Mental Disability

March 6, 2020

Routine cognitive tests for seniors? Not for now, blue-ribbon panel advises

It sounds like a good idea. Have primary care doctors learn about older patients’ cognitive health by putting all of them, during routine office check-ups, through a few minutes of tests in which they are asked to recall lists of words, draw a clock face, describe the day and date of their appointment, talk about current events, and take on other simple tasks.

Such screenings, some advocates for the aged say, can be an important way to diagnose early and try to provide for help for patients with dementia and its most common affliction, Alzheimer’s disease. But a blue-ribbon panel of experts that advises the nation on medical testing and procedures isn’t buying the argument: The U.S. Preventive Services Task Force (USPSTF) has given such screenings the group’s letter-grade rating of I, meaning the evidence is incomplete that a test or procedure is harmful or beneficial.

The panel, updating its 2014 findings, reported on the JAMA Network (the online medical journal collection) that:

December 20, 2019

Intoxicated drivers keep killing too many. New, targeted tactics may be needed.

by Patrick A. Malone

Politicians and police may need to step up their crackdown on drug- and alcohol-impaired drivers, targeting repeat offenders with substance-abuse and mental health problems who also are “disproportionately responsible for fatalities,” a leading traffic safety group recommends.

As the Wall Street Journal reported of new work by the Governors Highway Safety Association and its consultant Pam Fischer:

“Nearly 30% of all vehicular-crash deaths in the U.S. last year were alcohol-related … Last year, 10,511 people died in crashes involving at least one driver with a blood-alcohol concentration of at least .08%, the legal cutoff in every state except Utah, federal figures show. While that represented a 3.6% drop from 2017, alcohol-related fatality levels have largely stagnated for the past decade. ‘What we’re failing to do is get to the root cause of why they’re doing this, what’s behind the behavior,’ [said Fischer].”

October 29, 2019

Who will step up to deal with dementia and Alzheimer’s?

by Patrick A. Malone

With as many as 14 million Americans potentially suffering from various forms of dementia by 2040, including the common Alzheimer’s disease, and with the costs of the care for them forecast to soar soon to more than $500 billion, a frenzied race is on for ways to deal with the debilitating cognitive syndromes. But will individual initiative or Big Pharma products matter most for seniors and their loved ones in the days ahead?

Industry analysts and patient advocates alike were stunned when drug maker Biogen reversed itself and announced that it would seek federal Food and Drug Administration approval for aducanumab, which the New York Times reported “is a monoclonal antibody, an expensive type of drug that attaches to specific proteins in order to disable them. The drug clears a key protein in Alzheimer’s disease — beta amyloid — that accumulates in plaques in patients’ brains. Aducanumab is given as an intravenous infusion once a month.”

Biogen had spent heavily on multiple tests of this drug, suddenly pulling the plug on it last spring, declaring with the counsel of an independent advisory board that the prospective prescription medication — and possibly the line of inquiry about beta amyloids and Alzheimer’s that had led to its creation — was a failure.

August 12, 2019

Gun violence is a public health crisis. Research and treatment are needed now.

by Patrick A. Malone

With back-to-back-to-back incidents of mass gun violence killing almost three dozen children, women, and men, can this nation muster the political courage to treat this lethal scourge as a public health menace?

Can it, finally, green light and fund rigorous research that could inform public policies that both could protect Americans’ Second Amendment rights while also reducing the estimated 40,000 or so firearm deaths that occurred in 2018 alone?

For what it is worth, there is considerable and (what should be) convincing evidence that:

August 7, 2019

Loneliness, debilitation, and depression blamed for seniors’ rising suicides

by Patrick A. Malone

The nation’s rising suicide crisis torments seniors, too, with just under one out of five such deaths in 2017 occurring with individuals 65 and older. Men 65-plus, experts say, face the highest suicide risk, while seniors 85 and older, men and women, rank No. 2 in groups most likely to die by taking their own lives.

As the nation grays — 10,000 baby boomers a day turn 65, in a trend that will persist until 2029 — the already high concern about suicide, especially among seniors, is rising, National Public Radio reported.

