Sunday 27 October 2013

Are statins being overprescribed?


I was shocked to be told by a pharmacist that there's an 'unwritten principle' that everyone over 60 should be put on statins.  I know that statins have a number of possible side-effects, including memory loss (as I've mentioned previously).

A few days after my conversation with the pharmacist, I read this article:

http://www.theguardian.com/lifeandstyle/2013/oct/22/butter-cheese-saturated-fat-heart-specialist

For those who may not have time to read the article, this extract will give you a flavour:

"In the UK eight million people take statins regularly, up from five million 10 years ago," he writes. "With 60 million statin prescriptions a year, it is difficult to demonstrate any additional effect of statins on reduced cardiovascular mortality over the effects of the decline in smoking and primary angioplasty [a technique used by doctors to widen the arteries].
In the original trials carried out by drug firms, only one in 10,000 patients given statins suffered a minor side-effect. But among 150,000 patients in a "real world" study – people who had been routinely given statins by their GP – 20% had side-effects that were so unacceptable to them that they stopped taking the pills, including muscle pains, stomach upsets, sleep and memory disturbance, and erectile dysfunction."
Naturally the medical and pharmaceutical establishment disagree, but it's possible that the tide is starting to turn in favour of a more cautious approach to the prescription of 'statins for all'.

Oct 28th:  I'm adding to this post because I have learned that the British Medical Journal has come out against 'statins for all' (in this case, all over 50).  This article seems to me to explain the debate very clearly:

http://www.bmj.com/content/347/bmj.f6412

Thursday 24 October 2013

'Robotic' but useful behaviour

My wife sometimes behaves like a robot.  And I'm glad she does.

For example, we live in a Victorian house with steep stairs and no downstairs loo. We've had an extra handrail fitted and she manages the stairs pretty well.  I always set off down the stairs and remind her to follow me down.  Every so often, I realise after a couple of steps that she isn't following.  Invariably I find that her clothing has caught on the new narrow handrail.

Now what would be even better would be if she could tell me about the problem but, failing that, this seems to be the next best thing and it reminds me so much of video you see of robots encountering obstacles.

Similarly, she sometimes sits down unexpectedly, when we are out walking.  Sometimes because she is tired or because I'm hurrying her (which is always best avoided).  But she always sits down very, very carefully and seldom comes to any harm, much as a robot might be expected to do.

I don't know whether other people with dementia do this, but I'm glad she does.

Thursday 17 October 2013

Medication frustration

There's a post today from the Alzheimer's Society: http://forum.alzheimers.org.uk/showthread.php?63405-Statin-found-to-prevent-memory-problems-caused-by-surgery

Apparently, the commonly prescribed statin, atorvastatin, has been found to reduce inflammation in the brain that occurs after surgery in mice, which can lead to post-operative decline and Alzheimer’s disease.

This could be good news.

But if you google 'statins' you'll find that these drugs, which are prescribed on a massive scale, are possibly implicated in the development of 'memory problems' and everyone knows that memory problems are often the first sign of the onset of dementia. It's a bit like the way in which some drugs which are presribed for a particular condition, include that very condition (as well as many other unpleasant symptoms) amongst their possible side-effects.

 What are we to think?

Thursday 10 October 2013

Nuns study yet again

I keep discovering that people who should know better are apparently unaware of the Nuns Study:

http://adventureswithdementia.blogspot.co.uk/search?q=study

You would think that such dramatic and unexpected findings would have had a massive impact on the direction of research.



Monday 7 October 2013

Another care system disgrace

This could almost be a continuation of the last post.

The Leonard Cheshire Disability Charity have today done all of us a great service by drawing attention to the fact that a large proportion of all visits to the housebound (many of whom have dementia) by paid carers, funded by Local Authorities, last no longer than 15 minutes.

In fact, it's become clear during the day that in some cases it's even worse than that. As some companies do not reimburse staff for time spent travelling between jobs, many '15 minute' visits are in fact even shorter.

To put it starkly, vulnerable and helpless people who are dependent on these care visits, are often having to choose between being fed or being toileted.

Yet there are some Local Authorities who refuse to fund care visits lasting less than 30 minutes.  So it is possible to have a sane system.

The really depressing thing is that I would be willing to bet that the situation will be exactly the same in a year's time

Thursday 3 October 2013

People who never go outside

A topic raised by this article:

http://www.itv.com/news/2013-09-03/my-name-is-philip-and-i-have-dementia/

Some of the reasons why people don't get out are suggested in this article.  But it's not, of course, a problem that's confined to people with dementia.  Many elderly people are reluctant, or feel unable, to go out.

There are some schemes  -  such as 'Good Neighbours'  -  which involve, amongst other things, volunteers visiting people like this and taking them out.  Clearly, there should be a much greater effort to ensure that no-one feels trapped in their house.

Cameron used to promote the 'Big Society', a concept which encompassed schemes like these.

I don't think the words 'Big Society' have passed his lips for a long time though.

Sad.