FDA says – Ask yourself, your doc: Should I take drugs for #osteopenia, #osteoporosis or bone loss?

Twelve years ago, a Boston Globe story raised doubts some Canadian researcher had about bone scans for the diagnosis of osteoporosis. It was a scary story to write.  Doctors, some patient advocacy groups, researchers and drug makers were enthusiastic about the new-found ability to measure bone density and the development of bisphosphonates like Fosamax to treat it.  Osteoporosis was under-treated, they said. Still, it seemed the concerns needed to be explored.

Now comes this from the FDA, which rarely uses The New England Journal of Medicine as a forum .

The long-term safety and efficacy of bisphosphonate therapy for osteoporosis are important concerns for the Food and Drug Administration (FDA). In response to postmarketing reports of rare but serious adverse events associated with bisphosphonates, such as atypical femur fractures, osteonecrosis of the jaw, and esophageal cancer, the FDA performed a systematic review of long-term bisphosphonate efficacy. The findings, summarized here, were presented at a joint meeting of the FDA Advisory Committee for Reproductive Health Drugs and the Drug Safety and Risk Management Committee.1 The committees jointly recommended that bisphosphonate labeling be updated, although there was consensus that the data did not support a regulatory restriction on the duration of drug use.

• More here from a Globe forum

• Click here for the NYTimes story on the FDA publication:

In an unusual move that may prompt millions of women to rethink their use of popular bone-building drugs, the Food and Drug Administration published an analysis that suggested caution about long-term use of the drugs, but fell short of issuing specific recommendations.

• Here is the 2000 story from The Boston Globe: 

Specialists differ on the value of tests for bone density

By Tinker Ready Globe Correspondent 4//25/00

When Winchester gynecologist Robert Shirley does an ultrasound bone scan of a patient’s heel, the news he delivers  is often less than comforting.      Based on the heel scan, which measures bone density in the foot, Dr. Shirley diagnoses 1 in 3 of his older patients with either osteoporosis or osteopenia, the bone-thinning disease that is common in aging women and
also affects some older men.

“It’s a very helpful tool to make them realize that osteoporosis is real, and they need to think about it,” said Shirley.

Certainly, few women will fail to take notice when they hear they have a disease that may lead to brittle bones, a hunched back or “Dowager’s hump,” and painful, disabling fractures. As frightening as the diagnosis sounds, however, it does not always lead to serious fractures _ the most severe of which is  hip fracture _ and the bone scan itself cannot  accurately predict who will get hip fractures, or even fully measure bone strength.       Still, osteoporosis is now defined by bone density, even though density only accounts for about 70 percent of bone strength. Other factors _ such as the actual shape, structure and size of a bone, and the presence of tiny cracks know as “microdamage” _ seem to factor in as well.       But these things are not measured by bone scans. And, when it comes to hip fractures and the elderly, a person’s risk of falling seems to play as much of a role in fracture risk as does bone density.

So, when a group of scientists convened by the National Institutes of Health met for three days in late March to review the most current data on the diagnosis and treatment of osteoporosis, they declined to endorse the bone scan as a screening test for osteoporosis. In its March 29 consensus statement, the panel noted that the risks for osteoporosis _ as reflected by low bone density _ and the risks for fracture, overlap but are not identical.

In addition, the panel expressed concern that different bone scanning devices and techniques produce conflicting results. A committee of scientists is working on a plan to standardize the tests, but right now, an ultrasound bone scan of the heel might indicate osteoporosis, while an x-ray scan of the spine may not. And even though bone loss can accelerate at menopause, tests in women under the age of 60 are particularly weak at predicting hip fractures.

“There are other things outside of bone density that we may want to measure to better improve our prediction of fracture risk,” Mary Bouxsein, an instructor in the Orthopedic Biomechanics Laboratory at Beth Israel Deaconess Medical Center told the panel.

This is in stark contrast to what many doctors and advocacy groups say about bone scans and osteoporosis. Many see the disease as a silent epidemic that goes undiagnosed in millions of women.  The National Osteoporosis Foundation cites an alarming list of statistics to drive that point home: 28 million people either have the disease or are at risk, and half of all women will suffer a fracture of the spine, hip or    wrist during their lifetime.

The group recommends bone scan screening for all women over 65, has lobbied Medicare to cover the test, and is now pushing for mandatory private insurance coverage.

Bone scans are not perfect, but they are the best tool available to identify women with the disease, said Conrad Johnston, director of the Bone Studies Laboratory at Indiana University, who is the current president of the National Osteoporosis Foundation.

