Ira Rosofsky on Drugging the Elderly

Ira Rosofsky, a psychologist who has written a book called Nasty, Brutish and Long: Adventures in Old Age and the World of Eldercare, had an op-ed in the Los Angeles Times that was reprinted in the Star Tribune today. In the Strib, it was titled "Enough with the Drugging of Old People."

Rosofsky works in nursing homes with dementia patients, many of whom have been prescribed two common drugs -- Aricept and Namenda. Almost $3.5 billion is spent the two annually (almost all from Medicare, I would imagine). According to Rosofsky, Aricept's approval by the FDA was based on a 4 percent greater effectiveness than placebo, "mostly reflecting a slower decline rather than positive improvement. And the differences disappear when the drug is discontinued..."

Rosofsky wonders if the billions could be better spent. For instance, nursing home staff members spend about 2 hours and 20 minutes a day with each resident. Maybe some of the drug money could go to increasing that time. As he says, "...why not admit the failure of medication and instead spend some of that money on more staff to hold the hands of both patients and their families?"

And, of course, the other place that money could go is into research for a cure or even a meaningful treatment -- something resulting in something more than a 4% decrease in symptoms.

Rosofsky's story appeared in the Strib on a day when they reported the deaths by murder-suicide of an elderly couple, where the husband had been acting as caretaker to his Alzheimer's-afflicted wife. And only a few weeks after the news of former pro wrestler Verne Gagne's attack on a fellow Alzheimer's patient in a nursing home.

And, of course, it occurs in the midst of our current economic and health care crisis, so to hear that $3.5 billion is spent annually on drugs that have little effect is a bit hard to take.

I imagine Rosofsky's book would be a bitter pill to swallow, but I think I might have to give it a try anyway.