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8 out of 10 UK doctors criticise Alzheimer’s treatment

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London: Most doctors feel Alzheimer’s sufferers do not receive sufficient treatment, according to a new survey.

The IMPACT (Important Perspectives on Alzheimer’s Care & Treatment) study explored the views of 1800 people – physicians (GPs and specialists),1 Alzheimer’s carers,1 payors1 and the general public1 in France, Germany, Italy, Spain and the UK.

According to the new study presented at the 2009 Alzheimer’s Association International Conference on Alzheimer’s Disease (ICAD 2009), almost 8 out of 10 UK physicians (77 percent)1 consider Alzheimer’s disease to be undertreated in the UK.1 These perceptions reflect behaviours identified in earlier research by the Audit Commission for Local Authorities and the National Health Service which highlighted an uncertainty in diagnosing any form of dementia by GPs in the UK, with 40% of GPs reluctant to refer early for diagnosis.2

According to the study, supported by Eisai and Pfizer Inc, UK doctors feel the medical community hesitates in discussing the earliest stages of Alzheimer’s disease because of their uncertainty.1 Furthermore, 63% of responders from the general population, many of whom could be tomorrow’s carers, felt that most people would have difficulty identifying the early signs of the disease.1

“The National Dementia Strategy sets out a clear direction for dementia management and if adhered to closely, it could help the UK lead the way in Alzheimer’s disease care and management. Today’s survey findings suggest that although we are making progress, we still have a long way to go. Alzheimer’s disease needs to be tackled with the same force as the fight against cancer and we need to act now in order to halt this generational time bomb”, said Professor Roy Jones, Clinical Gerontologist and Geriatrician at The Research Institute for the Care of Older People, Bath, and Study Steering Committee Chair.

Alzheimer’s disease, the most common type of dementia, affects nearly half a million people in the UK3 – a figure expected to double within twenty years.4 According to IMPACT, Alzheimer’s disease is the most feared disease after cancer in the general population,1 with physicians1 and carers1 being the only groups surveyed to fear it even more than cancer. In 2007, the annual cost of caring for people with Alzheimer’s disease was £11 billion,5 with dementia costing the UK economy over £17 billion a year,6 more than cancer, stroke and heart disease combined.5 Additionally in 2007, Alzheimer’s disease research received 3 percent of the funds spent on cancer, a disease that affects a similar number of people.5

While the study revealed that UK doctors face a number of barriers to early drug treatment,1 it also showed that according to physicians in the UK, the medical community is more likely to recommend third party support (e.g. patient organisations) after the diagnosis of Alzheimer’s disease than in France, Germany, Italy and Spain.1

Marc Wortmann, Executive Director of Alzheimer’s Disease International and member of the IMPACT Study Steering Committee, said, “It is reassuring to note that the benefits of support groups are clearly recognised by clinicians and hopefully experienced by carers and patients. We strongly support the tendency to refer to patient groups at diagnosis, as it is well known that seeking support improves the quality of life for people living with Alzheimer’s disease and eases the burden for the carer.”

About Alzheimer’s disease

Alzheimer’s disease, a progressive and degenerative brain disease,7 is the most common type of dementia7 and affects more than six million Europeans.8 Symptoms of Alzheimer’s disease may include increased forgetfulness, repeating or asking the same question frequently, and problems making decisions.9

These symptoms gradually affect a person’s cognition, behavior and everyday activities, some severe enough to have an impact on their work, social activities and family life.9 While there is no cure for Alzheimer’s disease, there are treatments to help slow the progression of the symptoms of the disease.10

About the IMPACT Study

The IMPACT study was conducted online within the United Kingdom, France, Italy, Spain and Germany by IPSOS on behalf of Eisai and Pfizer Inc between April 1 and May 1, 2009, among 500 physicians (including general practitioners and specialists), 250 AD carers, 50 payors and 1,000 members of the general population age 18 and over. Statistical differences are noted using a 90% confidence interval. A full methodology is available upon request.

About the IMPACT Study Steering Committee

The IMPACT study was developed and implemented with the oversight of an expert Steering Committee comprised of a variety of leading AD specialists, including geriatricians, neurologists, epidemiologists, primary care physicians and old-age psychiatrists from the United Kingdom, France, Italy, Spain and Germany. The Executive Director of Alzheimer Disease International (ADI) was also part of the committee. Most members of the IMPACT Study steering committee received honoraria for their participation. The Committee was supported by Eisai and Pfizer Inc.

