Fraud is rampant everywhere, it seems:

In 2010, welfare officials in Tokyo tried to visit Sogen Kato, a local man living in the city’s Adachi district, to congratulate him on his 111th birthday. Their records identified him as the oldest man in the city, but his family kept turning them away, saying he didn’t want visitors or had taken a trip somewhere five hours away.

When police finally entered the house, they found Kato’s mummified remains lying in bed, dressed in pajamas and covered with a blanket. He’d been dead for at least 30 years, although his family claimed he’d shut himself away to become a living Buddha.

His pension kept paying, and someone withdrew 2.7 million yen, about $31,000 at the time, after officials started asking questions. …

“This prompted the Japanese Ministry of Justice to check in on other centenarians: not just in Tokyo but across all Japan,” writes scientist Saul Justin Newman in his new book, “Morbid: Debunking Modern Longevity Science” …

Across Japan, the audit identified 234,354 people still on family registers whose whereabouts couldn’t be confirmed. All would have been at least 100 if alive. Newman describes them as dead or missing and puts their share at more than 82% of the recorded centenarian population.

His findings have been disputed, however, and some researchers say there were only 600 such “missing” centenarians. That’s 600 too many, I’d say.

The whole thing reminds me of a bit of the Faulkner story “A Rose for Emily.”

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But not too much of it.

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Every time there’s a school shooting or any sort of mass violence, the subject of SSRIs comes up from one commenter or another.

Sometimes people also bring up the subject of fatherlessness and mass shooters, which I wrote about at length in this post, the gist of which is that there is no connection although it’s popularly thought that there is.

Now, on to SSRIs. It is notoriously difficult to do research on whether SSRIs trigger more violence, have no effect, or help prevent violence, and if so in what populations. It’s a popular internet meme that they trigger violence, but the evidence is not at all clear that that is so, and as I said it’s very difficult to design a good study. One obvious reason is that such people are often at higher risk for violence in the first place, and drugs are not given randomly. There is almost certainly something already different about the people who get them and those who don’t.

This is one of the better-designed studies, and as you can see if you read it it’s very hard to tell what it all means, if anything. For example:

As is often the case, the authors of the study themselves are rather cautious. While obviously concerned that it is possible that SSRIs may actually cause violent behavior in a small minority of people, they fully recognize that other explanations are possible. These include the possibility that what is driving the violent behavior is medication undertreatment, based on the finding that the risk with violence was only found among individuals who were likely taking subtherapeutic doses. As reported by MedScape, one of the study authors, Seena Fazel, states: “Our own view is that some evidence suggests that it’s a bit more complicated than that, because we found a link with subtherapeutic doses of SSRIs, and that would suggest to us that it may be that it’s actually a lack of treatment [and] it could be residual symptoms that are driving this link.” At the same time, if antidepressants really worked wonders for young people, we should see that therapeutic SSRI usage was associated with a reduced risk of violent behavior, which it wasn’t.

A couple other factors also deserve mention. The idea of comparing periods on and off medication within the same individual is a clever design, because many individual factors that might be related to risk of violence, like one’s socioeconomic status or DNA, are held constant. However, because the period of medication use was not randomized (and couldn’t be), it introduces the very likely complicating issue that individuals were taking medications during times when they were feeling more depressed, anxious, and angry to start with, and thus at higher risk of acting violently. Finally, it is important to note that a statistically significant association certainly does not mean that most people taking antidepressants are out there hurting others. When taking SSRI medications, the conviction rate of violent crimes was at a 1.0% rate compared to 0.6% without medications.

There’s also this:

Our study encompassed nationwide data over a 15-year period. In this period, the homicide rate per 100,000 remained fairly constant, with a moderate decline in recent years, leading to an average of 160 homicide victims per year. The suicide rate decreased steadily from 10.26 (approximately 1,500 victims) in 1994 to 8.77 (approximately 1,400 victims) per 100,000 in 2008. The homicide–suicide rate remained relatively stable, averaging at 0.05 per 100,000 (varying from 4 to 14 victims per year, see Fig. 1). In the same period, the rate of total antidepressant use increased considerably, from 3,038.81 in 1994 to 5,650.58 per 100,000 in 2008. A similar increase was observed for the rate of SSRI use alone, which more than doubled from 1,482.25 in 1994 to 3,161.15 per 100,000 in 2008 as well as the rate of SSRI use including venlafaxine, with an increase of 1,486.81 in 1994 to 3,904.20 per 100,000 in 2008. Over the same period, the number of defined daily doses used rose from 59.6 million in 1994 to 245.3 million in 2008: a fourfold increase. This indicates that not only more people used antidepressants, but also that the mean duration or intensity of the treatment grew…

Rates of the use of SSRIs including venlafaxine were also found to be negatively associated with both homicide rates and suicide rates. No significant independent association was found between rates of SSRIs including venlafaxine and homicide–suicide.

