary emboli). Some blood clots in the legs do not cause symptoms, whereas others cause cramping, swelling, and color changes of the calves and feet. 
The risk of developing blood clots may be reduced by

    Changing positions frequently
    Straightening and moving the legs frequently while seated
    Drinking enough fluids
    Getting up to walk and stretch every 1 to 2 hours

One concern many travelers have is the spread of infection during travel. No one wants to bring a cold or other illness to a family gathering. Spread of infection on airplanes and cruise ships often receives media attention but is relatively uncommon. Although colds are probably the most common infection, other infections include:

    Influenza
    Traveler’s diarrhea

People should also make sure they are up to date on their immunizations. Travelers can minimize their risk of infection by washing their hands frequently and using alcohol-based hand sanitizers.
After the trip
Sleep disturbance after air travel (jet lag) is common when people rapidly travel across more than 3 time zones. Sleep disturbance does not occur with sea, rail, or car travel because travelers have time to adjust to time zone changes. The most obvious symptom is fatigue on arrival. Other symptoms include

    Irritability
    Difficulty sleeping (insomnia)
    Headache
    Difficulty concentrating

People traveling westward tend to awaken earlier and feel tired earlier than they should by local time. People traveling eastward tend to awaken later and stay awake longer than they should by local time. In both instances, people should try to adjust by getting bright sunlight in the early morning and going to bed at an appropriate time without naps. 
Plan ahead to stay healthy
Staying healthy during travel, especially during the holidays, starts with good planning. The U.S. Centers for Disease Control and Prevention has an online hub on travelers’ health, including travel notices and advice for travelers on a wide variety of topics. It offers advice on packing, which includes bringing copies of important medical documents, medicines to address illnesses and symptoms during travel, and supplies to ensure a safe and healthy trip. 

Staying Safe and Healthy While Traveling for the Holidays

For many, travel is an essential part of holiday celebrations. It’s how we gather with family. It’s how we get away with friends. It’s how we make the most of our time off from work. An estimated...

PODCAST Altitude Illness Myths with Dr. Andrew Luks

Season 6 | Episode 7Joe McIntrye (Host): Welcome to another episode of the Merck Manuals Medical Myths podcast. On this show, we set the record straight on today's most talked about medical...

Age-related macular degeneration (AMD or ARMD) is one of the most common retinal diseases among older adults. It does not lead to total vision loss, but AMD does impair vision in the central area of the retina. Vision impairment can progress and eventually affect a person’s ability to drive, read, and even recognize faces. 
There are different types of AMD, and it can progress differently for different people. For anyone diagnosed with AMD or caring for someone with AMD, understanding more about the disease and its impact on daily life is essential. Here are answers to some of the most common questions about AMD.
What is age-related macular degeneration?
If we think of the eye like a camera, the retina is like film where light is converted to electrical signals that are sent to the brain. The macula is the central and most vital area of the retina. As people get older, they can develop spots on the macula known as drusen, which are similar to age spots on the skin. As a result, central vision becomes washed out and loses detail, and straight lines may appear wavy.
What is the difference between wet and dry age-related macular degeneration?
There are 2 types of AMD: dry and wet. All AMD starts as the dry type. In dry AMD, which is characterized by the drusen deposits, the tissues of the macula become thin as cells disappear. 
In dry AMD, the loss of central vision occurs slowly and painlessly over years. People may have few or no symptoms but, when they do have symptoms, they often occur in both eyes. As the disease progresses, central blind spots (scotomas) usually occur and can sometimes severely impair vision. 
About 10% to 15% of people with dry AMD go on to have wet AMD. Wet AMD develops when abnormal blood vessels grow under the damaged macula and leak fluid and blood (hence the description as "wet"). The abnormal blood vessels cause vision loss to progress quickly. Eventually, a mound of scar tissue develops under the macula. The wet form develops in one eye first but eventually may affect both eyes.
What causes AMD?
There’s no single known cause of AMD. It’s a degenerative condition that develops over time, most often in people over the age of 50. It can run in families, although having a family history does not mean someone will definitely develop it.
Several risk factors can increase the likelihood of AMD, including smoking, poor nutrition, high blood pressure, and cardiovascular disease.
Can AMD be prevented?
The best ways to lower the risk of AMD include avoiding smoking, controlling blood pressure, staying physically active, and eating a healthy diet, especially one rich in omega-3 fatty acids found in fish and dark, leafy green vegetables.
There is no universal screening guideline for AMD, but people with a family history should have a dilated eye exam beginning around age 50. In addition, anyone diagnosed with AMD should see an ophthalmologist right away if they notice any change in vision. The sooner a transition to wet AMD is detected and treated, the better the chances of preserving sight.
How is AMD treated?
For people with intermediate or advanced AMD in at least one eye, certain dietary supplements (based on the AREDS2 formula) are recommended to help slow disease progression.
In the wet form of AMD, medications can be injected directly into the eye (intravitreal injections) to stop abnormal blood vessels from leaking. These treatments significantly reduce the risk of vision loss and can even improve reading vision in about one-third of patients.
For people with severe vision loss from AMD, doctors may also:

    Give additional injections in the back of the eye
    Use laser or light-based treatments to seal abnormal blood vessels
    Recommend low-vision tools, such as magnifiers, special reading glasses, or electronic devices
    In select cases, implant a miniature telescope inside the eye to improve central vision

Can people with AMD still drive?
It is very common for people with AMD to worry about losing the ability to drive, and understandably so. Driving is central to independence for many adults. The good news is that most people with dry AMD keep enough vision to continue driving safely and to read, especially in the earlier stages. However, AMD is a progressive condition, so regular monitoring for any vision changes is important.
For caregivers, a helpful guideline is this: if you feel unsafe as a passenger while a family member with AMD is driving, it is time to encourage an evaluation with their eye doctor.
Beyond driving, AMD can affect many daily activities, but there are excellent low vision tools and resources available to support both near and distance vision. The first step is to meet with an ophthalmologist, who can recommend the right aids or specialty care based on the individual’s current vision.
This is a rapidly advancing field. New treatments and technologies are emerging all the time. Even with vision loss, there is real reason to remain hopeful.
To learn more about AMD, visit the Manuals page or the Quick Facts on the topic. 

Answering Common Questions About Age-Related Macular Degeneration

Age-related macular degeneration (AMD or ARMD) is one of the most common retinal diseases among older adults. It does not lead to total vision loss, but AMDdoes impair vision in the central...