“Everybody who has high cholesterol doesn’t have a heart attack, and everyone who has low bone mass doesn’t have a fracture.   But for many women, he said, “low bone density is the single best predictor of who will    fracture.”

So should women just ignore this? The pharmaceutical industry certainly isn’t. The makers of bone building drugs are active in promoting bone scans. Merck, which makes Fosamax, recently ran ads in magazines like Good Housekeeping and Parade encouraging healthy women to seek testing. Warning that undiagnosed osteoporosis can lead to broken bones or the disfiguring Dowager’s hump, the ad equates the simple, painless bone density test with mammography to detect breast cancer.

Osteoporosis is serious business for many who have it. According to the National Osteoporosis Foundation, the disease causes 1.5 million fractures annually, about half of them in the spine. Spinal fractures can cause a range of symptoms; some people may feel nothing at all, others may have back pain, and yet others may develop the Dowager’s hump.      The scientific data on the incidence and severity of spinal fractures is incomplete. But, all agree that the hip fracture, which strikes about 300,000 people per year in their 70s and 80s, can be a devastating and sometimes deadly event.  About 30 percent of older people who fall and break a hip end up in a nursing home.      Bone density contributes to hip fractures, but so does a long list of other factors including age, low body weight, smoking, mobility, exercise habits, and poor eyesight, which can make someone more vulnerable to falls, says Dr. Arminee Kazanjian, the director of the British Columbia Office of Health Technology Assessment.

After reviewing years of research into bone mass and fracture, her agency released on of the most scathing critiques on the use of bone scans. It concluded that as many as 70 percent of the women who eventually break a hip will not be diagnosed at menopause with osteoporosis, if that diagnosis is based on a bone scan alone. And, only half of the 30 percent of women identified as having osteoporosis or osteopenia will go on to have a fracture.

“The important health outcome is bone fracture,” said Kazanjian. “Bone mineral density is a minor factor. Any other combination of factors is much more important.”  Rather than rely on the bone scans alone to diagnose osteoporosis,    Kazanjiam and others suggest that doctors focus on the other factors that contribute to fracture risk.     For example, a woman with low bone density, but who doesn’t smoke (which contributes to thinning bones) and has good eyesight, may be less likely to break a hip than a woman with high bone density who uses a walker and has a family history of fractures, she said.
Amy Allina of the National Women’s Health Network, a Washington,  D.C.-based advocacy group, says that women who are told they don’t have  osteoporosis based on a bone scan alone may not take steps to prevent the  falls that cause hip fractures, even though they may be at risk. And those  whose bone scans indicate that they have osteoporosis may spend years on medication, even though they may never have broken a bone.

That’s a problem, Allina said, because the treatments for osteoporosis themselves come with risks. Hormone replacement therapy, which millions of women take to both treat and prevent osteoporosis, can increase a woman’s odds of developing breast cancer. And Fosamax, a non-hormone drug that builds bone,  irritates the throat and its long-term effects are unknown.

A 1993 decision by a World Health Organization panel set the stage for the bone scan to inadvertently become a routine diagnostic test for osteoporosis. The panel established a scale _ based on the average bone density of a premenopausal woman _ that allows doctors to measure bone loss, diagnose osteoporosis, and establish fracture risk.     The average 55-year-old woman has a 15 percent chance of breaking her hip someday. If her bone density is 1 point below the WHO average, she is defined as having osteopenia, a level of bone thinning that increases the lifetime risk of hip fracture by 20 to 45 percent. Osteoporosis is diagnosed when bone density falls 2.5 points below the WHO average. This, by some measures, raises the risk of hip fracture to greater than 45 percent.         Brigham and Women’s Hospital in Boston recently produced a detailed set of osteoporosis diagnosis and treatment guidelines for its patients and doctors. The guidelines don’t endorse bone scans to be used as screening tools alone, but they advise doctors to recommend bone scans to all women over the age of 65.
Dr. Robert Barbieri, chairman of the Department of Obstetrics and Gynecology at Brigham and Women’s, sees the bone scan as a useful tool but  he emphasized that a diagnosis of osteoporosis should not be based on the test alone. He says he is confident that doctors are considering other factors when assessing a patient’s bone strength and risk of a fracture.
“They use history and physical exams and laboratory tests in an integrative way and pull them all together,” he said.

But Mark Hefland, a researcher at the Oregon Health Sciences University, told the NIH pane that doctors are relying too heavily on bone scans, even though many of them admit that they don’t understand how bone scan scores relate to fracture risk.