NPR, noting that suicide already is the 10^th leading cause of death among all Americans, said that experts see loneliness, bereavement, grief, and depression as key factors in cases in which older individuals kill themselves. They find themselves isolated, overwhelmed, and with unending sadness when spouses and friends die. Their children, grandchildren, and other family members often live far away. They also struggle with their lives due to age’s increasing debilitation. As NPR reported:

March 27, 2019

Clinicians are facing up to the preventable harms that ICU’s inflict on many patients in the process of saving lives

by Patrick A. Malone

Doctors and hospitals finally are owning up to and treating mental and physical damages inflicted on some of the sickest and most vulnerable individuals in their care—the 5 million or so patients who get helped in intensive care units, published research shows.

Although ICU patients may get dramatic emergency care that saves them from deadly infections, major disease, and significant accident or injury, experts only recently have begun to recognize and assist them with a condition associated with their stays: post-intensive care syndrome (PICS). A readable new study in the medical journal JAMA says that ICU patients may suffer a “constellation of symptoms” with PICS that hinders their recovery to their pre-hospitalization well-being, including: “muscle weakness, cognitive impairment, depression, anxiety, and post-traumatic stress disorder (PTSD).”

December 21, 2018

As assisted living facilities increase dementia care, resident safety risks rise

by Patrick A. Malone

They look like nursing homes, but they’re not. And for the health and safety of our elderly loved ones, we must know the difference.

These so-called assisted living facilities, operating with much less regulation and oversight than nursing homes, are raising concerns about the safety and quality of their dealings with a growing number of elderly Americans. That’s because they’re full not only of older residents but also difficult — and costly to care for — seniors with dementia.

Jordan Rau, of the independent, nonpartisan Kaiser Health News Service, deserves credit for diving deep into rising complaints and documented harms to residents of facilities “originally designed for people who were largely independent but required help bathing, eating or other daily tasks.” These places, “unlike nursing homes … generally do not provide skilled medical care or therapy, and stays are not paid for by Medicare or Medicaid.”

September 6, 2018

As 2018 season kicks off, college football reckons with head trauma harms

by Patrick A. Malone

College football has kicked off its fall season with a flourish, but the signs are increasing that concerns about players’ health and safety may slash at the game’s size, spectacle, and importance.

Just as the pro leagues were forced to answer in court for the harms that athletes suffer due to repeated blows to their heads, the National Collegiate Athletic Association (NCAA) has been hit with claims in the civil justice system, asserting wrongful deaths of players from the recent past.

Lawsuits, believed to be part of what will be a wave, were filed against the college sports conference on behalf of the survivors and estates of a onetime University of Southern California fullback and a University of California at Los Angeles running back.

August 24, 2018

Millions of teens suffer concussions as experts link head trauma to suicide risk

by Patrick A. Malone

Rigorous researchers avoid leaping to unfounded conclusions, but it’s hard not to look at two separate studies on areas of high current interest and just go “Hmmm ….”

In the first work, experts from the federal Centers for Disease Control and Prevention analyzed available reports and surveys to find that 15.1 percent of American high school students or 2.5 million or so “reported having at least one of these concussions” in the most recent year, while 6 percent reported two or more concussions.

The researchers said:

July 31, 2018

Patients? We’re just profitable bit$ and byte$ to Big Pharma and insurers

by Patrick A. Malone

Big Data may be a business buzzword that puts most consumers into a big sleep, but big alarms are sounding for Americans about Big Brother intrusions into their lives via the collection and analysis of vast amounts of highly personal information. Of course, Big Pharma and medical insurers are at the fore of invasive practices — some of which patient-consumers themselves are helping, likely without knowing they’re doing so.

Millions of Americans may be little aware, for example, that they’re now working for GlaxoSmithKline, a global pharmaceutical conglomerate with $9 billion in revenues in just the most recent quarter. GSK just struck a $300-million deal with 23andMe, the company that has persuaded roughly 5 million consumers to spit in a test tube to get a glimpse of their genetic information, notably information about their ancestry and purportedly some of their genomic health risks.

Firms like 23andMe, with promotions at events like Baltimore Ravens pro football games, also have amassed highly personal genetic and medical data on millions of patient-consumers, promising to protect the information but also offering, casually and by the way, that this vital information could be shared — ostensibly for the betterment of public health.