About Eisai

Eisai is a research-based human health care (hhc) company that discovers, develops and markets products throughout the world. Eisai focuses its efforts in three therapeutic areas: Integrative Neuroscience including neuroscience, neurology and psychiatric medicine; Integrative Oncology including oncotherapy and supportive-care treatment and Vascular/Immunological Reaction which includes acute coronary syndrome, atherothrombotic disease, sepsis, rheumatoid arthritis, psoriasis and Crohn’s disease.

Through a global network of research facilities, manufacturing sites and marketing subsidiaries, Eisai actively participates in all aspects of the worldwide health care system. Globally, Eisai operates in five key regions: its home market of Japan, North America, China, Asia/Oceania/Middle East and Europe and employs more than 11,000 people worldwide.

About Pfizer

Pfizer Inc., founded in 1849, is dedicated to better health and greater access to health care for people and their valued animals. Every day, colleagues in more than 150 countries work to discover, develop, manufacture and deliver quality, safe and effective prescription medicines to patients.
In the UK, Pfizer has its European R&D headquarters at Sandwich and its UK business headquarters in Surrey, and is the major supplier of medicines to the NHS. Pfizer’s annual UK R&D investment is more than £550 million – more than £10 million a week.

1 Impact Study 2009: Global Alzheimer’s Awareness Study. Data on File Eisai, Pfizer Ltd

2 Audit Commission Update, Forget Me Not 2002: Developing Mental Health Services For Older People In England. Audit Commission February 2002.

3 Alzheimer’s Society Factsheet available at What is Alzheimer’s Disease?.
4 Alzheimer’s Society. Facts for the Media.
5 Alzheimer’s Research Trust. Annual Review 2007. February 1, 2007.
6 Alzheimer’s Research Trust. Dementia Statistics. Available at: Dementia Statistics.
7Alzheimer’s Association. 2008 Alzheimer’s Disease Facts and Figures. Available at: Alzheimer’s Disease Facts and Figures.
8 Alzheimer Europe. Policy watch Europe Unites Against Alzheimer’s disease. Dementia In Europe: The Alzheimer Europe Magazine. December 2008;2: 9.
9 Alzheimer’s Association. 10 Signs of Alzheimer’s Signs of Alzheimer’s Disease
10 Alzheimer’s Association. Treatments Available at Treatments and Treatments

UK demand for cosmetic surgery continues to grow

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London: The number of people choosing cosmetic surgery continues to increase in the UK, with 32, 453 procedures carried out by members of the British Association of Aesthetic Plastic Surgeons in 2007.

This figure is an increase of 12.2% from 2006, when 28,921 were performed.

Facelifts had the largest increase among all procedures, rising by 36% (4,468 procedures carried out) from 2006, keeping its place as the 4th most popular procedure.

Women had 29,572 procedures in 2007, up from 26,469 the previous year. The majority of cosmetic surgery was carried out on women (91%), while male surgery increased by 17.5% with 2,881 surgical procedures carried out (2,452 procedures in 2006).

* The top procedure for women continues to be breast augmentation, with 6,497 carried out

* Rhinoplasty continued to be the top procedure for men, with 716 undertaken by BAAPS members, a 36% increase from last year – but by far the most impressive percentage rise was in the number of male abdominoplasty procedures (or ‘tummy tucks), which went up by 61%

* Liposuction for men increased by 18% and is now the 2nd most popular procedure for males, taking over the spot from eyelid surgery (now 3rd most popular)

* Male breast reduction has risen by 27% with 224procedures achieved in 2007 (177 procedures in 2006)

* The number of women having facelifts increased by 37%, making it now the 3rd most popular procedure for females (pushing Liposuction down to 4th most popular)

* Other Anti-ageing procedures (eyelid surgery and brow lifts) continued to show a steady rise in popularity for both men and women, increasing by 13% and 11% overall

Mr Douglas McGeorge, consultant plastic surgeon and President of the BAAPS said: “This year’s audit clearly reflects the UK’s continued acceptance of aesthetic surgery, particularly in the area of anti-aging. Wide media coverage has helped to educate the public about the latest advances and choices available, but it is crucial that people do their research carefully when choosing a provider. At the BAAPS we are committed to continue educating those considering cosmetic plastic surgery by providing independent advice that promotes sensible decision-making.”

The figures in full:

A total of 32,453 procedures were carried out in 2007 by BAAPS members in their private practices, compared to 28,921 in 2006. The 2007 results indicate that surgical numbers continue to grow, with a 12.2% rise over the previous year.