“However we may like it, this is how diagnosis is occurring in everyday practice,” said Hefland, the director of the school’s Evidence-Based Practice Center.

Dr. Shirley of Winchester says he relies on bone scans to diagnose osteoporosis, but said that he also spends a lot of time with patients talking about fracture risk and alternatives to drug therapy like increasing weight-bearing exercise and boosting calcium intake.     But according to Diane Saparoff, who runs a monthly support group for women with osteoporosis at the Jenks Senior Center in Winchester, Dr. Shirley’s approach differs greatly from that of other doctors.

“Many of  the doctors order these tests but there is no follow up,” she said. The
doctors often don’t explain the test scores or help women come up with a fracture prevention plan, she said. “They just throw Fosamax at them.”

Dr. Johnston of the National Osteoporosis Foundation acknowledges that some doctors may be relying too much on bone scans to diagnose
osteoporosis. “I think that’s probably happening but it shouldn’t be,” he said. “This is a reasonably new area. Bone mineral measurements have only been around for about 10 years. Its takes a while for people to get up speed.”

Report lists ways to avoid injuries

A recent report from the National Institutes of Health offers advice on how to build and maintain strong bones:

*Get adequate calcium and vitamin D both early in life and throughout adulthood.

* Engage in regular exercise; it contributes to the development of peak bone mass and may reduce the risk of falls in older individuals.

*As needed, use drugs that enhance bone mass; medications have been been shown to reduce the risk of osteoporotic fractures.

In addition to regular exercise, there are several steps seniors can take to avoid falls, according to the National Center for Injury Prevention and Control:

* Use non-slip rugs and bath mats. Put grab bars in the  bathroom and handrails on the stairs.

* Ask your doctor to review medicines that may cause drowsiness or
confusion when combined with others you may be taking.

*Stay current with eye exams.

–Tinker Ready

This story ran on page D01 of the Boston Globe on 4/25/2000.

TedMed2012: Alzheimer’s research and a”ticking time bomb” from Brandeis

Say what you will about TED talks, they do offer an impressive list of speakers. TEDMED is underway in DC. And while the organization’s own site features more videos about parties than talks, you can find a nice post here about what two local researchers had to say.  From Chemical and Engineering News

Gregory Petsko knows why he came to TEDMED. “I’m looking for Al Gore,” he told me flat-out over lunch. Folks who know Petsko know the former Brandeis University biochemistry department chair isn’t one to mince words. And he’s nailed the reason why an academic might want to look outside traditional conferences and soak up some of the TEDMED aura. He’s looking for a charismatic champion to take up a biomedical cause: in Petsko’s case, it’s support for research in Alzheimer’s disease.

Petsko and Reisa Sperling, director of the Center for Alzheimer’s Research and Treatment at Brigham and Women’s Hospital, talked about Alzheimer’s at TEDMED on Wednesday. Both talks were cast as calls to action. Just consider the introduction Petsko got from TEDMED chair and Priceline.com founder Jay S. Walker: “This is a man who hears a bomb ticking.”

New fitness and exercise blog on the Globe web site

The Globe has added another health blog — this one on fitness:

Elizabeth Comeau is the senior health & wellness producer at Boston.com. She will be blogging about her personal fitness journey and using a device called a FitBit to track her weekly goals and progress (see below). Follow her journey and share your own. Read more about Elizabeth and this blog.  

Bring on the user-generated content. Pairs up nicely with CommonHealth’s “Why to Exercises Today” series.

We’ve added it as a link, along with another for  WBUR’s Healthcare Savvy:

What is Healthcare Savvy?

We are a community of patients who are starting to shop for health care based on quality and cost.        Have you thought about whether you are getting the best care for the best price?        Share your experiences. Read about ours. Post a tip or a resource. Ask questions! Browse at your leisure. Join anytime by registering.

MIT science news tracker accuses NY Times of “trashing” yoga #altmed #yoga

More discontent about reporting on alternative approaches to wellness.

Paul Raeburn – who discloses that he’s been practicing yoga for a dcade — writes:

The magazine excerpt notes, in the setup near the top, that “Among devotees, from gurus to acolytes forever carrying their rolled-up mats, yoga is described as a nearly miraculous agent of renewal and healing.” That makes the criticism easy. It’s much easier to argue that yoga is not nearly miraculous than to discuss the risks and rewards, which would likely have resulted in a more accurate story.