When people talk about the dangers of smoking, chronic obstructive pulmonary disease (COPD) is one of the conditions they’re talking about. In fact, smoking is the most important cause of COPD. 
COPD is a common cause of death, accounting for about 140,000 deaths in the United States each year. It takes people with COPD longer to exhale all the air from their lungs, often because of narrowing and damage in the airways. This causes air to be trapped in the lungs. Over time, it leads to chronic cough, shortness of breath, limitations in physical activity, and an increased risk of contracting respiratory infections.
While COPD is a leading cause of death, people can take steps to control the condition. There are treatments that can improve people’s quality of life and help them live longer with COPD. Here are 4 things individuals and caregivers should know about COPD.
1. COPD encompasses other respiratory conditions
COPD is an umbrella term that includes chronic obstructive bronchitis and emphysema. 
Chronic bronchitis is defined as cough that produces sputum for at least 3 months during 2 consecutive years. When chronic bronchitis involves airflow obstruction, it qualifies as chronic obstructive bronchitis. Emphysema is defined as widespread and irreversible destruction of the alveolar walls (the cells that support the air sacs, or alveoli, that make up the lungs) and enlargement of many of the alveoli. Doctors often perform lung function testing to help confirm the diagnosis.
Chronic bronchitis and emphysema can occur together in the same person. The most important determinant of how the person feels and functions is the severity of the airflow obstruction.
While often linked to environmental factors like smoking, COPD can also be hereditary. In people who develop COPD at a young age, especially when there is a family history of COPD, the level of alpha-1 antitrypsin in the blood is measured to determine whether alpha-1 antitrypsin deficiency is present. If the level is low, further genetic tests, sometimes using a buccal (cheek) swab or a fingerstick (dried blood spot), may be done to confirm whether the disorder is present. This genetic disorder is also suspected when COPD develops in people who have never smoked.
2. COPD is different from asthma
Asthma is another very common respiratory disease that can cause similar symptoms to COPD. In addition to having a cough that produces sputum, people with both asthma and chronic bronchitis can have wheezing, shortness of breath, and partially reversible airflow obstruction. Some people can also have both COPD and asthma at the same time. This is called Asthma-COPD overlap syndrome. People with both disorders are treated primarily for asthma.
One key difference between COPD and asthma is that airflow obstruction in asthma is completely reversible in most people, either spontaneously or with treatment. With COPD, although airflow obstruction due to emphysema is not typically reversible, bronchial smooth muscle spasm, inflammation, and increased secretions are all potentially reversible. Inhaled medications are available in various forms, including handheld metered-dose inhalers, dry powder inhalers, and nebulizers, and can help relax muscles in the airway and relieve symptoms of COPD. 
Both COPD and asthma can have flare-ups, also known as exacerbations. Asthma flare-ups can be triggered by allergies, infection, and even exercise. On the other hand, with COPD, these flare-ups are typically triggered by a viral infection or exposure to high levels of air pollution. COPD flare-ups are characterized by worsening shortness of breath and the production of excessive yellow or green phlegm. They should be treated as soon as possible.
3. Early treatment can help 
One of the biggest myths surrounding COPD is that there’s nothing that can be done about it. The reality is, there are effective treatments that can improve exercise capacity, reduce symptoms, improve overall lung function, and extend survival. COPD often takes years to progress, and the earlier individuals can take proactive steps to address it, the better. 
Maintaining a generally healthy lifestyle is an important step. That includes maintaining a normal body weight, regular exercise, and a healthy diet. In addition to medications like inhaled medications, all people with COPD should receive an influenza vaccination every year. Pneumococcal vaccination as well as vaccination against COVID-19 and respiratory syncytial virus (RSV) also help.
4. It’s never too late to quit smoking
The biggest thing individuals can do to improve their health when it comes to COPD is to quit smoking. Stopping smoking when the airflow obstruction is mild or moderate often lessens cough, reduces the amount of sputum, and slows the development of shortness of breath. Stopping smoking at any point in the disease process provides some benefit. 
When it comes to quitting, it’s best to try several strategies at once, including:

    Committing to a specific date for quitting
    Using behavioral modification techniques (making cigarettes difficult to obtain or rewarding oneself for abstaining for increasingly long periods of time)
    Group counseling and support sessions
    Nicotine replacement (chewing nicotine gum, wearing a nicotine skin patch, or using a nicotine inhaler, nicotine lozenge, or nicotine nasal spray). 
    Medications designed to decrease tobacco cravings

There are many resources for individuals with COPD to find a community and learn about the disease. The COPD Foundation provides information on COPD diagnosis and treatment and tools to support people with COPD and their caregivers. The American Lung Association’s Better Breathers Club connects people living with lung disease to education, support, and each other. 
To learn more about COPD, visit the Manuals page or the Quick Facts on the topic. 

What Patients Need to Know About COPD

When people talk about the dangers of smoking, chronic obstructive pulmonary disease(COPD) is one of the conditions they’re talking about. In fact, smoking is the most important cause of COPD...