The top surgical procedures for men & women in 2007 were, in order of popularity:

Breastaugmentation: 6,497 – up 6% from last year
Blepharoplasty(eyelid surgery): 5,706 – up 13%
Liposuction: 4,572 – up 15%
Face/NeckLift: 4,468 – up 36%
Breast Reduction: 3,402 – up 6%
Rhinoplasty: 3,021 – up 13%
Abdominoplasty: 2,799 – up 2%
Otoplasty(ear correction): 1,024 – up 9%
Browlifts 964– up 11%

Women had 91% of all cosmetic procedures in 2007 (29,572, up from 26,469 in 2006). The top five surgical procedures for women in 2006 were: breast augmentation (6,487), blepharoplasty or eyelid surgery (5,148 – up 13% on last year), face/neck lift (4,238, an impressive rise of 37%), liposuction (3,990 – up 15%), and breast reduction (3,178).

Men had 2,881 cosmetic procedures in 2007. The top five surgical procedures for men in 2007 were: rhinoplasty (716), liposuction (582), eyelid surgery or blepharoplasty (558), ear correction or otoplasty (418), and face/neck lift (230 – rise of 21%).

Rajiv Grover, consultant plastic surgeon and BAAPS Secretary responsible for the UK national audit of cosmetic surgery says: “This year we have recorded a dramatic rise in facial plastic surgery. 10 years ago, there may not have been much choice between a face cream and a facelift, but more recently non-surgical procedures such as botox and fillers have introduced a large number of patients to gradual facial rejuvenation, and the effects of these less invasive treatments can sometimes be limited once jowling or loose skin has developed, so this could explain why more patients now feel ready for the surgical option.”

Nigel Mercer, consultant plastic surgeon and BAAPS President-Elect adds: “When considering aesthetic surgery it is essential to be selective in choosing the right surgeon as the results of good surgery may be long lasting, but no procedure is without some risk. When performed under the right circumstances, aesthetic surgery can have a very positive psychological impact and improve quality of life.”

The BAAPS based at the Royal College of Surgeons, is a not-for-profit organisation, established for the advancement of education and practice of Aesthetic Plastic Surgery for public benefit. Members undergo thorough background screening before they can join. Information about specific procedures and surgeons’ contact details can be found on the web site, or by contacting their advice line at 020 7405 2234.

Millions die of cancer around the globe – latest statistics

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New York: Cancer deaths continue to increase, with the American Cancer Society reporting 12 million new cases of malignancy diagnosed worldwide in 2007, with 7.6 million people dying from the disease.

The report, Global Cancer Facts & Figures, finds that 5.4 million of those cancers and 2.9 million deaths are in more affluent, developed nations, while 6.7 million new cancer cases and 4.7 million deaths hit people in developing countries.

“The point of the report is to promote cancer control worldwide, and increase awareness worldwide,” said report co-author Dr. Ahmedin Jemal, director of the society’s Cancer Occurrence Office.

The number of cancers and cancer deaths around the world is on the rise, Jemal said, mostly due to an aging population. “There is increasing life expectancy, and cancer occurs more frequently in older age groups,” he noted.

Lifestyle may be another reason for the rise in malignancies in developing countries, Jemal said, as people adopt Western behaviors such as smoking, high-fat diets and less physical activity.

The best way to stem the increasing number of cancer cases and deaths is prevention, especially in poorer countries, the expert said. In many developing nations, the health-care infrastructure simply isn’t there to offer cancer screening and treatment for most people, Jemal added.

In developed countries, the most common cancers among men are prostate, lung and colorectal cancer. Among women, the most common cancers are breast, colorectal and lung cancer, according to the report.

However, in developing countries the three most common cancers among men are lung, stomach and liver, and among women, breast, cervix uteri and stomach.

Worldwide, some 15 percent of all cancers are thought to be related to infections, including hepatitis (liver cancer) and human papilloma virus (cervical cancer). But the incidence of infection-related cancers remains three times higher in developing countries compared with developed countries (26 percent vs. 8 percent), according to the report.

In addition, cancer survival rates in many developing countries are far below those in developed countries. This is mostly due to the lack of early detection and treatment services. For example, in North America five-year childhood cancer survival rates are about 75 percent compared with three-year survival rates of 48 percent to 62 percent in Central America, the report notes. The report estimates that 60 percent of the world’s children who develop cancer have little or no access to treatment.