We then hear about a yoga student who had trouble walking after remaining in a particular yoga position “for hours a day.” Well, sitting in an office chair for hours a day has adverse health consequences, too. Is Broad demolishing yoga on the basis of the experiences of a fanatic?…

You make the call. From the Times:

After class, I asked (instructor Glenn)  Black about his approach to teaching yoga — the emphasis on holding only a few simple poses, the absence of common inversions like headstands and shoulder stands. He gave me the kind of answer you’d expect from any yoga teacher: that awareness is more important than rushing through a series of postures just to say you’d done them. But then he said something more radical. Black has come to believe that “the vast majority of people” should give up yoga altogether. It’s simply too likely to cause harm.       

Not just students but celebrated teachers too, Black said, injure themselves in droves because most have underlying physical weaknesses or problems that make serious injury all but inevitable. Instead of doing yoga, “they need to be doing a specific range of motions for articulation, for organ condition,” he said, to strengthen weak parts of the body. “Yoga is for people in good physical condition. Or it can be used therapeutically. It’s controversial to say, but it really shouldn’t be used for a general class.”

Lack of autopsies = missed medical errors: a Pro Publica investigation

This story notes that “when patients were autopsied, major errors related to the principle diagnosis or underlying cause of death were found in one of four cases. In one of 10 cases, the error appeared severe enough to have led to the patient’s death.”

So, it is bad news that all of the New England states report low autopsy rates in cases of unexpected deaths. Personally, it’s sad that NC also reports a low rate.  The Raleigh News & Observer  did a similar same story in 1995.

Without Autopsies, Hospitals Bury Their Mistakes

by Marshall Allen ProPublica, Dec. 15, 2011, 12:36 p.m.by Marshall Allen, ProPublica, Dec. 15

When Renee Royak-Schaler unexpectedly collapsed and died on May 22, no one ordered anautopsy.

Not the doctors at Howard County General Hospital in Columbia, Md., where the 64-year-old professor and cancer researcher was pronounced dead.

Not the Maryland Office of the Chief Medical Examiner, which passed on the case because no foul play was involved.

And not Royak-Schaler’s physicians at Johns Hopkins University School of Medicine who had diagnosed cancer in her hip two days beforehand but acknowledged they didn’t know what had caused her unforeseen death.

A half-century ago, an autopsy would have been routine. Autopsies, sometimes called the ultimate medical audit, were an integral part of American health care, performed on roughly half of all patients who died in hospitals. Today, data from the Centers for Disease Control and Prevention show, they are conducted on about 5 percent of such patients.

As Royak-Schaler’s husband, Jeffrey Schaler, discovered, even sudden unexpected deaths do not trigger postmortem reviews. Hospitals are not required to offer or perform autopsies. Insurers don’t pay for them. Some facilities and doctors shy away from them, fearing they may reveal malpractice. The downward trend is well-known — it’s been studied for years.

What has not been appreciated, pathologists and public health officials say, are the far-reaching consequences for U.S. health care of minuscule autopsy rates.

Diagnostic errors,which studies show are common, go undiscovered, allowing physicians to practice on other patients with a false sense of security. Opportunities are lost tolearn about the effectiveness of medical treatments and the progression ofdiseases. Inaccurate information winds up on death certificates, undermining thereliability of crucial health statistics.

It was only because of Royak-Schaler’s connections that her case ended differently. Her colleagues at the University of Maryland School of Medicine urged her husband to authorize an autopsy and volunteered to conduct it for free.

In her case, as in so many, the autopsy revealed a surprise: Royak-Schaler, the renowned cancer researcher, had cancer ravaging her body — in her lungs, kidneys ,abdomen and the marrow of her bones. A blood clot, likely related to thetumors, caused her sudden death.

Jeffrey Schaler has wrestled with anger that his wife wasn’t diagnosed sooner but said knowing how she died was better than not.

“There’s a sense of peace that accompanies that knowledge,” he said.

For the last year, ProPublica, PBS “Frontline” and NPR have probed America’s deeply flawed system of death investigation [1], focusing primarily on forensic autopsies, which are conducted by coroners’ offices and medical examiners when there is suspicion of an unnatural death. State laws vary, but the preponderance of deaths that occur in hospitals are considered natural. Whendeaths are unexplained, unobserved or within 24 hours of admission, hospitalsmay be required to report them to local coroners or medical examiners, but such  agencies rarely take hospital cases.

Did news reports miss the message on IOM breast cancer/environment study?