It’s happened to countless travelers on hiking, climbing, and skiing trips. You’ve prepped your gear and your itinerary. You’ve arrived at your destination. You’re ready to get out there and enjoy yourself. But after a few hours (or less), you start feeling tired and irritable, a bit nauseous with a headache. 
These symptoms, combined with recent travel, are telltale signs of altitude illness. Altitude illness occurs because of a lack of oxygen at high altitudes, and it affects mountain climbers, recreational hikers, skiers, and others who travel to high altitudes. 
Altitude illness should be a consideration for anyone planning a trip to high altitudes (generally above 8,000 feet, but sometimes lower). Here are four things to know about altitude illness. 
1. Altitude illness falls into three categories
Generally, there are three conditions related to altitude illness. Acute mountain sickness (AMS) is the mildest and most common of the three. Symptoms usually develop within 6 to 10 hours of ascent (increase in altitude) and often include headache and one or more other symptoms, such as light-headedness, loss of appetite, nausea, vomiting, fatigue, weakness, or irritability.
High-altitude cerebral edema (HACE) is a rare but potentially fatal condition in which the brain swells with fluid. People with HACE have headaches, confusion, and unsteady and uncoordinated walking (ataxia).
The third condition is high-altitude pulmonary edema (HAPE), which causes difficulty breathing and can cause low blood oxygen levels because of fluid build-up in the lungs that usually develops 24 to 96 hours after a rapid ascent to over 8,000 feet. It can occur in people even if they do not have symptoms of AMS.
HACE and HAPE are severe conditions that require immediate attention and treatment that often involves a descent to lower altitudes. 
2. Don’t overlook AMS as a cause of symptoms
Many symptoms of AMS are relatively common when traveling. Plenty of people suffer from a headache, irritability, or fatigue after a long flight or car ride. But if you’re at a higher elevation, remember that AMS could be a cause and watch for more serious symptoms. If you don’t feel better with rest, water, and maybe some over-the-counter headache medicine, it may be time to talk to a medical professional and get to a lower elevation. 
People say dehydration causes AMS. That’s not true, but it’s easier to become dehydrated at higher altitudes. It’s still a good idea to drink plenty of fluids. Dehydration can also make you feel tired and lightheaded just like AMS, so if you don’t feel better after drinking enough water this might be another time to talk to a medical professional.
3. The altitude always wins
One of the biggest misconceptions about altitude illness is that being in good shape reduces your risk. That’s not true. What’s more, other medical conditions like asthma or high blood pressure (hypertension) don’t make people more likely to suffer from AMS. Everyone’s tolerance is different, and you won’t know how you handle different altitudes until you’re exposed to them. 
At the same time, physical exertion at higher altitudes is hard work. Being in good shape won’t prevent altitude illness, but it is still an essential consideration for strenuous trips at higher elevations. 
If you’re traveling at heights, remember: The altitude always wins. Altitude doesn’t care how determined you are or how excited you are to ski a particular slope or hike a particular mountain. If you’re having symptoms of altitude illness, you need to stop and potentially get to a lower altitude. Pushing yourself to go higher is a risk. 
4. Staying safe starts with smart planning
Everyone wants to make the most of their trips and travel. But ascending too quickly is the primary risk factor for altitude illness. Build time to acclimate to higher altitudes into your trip planning and give yourself and your group time to get used to the new conditions. You may be anxious to start skiing or hiking, but it’s often better to take it easy on that first day and make sure everyone is comfortable at that elevation. 
When planning trips with large groups, keep in mind that each person will acclimate differently. Ask people if they’ve traveled to high altitudes before and be conservative in planning activities. And remember — the altitude always wins. If in doubt, go down where there is more oxygen. 
To learn more about altitude illness, visit the Manuals page or the Quick Facts on the topic.

Heading for High Altitudes? 4 Things Travelers Should Know About Altitude Illness

It’s happened to countless travelers on hiking, climbing, and skiing trips. You’ve prepped your gear and your itinerary. You’ve arrived at your destination. You’re ready to get out there and...

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