Cartoons for the holidays I

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Dementia rates are dropping

According to a new study by the National Institute on Aging, the dementia rate in Americans 65 and older fell by 24 percent over 12 years. In 2000, people received a diagnosis of dementia at an average age of 80.7; in 2012 the average age was 82.4. Nobody knows why.

The study was nationally representative. That is, it included all races, education, and income levels. The study included 21,000 Americans 65 and older who participate in the Health and Retirement Study which regularly surveys people and follows them as they age. To assess dementia, participants are asked, among other things, to recall 10 nouns immediately and after a delay, to serially subtract seven from 100, and to count backward from 20.

Researchers were surprised about these results, especially given the increase in diabetes, which supposedly increases the risk of dementia. The study also reaffirmed another finding: that those with more education were less likely to develop dementia than those with less. But here’s what I love: compared with people of normal weight, overweight and obese people had a 30 percent lower risk of dementia.

Four to five million Americans develop dementia each year. It is the most expensive disease in America, costing up to $215 billion a year, surpassing heart disease at $102 billion and cancer at $77 billion.

I would hate to take the test for dementia. I’m not sure I could easily subtract seven from 100, and on down, or even remember 10 nouns. However, I’m quite certain I can count backward from 20. I’m thinking I might start practicing with the words and subtraction so I can ace the test.

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More bad pharma behavior at home and abroad

An executive at Valeant, a major pharmaceutical company, and the head of a mail order pharmacy called Philidor RxServices have been secretly enriching each other: the Valeant guy steered his company’s products through Philidor and Philidor altered prescriptions such that Valeant’s brand name drugs were dispensed instead of a cheaper generic drug. What’s more, at least 90 percent of the drugs Philidor dispensed were those sold by Valeant. The Valeant guy got about $30 million from this maneuver. He gave $10 million to the Philidor guy. Of course, it was more complex than this, but this outline is true.

Meanwhile, in China, GlaxoSmithKline, another big pharma company, was nailed for fraud and bribery. The company has been charged with giving kickbacks to doctors and hospital workers who prescribed its medicines. It was also pitching drugs for unapproved uses and bribing regulators with money and gifts. In one scheme, Glaxo funneled cash through a network of 700 travel agencies and consulting firms to bribe doctors and workers at government-owned hospitals. By the way, both Eli Lily and Pfizer have also been bribing doctors in China. In the past China had been looking the other way. Now it’s no more Mr. Nice Guy.

I regularly scan the business pages of The New York Times just to see what’s going on. The above two stories are recent. But stories like these involving big pharma appear on a regular basis. So I ask myself, are drug companies worse than others from an ethical/moral standpoint? It seems that they are. I don’t know the reason for this unless it’s that the culture of drug companies is one of greed and deceit.

I hope you don’t depend on life-saving drugs. It’s nice to just say no.

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LDL and HDL: Neither good nor bad; just doing their jobs

I’ve just finished watching a French-made, feature-length documentary called, in English, “Cholesterol Capers: The Damaging Lunacy of theDiet-Heart Hypothesis.”   (It has English sub-titles, in case you’re wondering.)  It’s mostly about debunking the notion that saturated fat and cholesterol cause heart disease.

Anyhow, I liked the way one of the French scientists discussed HDL and LDL—the supposed “good” and “bad” cholesterol, respectively. In the first place, HDL and LDL are not types of cholesterol, which, by the way, is a sort of alcohol. They are lipoproteins: packages that carry fats, cholesterol, and proteins to and from the liver to various organs. The term density refers to the proportion of protein in the packages. The less protein, the more fats and cholesterol (low density lipoprotein or LDL); the more protein, the less fats and cholesterol (high density lipoprotein or HDL). The scientist in the film described the lipoproteins as “little submarines”. 

The liver produces both LDL and HDL. LDL is the little submarine containing cholesterol, fats and protein that carries its cargo to the organs (cells) that need it. Sometimes a cell will have too much cholesterol. To handle this problem, the little HDL submarine shows up and picks up the unwanted cholesterol as well any other excessive materials and takes it to the liver. This is why LDL (the cholesterol delivery submarine) is considered “bad” and the HDL (the cholesterol collection submarine) is considered “good.”

But, as the scientist says in the film, “To show how this story of good and bad cholesterol is absurd,” picture the liver a hospital and an organ as the scene of an accident. The ambulance going to the accident would be considered bad, while the ambulance going to the hospital would be considered good. Both, of course, are necessary. What's more, new research has shown that people over 60 with the highest levels of LDL lived the longest.

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