Earlier this week, we cast this IOM study as offering little new news.  But, as Julia Brody of  The Silent Spring Institute points out, that’s not quite true.  From the environmental Health News website:

…(M)ost of the news media missed the significance of the assessment on environmental chemicals. The real news is that the report is an authoritative statement that a cascade of scientific evidence plausibly links consumer product chemicals and pollutants with biological activity suggesting breast cancer risk.

Instead of saying what is in the report, glass-empty stories said that the IOM “failed” to “definitely” link any chemicals to breast cancer or find “clear” environmental links. Some incorrectly said the report tells women to stop worrying about consumer product risks. These stories ignore the report’s important explanation that definitive evidence is not attainable and lack of human evidence of harm doesn’t mean something is safe.

From original NYTimes story on the report:

The report, 364 pages long and two years in the making, was issued on Wednesday by the Institute of Medicine, an independent group that is part of the National Academy of Sciences and advises the government and public. The work was done by a committee of 15 outside experts, mostly from universities, and nine institute staff members. The sole sponsor was a breast cancer advocacy group, Susan G. Komen for the Cure, which requested the report and spent $1 million on it.

For women who were hoping for definitive safety information about the huge number of chemicals to which people are exposed — from air pollution and cosmetics to cleaning products, food and drinking water — the report may come as a disappointment. It is based largely on a review of existing research, and its limited advice reflects the lack of solid scientific information in many areas of concern to the public.

Women should take note on Cape Cod, where the breast cancer rate is higher than average.  The Silent Spring Institute, one of the few groups doing research on environmental links to breast cancer, recently reporting finding 27 chemicals in well water on the Cape.

The 27 contaminants detected included 12 pharmaceuticals (the most common being one antibiotic and one epilepsy drug); five perfluorinated chemicals (found in non-stick and stain-resistant household products); four flame retardants; two hormones; one skin care product; one artificial sweetener; one insect repellent; and one plastics additive. Health-based guideline values were available for only four detected chemicals (PFOS, PFBS, DEET, carbamazepine), and no samples approached or exceeded these values. The most frequently detected chemical was acesulfame, an artificial sweetener, which was found in 85 percent of wells, and perfluorinated chemicals were detected in 70 percent of wells.

“While the levels of pharmaceuticals, flame retardants, and other emerging contaminants in drinking water are not currently regulated, we still think that it is prudent to find ways to prevent discharges from septic systems and wastewater treatment plants from impacting drinking water supplies, as we don’t fully understand the potential health impacts,” lead investigator Laurel Schaider said.

For more on health and the Massachusetts environment see  SSI or the Massachusetts Environmental Public Health Tracking (MA EPHT) Program Website

This website is designed to provide you with access to current and accurate health and environmental information available for Massachusetts. You can use Massachusetts Environmental Public Health Tracking (MA EPHT) information to learn about the health of your community and access information about your environment.

 

 

 

 

Globe, WBUR on Alzheimer’s disease

Both The Globe and WBUR have had recent series on Alzheimer’s disease.

On Sunday, the Globe ran the last of a four-part, year-long series on a family coping losing their patriarch to early stage Alzheimer’s.

Bruce Vincent sits at a table in a stark room at Massachusetts General Hospital’s Charlestown research center, just a few minutes into what will be an hourlong test of his fading memory.

“Next, I will read you a list of words,’’ says research assistant Natacha Lorius, who sits across the table from him. “I need you to repeat the words back to me, in any order.

Suds, noose, spree, proxy, simile, nectar,’’ she says, reading slowly from a list of about 15 words.

When she finishes, Vincent, still raven haired and nearly wrinkle free at 49, stares at her for several seconds.

“I don’t remember any of them,’’ he says.

Alzheimer’s has recently quickened its devastating pace, snatching from Vincent more social skills and abilities than it had since his diagnosis three years earlier. He has a form of the disease that strikes at a young age.

Gone in the latest slide is the easy back and forth of conversation, the ability to sort and price products at the family’s Westminster grocery store that he once ran, and his recall of words, and sometimes entire conversations, from a few minutes earlier. Often he hovers, almost childlike, looking for direction in everyday tasks such as serving salad from a bowl to a dinner plate.

When Vincent shoveled his driveway after the snowstorm last month, he inexplicably walked dozens of yards to the backyard to empty each scoop, instead of simply tossing the snow to the side.

As the disease accelerates, Vincent’s family treasures all the more the bedrock pieces of his personality that remain — his optimism, his gentle nature, and especially his boyish humor.

“If I didn’t have Alzheimer’s,’’ Vincent confided after completing the memory-testing session, “that would have been a blast.’’ 

