Mammograms Being Pushed on Elderly Women With Alzheimer’s

February 5, 2010

Natural News

By Sherry Baker

Here’s a story about the mammography industry that sounds almost too crazy — and too greedy — to be true. But the facts are documented in a new study by University of California at San Francisco (UCSF) researchers. It turns out that unneeded, expensive mammograms are being pushed on elderly women who are incapacitated from Alzheimer’s disease or other forms of dementia, especially if the women have savings or assets of $100,000 or more.

The study, which was just published in the January edition of American Journal of Public Health, used 2002 data from the Health and Retirement Study, an ongoing national prospective study sponsored by the National Institute on Aging that is investigating the relationship between health, income, and wealth over time. The researchers were able to document screening mammography rates by compiling information from Medicare claims.

When they looked closely at the mammogram history of 2,131 elderly women with severe cognitive impairment, the research team found nearly 20 percent received mammograms (compared to 45 percent of women with normal mental status) — even though these women were unlikely to live three more years and mammograms are not indicated for women with a life expectancy of five years or less. However, the rate of mammograms ordered for elderly women with severe dementia went up dramatically if they were married and the couple still had tens of thousands of dollars in assets. In fact, the rate of unnecessary screening mammography for seriously cognitively impaired women soared to nearly 50 percent if they were still married and the couple’s net worth was $100,000 or more.

It’s important to note that the women who were studied were given mammograms not because a suspicious lump had been detected during a physical exam. Instead, these dementia patients were subjected to screening mammography to see if any hidden masses could be spotted that were not causing any symptoms but could possibly cause problems in the future.

Geriatrics researcher and lead author Dr. Kala Mehta pointed out in a statement to the press that “a woman must have a life expectancy of at least four to five years,” for a mammogram to possibly do any good; whereas, the severely cognitively impaired women in this study had a life expectancy of only 3.3 years on average. “Otherwise,” she stated, “the potential harms are likely to outweigh the benefits.”

What are those harms, specifically? Dr. Mehta lists them as invasive follow-up tests such as biopsies in women who don’t have the mental capacity to know what is going on and surgery for asymptomatic lumps that would almost certainly never cause any problems for these women in their lifetimes. What’s more, all this unneeded and expensive medical intervention diverts time and money away from the daily needs of women with profound dementia. Bottom line: unnecessary mammograms can cruelly rob these women of whatever quality of life they have left.

The study authors concluded that screening mammography guidelines should be enforced that explicitly recommend against screening severely cognitively impaired older women. “I don’t think most people would say that putting a very demented older woman through screening mammography is a good thing,” stated principal investigator Louise C. Walter, MD, an associate professor of medicine at UCSF, in the press statement.

Click here for  the full report

Over 65 Waiting Longer for Flu Vaccine

November 23, 200

New York Times

By Donald G. McNeill Jr.

Life is unfair. Or, at least, it sure can look that way.

For example, consider this: Who of these four is first in line for a swine flu shot:

1. A great-grandmother in a nursing home with lung problems?

2. A hospital cafeteria worker being treated for AIDS?

3. An overweight department-store Santa with a line of children waiting for his lap?

4. A healthy Wall Street banker whose trophy wife is pushing a new baby in a $600 Bumbleride jogging stroller?

Answer: The banker.

Normal flu seasons have accustomed Americans to an “old people first” ethic, but swine flu has reversed that. It’s pregnant women and children first, and in the rush for the lifeboats, elbows are beginning to fly.

Mostly, as in any panic, confusion has reigned. Older people are still first in line for seasonal flu shots, but all the media attention has been on swine flu. Both kinds of shots are in short supply. More swine vaccine is being made, but slowly. All the seasonal vaccine has already been made — but much of it was taken up by middle-aged people who didn’t know one shot from another and bared their arms for any available needle.

Now that the health authorities are cracking down on the swine flu vaccine and real triage has begun, some older Americans are finding the new realities pretty harsh. Breathing problems and heart conditions are common among people over 50, and some have been calling their Congressmen to complain. Those older Americans and their advocates point to studies indicating that elderly people rarely catch swine flu but, when they do, their outcomes are just as grim as they are for seasonal flu, which kills 36,000 mostly elderly people a year.

“We’re not used to this in the U.S.,” said Jeffrey Levi, executive director of Trust for America’s Health, a nonpartisan group that works to prevent epidemics, and who testified before Congress last week, essentially defending the Centers for Disease Control and Prevention’s choices. “When there’s a limited supply of a scarce resource, you have to give it to those who are most at risk and who will benefit the most.”

So why the banker? He gets the shot not for his sake — many Americans would be pleased to see him roast on a spit — but to save his baby. Infants under six months old are at very high risk but too young for a flu shot.

The hospital employee does not have direct patient contact; if he is taking his anti-AIDS drugs, his immune system is not suppressed. And even if Santa is morbidly obese — though that could create a lap problem — he is presumably over 18.

And the great-grandmother? She was born before 1957, probably caught H1N1 flus several times growing up, and may still have protective antibodies. True, if she is unlucky enough to catch swine flu anyway, she is at risk. But public health is a numbers game and her probability is low. Also, flu shots don’t protect the aged well, since their immune systems may be too weak to build new antibodies. Studies suggest it is more effective to inoculate their nurses and visitors.

On the AARP Web site, some people are complaining. “I’m 70 and my wife is 69 and we are last on the list for H1N1. I thought there was no death panels,” wrote one.

But Dr. J. T. Howell, a geriatric specialist in Bucks County, Pa., said most of his older patients were taking their back-of-the-line status in stride.

Click here for the full report