Posts Tagged ‘New England Journal of Medicine’

Smoking and Alcoholism

April 17, 2017

This post is based largely on the book “Willpower:  Rediscovering the Greatest Human Strength” by Roy Baumeister and John Tierney.  Just like dieting, quitting smoking requires your maximum willpower.  So it should be the lone habit you’re trying to rid yourself of.  One research program found that a written contract committing to temporarily stop smoking was nearly 40% more likely than a control group to be nicotine free after a year.  Given an incentive to temporarily restrain their smoking, they were more likely to make a lasting change in their lives.  What began as a recommitment turned into something permanent and more valuable:  a habit.

If you can’t bring your self to quit smoking, try cutting down to two or three cigarettes per day.  This should have health benefits plus it puts you closer to quitting smoking altogether.

Smoking cigarettes had long been regarded as a personal physical compulsion due to overwhelming  impulses in the smoker’s brain and body.  That belief was challenged  in 2008 by an article in the “New England Journal of Medicine” by Nicholas Christakis and James Fowler found that quitting smoking seems to spread through social networks.  They fond that kicking the habit seemed to be contagious.  If a member of a married couple quit smoking, the odds of the other spouse quitting increased dramatically.  The odds also increased if a brother, sister or friend quit.  Even coworkers had a substantial effect as long as the people worked together in a fairly small firm.  Generally speaking, smokers who live mainly among nonsmokers tend to have high rates of quitting, indicating the power of social influence and the social support for quitting.

Religions provide large social networks that can assist in quitting smoking.  Of course, religious people are less likely to smoke in the first place, but both new converts along with committed smokers have a good social support network for quitting.  Baumeister and Tierney  also have high praise for Alcoholics Anonymous.  Although they seem to be somewhat skeptical of the method, as good scientists they cannot argue with the results of AA.  AA does not provide an automatic cure.  Rather, it assists in developing the personal discipline using willpower to overcome alcohol abuse.

Smoking and Alcoholism are serious problems and they should be dealt with individually.   Limited willpower should be focused on each separately.

Alzheimer’s is the Most Expensive Malady in the United States

April 14, 2013

According to a recent Rand Study reported in the New England Journal of Medicine, Alzheimer’s is the most expensive malady in the United States, costing somewhere from $157 billion to $215 billion per year. This makes it more expensive than heart disease and cancer, the two biggest killers, but as patients ultimately die from Alzheimer’s, this is a matter of how the books are kept. It is not the drugs nor other medical treatments that is the biggest cost of Alzheimer’s and other types of dementia, but the care that is needed to get mentally impaired people through daily life. Dementia’s direct costs, including medicines and nursing homes, are $109 billion in 2010 dollars.

According to the RAND study, nearly 15% of people aged 71 or older have dementia. That is about 3.8 million people. It is estimated that by 2040 the number will balloon to 9.1 million people. According to Dr. Richard J. Hodes, the director of the National Institute on Aging, “ I don’t know of any other disease predicting such a huge increase. And as we have the baby boomer group maturing, there are going to be more older people with fewer children to be informal caregivers for them, which is going to intensify the problem even more.”

The prospects of a cure are remote and drug treatments promise only to delay the progression of the disease. 74 to 84 percent of the costs involves helping patients in nursing homes or at home manage the most basic activities of life as they become increasingly impaired cognitively and then physically. A case of dementia costs from $41,000 to $56,000 a year. The projection is that the total costs of dementia care will more than double by 2040, to a range of $379 billion to $511 billion. They ranged from $159 billion to $215 billion in 2010. It is estimated that 22 percent of the people aged 71 and older (about 5.4 million) have mild cognitive impairment. This means that the level of cognitive impairment is mild and does not reach the threshold for dementia. About 12% of these people develop dementia each year.

The preceding solely concerns the economics of dementia. The personal loss is tragic. A lifelong of learning and experiences increasingly slip from memory. Friends and family members might not be recognized. Eventually, the self is lost, and the person does not remember who he or she is or whether he or she is a he or a she.

The best hope an individual has of avoiding or mitigating this loss is to live a healthy lifestyle, not only physically, but also cognitively, and to build a cognitive reserve. Research has shown that there are individuals with plaque and neurofibril tangles who have not exhibited symptoms of dementia. The healthymemory blog is dedicated to helping individuals build this cognitive reserve.

© Douglas Griffith and, 2013. Unauthorized use and/or duplication of this material without express and written permission from this blog’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Douglas Griffith and with appropriate and specific direction to the original content.