The report also includes a section on the toll tobacco use takes around the world. In 2000, some 5 million people worldwide died from tobacco use. Of these, about 30 percent (1.42 million) died from cancer — 850,000 from lung cancer alone.

Jemal believes smoking is a key culprit.

“Smoking prevalence is decreasing in developed countries. So, as tobacco companies are losing market in developed countries they are trying to expand their market in developing countries,” he said.

In China alone, more than 350 million people smoke. “That’s more than the entire population of the United States,” Jemal said. “If these current patterns continue, there will be 2 billion smokers worldwide by the year 2030, half of whom will die of smoking-related diseases if they do not quit,” he added.

In the 20th century, tobacco use caused about 100 million deaths around the world. In this century, that figure is expected to rise to over 1 billion people. Most of these will occur in developing countries.

One expert agreed that many cancer deaths can be avoided through lifestyle changes.

“What is most provocative here is not the total global burden of suffering and death cancer causes, dramatic though that may be, but the variations in cancer occurrence around the world, and the insights provided about how much of the cancer burden need not occur at all,” said Dr. David Katz, director of the Prevention Research Center at Yale University School of Medicine.

In developing countries, cancer of the uterine cervix is a leading cause of death in women, Katz noted.

“Yet this infection-related cancer is now preventable by vaccine, and long treatable when detected early using the Pap smear. As a result, death from cervical cancer in developed countries is dramatically lower. Its toll in the developing world is testimony to missed opportunities to apply our resources effectively, and equitably,” he said.

Cancer of the liver, often related to hepatitis infection, is a leading cause of death in developing countries, but not so in developed countries. “Again, an infection preventable with vaccine is causing death because of inequities in the distribution and use of existing resources,” Katz said.

Prostate and colon cancers are more common in wealthier countries, where they are likely related to poor diet and obesity, Katz said. “Unnecessary suffering and death are occurring in affluent countries due to dietary excesses,” he said.

Katz also noted that tobacco-related cancer is largely preventable. “The toll of tobacco-related disease, including lung cancer, is an appalling example of a global willingness to tolerate preventable suffering and death for the sake of profit,” he said.

These data show both developed and developing countries how to move toward the lower rates of specific cancers, Katz said.

“It will be a tragic failure for public health if instead of applying these lessons developed countries continue to export tobacco and dietary transgressions so that the developing world adds to its current cancer burden ours as well,” he said.

Longevity accelerating, says new research

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London: Longevity is accelerating and there are more 100 year olds than ever before, according to a new report by the Cass Business School.

They say that men born in 1985 can expect to live to an average age of 91, according to a new forecast of life expectancy which concludes that all existing projections are too low.

The Government’s key forecast for longevity, which is also used in the pensions and life insurance industry, has seriously miscalculated how long men will live in the future, they also say.

Life expectancy is currently 76.6 years for men and 81 for women. The new research suggests that life expectancy for men born in 1985, who turn 65 in 2050, could be as high as 97 under the most optimistic scenario, although 91 is its central forecast. That is six years higher than the Office for National Statistics’ projection. The new Cass model has been applied only to men so far, but the next phase of the research will cover women.

The new calculation has serious implications for the Government and the pensions industry, who face having to pay an extra £160,368 per person in state benefits and occupational pensions, Cass calculates.

David Blake, director of the Pensions Institute at Cass Business School, said: “Our calculations demonstrate that longevity is accelerating far beyond what is currently predicted, and there is considerable uncertainty surrounding future life expectancy. This will present a huge challenge for long-term healthcare providers and intensifies the problems faced by both government and the pensions industry. They need to update the projections they use before the pensions deficits reach catastrophic proportions.”

Professor Blake said that the Office for National Statistics had a history of underestimating new trends: “It completely underestimated the scale of the postwar baby boom, which had serious implications for the provision of schools and hospitals, and it has continually underestimated longevity of elderly people.”

The Government has voiced concerns about the ageing population and has taken some steps to make provision for more older people. The retirement age is rising from 65 to 68 by 2044. Those actions were promoted by the ONS forecast that the proportion of over65s will go from 15 per cent now to 25 per cent by 2050. However, less provision for the older population has been made in healthcare.

The new centurions

– There are about 9,000 men and women over the age of 100, but the numbers are rising by 7 per cent a year

– By 2050, more than 150,000 people will be centenarians

– The costs of treating dementia and caring for sufferers have been calculated at £17 billion (and rising) per year