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« From Denmark | Main | Too Old to Ditch a Plane? »

January 16, 2009 |Permalink |Comments (0)

Power Up Friday

I know what you're thinking out there - you are expecting me to
blog about the new Clive Ballard dementia study on
anti-psychotic safety. Well, okay, but that seems too easy.
Let's see if we can get more creative with it...

First, the study. Just published in Lancet Neurology is Dr.
Ballard's three-year, placebo controlled study of anti-psychotic
use in people with dementia. The results show a doubled
mortality of those on the drugs. After three years, two thirds
of those taking the placebo were still alive, versus fewer than
one third on the drugs.

UK officials stressed the need to use these drugs sparingly, and
recommended further education and research into alternate
approaches. Regular readers know that we've been blogging about
these concerns for some time. So where else can we go with this?

Let's look at an unrelated (?) Associated Press item from
January 8th: A group of federal scientists has filed a complaint
with the Obama Administration about gross misconduct within the
FDA. Ricardo Alonso-Zalvidar writes that the group alleges that
"agency managers use intimidation to squelch scientific debate,
leading to the approval of medical devices whose effectiveness
is questionable and which may not be entirely safe... Managers
have ordered, intimidated and coerced FDA experts to modify
scientific evaluations, conclusions and recommendations in
violation of the laws...and to accept clinical and technical
data that is not scientifically valid." Similar FDA complaints
arose a few years ago during the firestorm surrounding the drug
Vioxx.

So let's take a bit of a leap and put these two news items
together:

To me, this is another indictment of a system where careful
science is overshadowed by politics and pharmaceutical profit
motives. Superimpose this on a society that increasingly "looks
to the pill" to create health and well-being, and it's no
surprise that we have bought into such a wrong-headed approach
to behavioral symptoms of dementia.

There's a way out, but it's not easy. It requires that we
continue working to change our view of aging, and to see people
with dementia not as broken people to be "managed", but as whole
people whose needs are unmet by our current approach to care. It
takes creativity, artistry and compassion to truly get "out of
the box" and accomplish this.

Next week, I'll summarize the new paradigm that can take us out
of this vicious circle.

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