Best in the biz in new book on medical errors

We’re saps for top ten lists, even though we find the gimmick annoying. But, we are big fans of Joe and Terry Graedon. We’ve been following both the print and radio versions of “The People’s Pharmacy” since our days in the NC’s Research Triangle. They offer solid advice about meds
and also know the difference between quackery and home remedies. And where else
can you get Milk of Magnesia deodorant?

So we can forgive all  18 top ten lists in their new book “Top Screwups Doctors Make and How to Avoid Them.” Joe Graedon believes his mother’s 1996 death was caused by medical errors at Duke Hospitals. But, instead of suing, he tells the tale of how he and his partner/wife worked with Duke to improve care. They describe it as a “slow and frustrating” process, but think that Duke Hospital is now a safer place.

So, we offer this link and note the Boston contributors to the book. They include Harvard’s Jerry Avorn and David Bates, the head of The Center for Patient Safety Research and Practice at the Brigham.  Also contributing, couple of the best sources on drug safety around – Curt Furberg of the Wake Forest School of Medicine and Thomas Moore of the Institute for Safe Medicine Practices.

We refer you to these Demon Deacons and the Blue Devils with one caveat: Go Heels! We’ve got a UNC grad/NC native in the family. So, while he’s a Tar Heel born and a Tar Heel bred, here’s hoping that medical mistake will never render him Tar Heel dead.

Tweets from Boston meeting on health, the Internet and mobile communication

Check out #chs11 f for tweet from the Connected Health Symposium in Boston. Each year, Partners sponsors this meeting to look at how the Internet and mobile communication are changing the health care system.  Here’s a link to the Tweetstream and a few samples below from a session on social networking and health.

“	RT @MGHDiabetesEd: “online patient communities can increase engagement, decrease isolation.” #chs11
	jillplev October 20, 2011

“	@taracousphd at #SoMe panel at #chs11: 35% of young people search for #healthcare informaton online
	sonnyvu October 20, 2011

“	Giving patients the choice to use an alias-based identity on social networks is a key way to address privacy concerns #chs11
	dsgold October 20, 2011

“	@dsgold How so? Alias identity does not equal unidentifiable, does it? I’d be concerned this is a false sense of security. #chs11
	Dermdoc October 20, 2011

“	Facebooking health @taracousphd facebook campaigns have huge opportunity for reaching teens, can use it for health literacy #chs11
	connectedhealth October 20, 2011

“	@lisagualtieri : There are credit #literacy programs for teenagers, why not more health literacy ones? #chs11
	sonnyvu October 20, 2011

“	We need to be inter-generational in our social media “prescription” including seniors as well as youth #chs11
	pamressler October 20, 2011

“	Social media can help make a disease more than just a disease for teens @drjosephkim #chs11
	connectedhealth October 20, 2011

“	@drdannysands telling about how he prescribed acor to @epatientdave & it save his life #chs11 #s4pm
	pjmachado October 20, 2011

“	Next up, Facebooking Health moderated by my wonderful #TUSM colleague @lisagualtieri #chs11
	pamressler October 20, 2011

“	@meyouhealth Chris Catter shows first ever social graph to visually render well-being among participants in social networks #chs11
	dsgold October 20, 2011

“	CDC traditional data tracked same as social media during H1N1 #chs11
	pamressler October 20, 2011

“	should MDs, nurses, etc recommend online pt communities? -yes! #chs11
	ICherryBlsm October 20, 2011

Are fears of Alzheimer’s overblown?

Margaret Morganroth Gullette’s op-ed in last week’s NYTimes dared to suggest that our fears about Alzheimer’s
may be overblown.  The Brandeis-based writer said:

 The mere whiff of perceived memory loss can have terrible consequences in an insecure economy in which midlife workers are
regularly (and illegally) laid off on account of their age. This epidemic of anxiety around memory loss is so strong that many older adults seek help for the kind of day-to-day forgetfulness that once was considered normal …Greater public awareness of Alzheimer’s, far from reducing the ignorance and stigma around  the disease, has increased it.

Today’s letters to the editor included several outraged responses

Having witnessed the disease firsthand, I can truly say there is something worse than death…I truly hope that Margaret
Morganroth Gullette and those she loves never experience the disease as my family has. I implore her not to use her public platform to minimize the horror that is Alzheimer’s.

But, Douglas Powell, described as the author “The Aging Intellect” and a psychology instructor at the Harvard Medical
School, came to her defense

Studies that followed up mildly impaired elders for three to five years found that a large minority remained stable and about 14 percent returned to normal. No one yet knows why.