Here’s an article about suicide and SSRIs for young people:

The 2004 study examined the clinical trial data that had been collected on two types of medications, selective serotonin reuptake inhibitors (SSRI) and selective norepinephrine reuptake inhibitors (SNRI). The results of the study prompted the Food and Drug Administration (FDA) to issue a black box warning, the most serious level of warning in prescription drug labeling, for the risk of suicides in children and adolescents being treated with antidepressants in 2004. The warning was extended to young adults ages 18 to 25 years in 2006.

The researchers in the current study performed a meta-analysis of 41 studies, reviewing the data on a total of 9,185 youths, adults, and geriatric patients who were treated with fluoxetine (Prozac is one common brand) and venlafaxine (Effexor) immediate (IR) and extended release (ER) preparations…

In all three age groups, treatment with fluoxetine and with venlafaxine IR and ER resulted in a statistically significant improvement in depressive symptoms when compared to treatment with placebo. The decline in depressive symptoms was also faster for patients treated with medication than control group patients. In the adult and geriatric patients who were treated with fluoxetine or venlafaxine, suicidal thoughts and behaviors decreased over time.

As the patients became less depressed, they had fewer suicidal thoughts and attempts. Although the youths who were treated with medication showed the same statistically significant decrease in depressive symptoms as the older populations, they did not show a decrease in suicidal ideation and actions.

“In kids, we don’t see a harmful effect, but we do see a disassociation between the beneficial effects on depression and the potential beneficial effect on suicide,” said the study’s lead author…

The newest analysis did not support the idea that there was an increased risk of suicide in children and adolescents taking fluoxetine, an SSRI. In explaining the difference in their findings, the researchers note that these original meta-analyses included fewer studies and the studies were of shorter term than the longitudinal data they analyzed.

There probably will be a number of readers here who say something like this: “It’s all lies promulgated to cover up the damage drug companies do and to preserve their profits.” You’re welcome to that point of view, and certainly during the COVID years the CDC and many other official entities have earned our distrust. But if you throw out all research, including older studies such as these, you are left with internet memes and paranoia. That’s not science, either. I believe that most of these studies are attempts at valid research on a subject that is inherently difficult to study, and that the bulk of the evidence indicates that SSRIs do not increase violent behavior.

The post SSRIs and violence appeared first on The New Neo.

But anyway, here’s the latest correlation with dementia:

Participants with a voice disorder but no hearing loss were 58 percent more likely to develop cognitive problems or dementia later on, while for those with a voice disorder and hearing loss the chances more than doubled: 104 percent. …

It’s important to note that cause and effect isn’t proven here: having a voice quality problem doesn’t mean later brain health complications are inevitable, or that the voice issues are directly triggering cognitive decline, dementia, or Alzheimer’s disease (the study didn’t separate these three end results).

One thing that occurs to me is that voice problems – particularly, a soft voice – can go along with Parkinson’s, which can also correlate with dementia.

The post Another dementia warning appeared first on The New Neo.

Consider the case of 83-year-old Brigitte Stegemann, whose assisted suicide under Canada’s MAiD program sounds more like it may have been a murder. It’s necessary to read the whole thing to understand the story, but the gist of it is that the elderly grandmother seemed to have lacked the ability to understand what MAiD was intending to do, and she was nowhere near the point of agreeing anyway:

… [A]ccording to [her granddaughter and primary caregiver] Kranendonk, her grandmother still had a good appetite even following a stomach cancer diagnosis, and rejected the idea of using MAiD when it was presented as an option.

Everything changed, however, in June when Kranendonk left to go on a 10-day road trip with her husband.

… [O]n July 3, near the end of her trip, Kranendonk said she received a call informing her that the home planned to arrange a MAiD assessment for Stegemann, despite her grandmother previously telling her that she did not want an assisted death.

Kranendonk said, according to The Daily Mail, that when she returned, she asked a nurse at The Pearl about who had initiated the MAiD conversation. …

When Kranendonk interjected and said, “She doesn’t understand what you’re saying,” the doctor allegedly looked at Stegemann and said, “We’re going to make sure you won’t have any more pain.”

According to a doctor, Stegemann was “deemed fit for MAID, and we’re going to proceed,” The Daily Mail reported.

It’s a chilling story, one of many under such programs. It has a special resonance for me at the moment because, although the details were very very different from that of Brigette Stegemann, I have recently experienced what it is like to feel that a hospital gave up on an older patient prematurely and to have nearly all my input and all my requests fall on deaf ears.

The distinct impression I got was that, once my ex-husband became very ill (at least in part because of what I consider to have been doctor negligence), many of the doctors seemed to ignore the fact that I kept telling them that his quality of life prior to this surgery had been pretty decent despite his Parkinson’s, and that he had been living completely independently.

I never got the impression they believed me. They didn’t seem to be able to adapt by changing interventions. Their concern seemed fake and unctuous, and it was combined with a condescension and early pessimism that were infuriating.

The hospital has a good reputation. Would another have been better? I’m not at all sure, and at any rate I didn’t know how to find that hospital or how to accomplish a transfer. The hospitalist system, in which doctors (some of whom don’t have particularly good English skills) rotate constantly, is extremely frustrating as well. The doctors didn’t take much time with my ex, and I’m virtually sure they didn’t read the bulk of the notes on his case. With a long hospital stay (three and a half weeks from relatively good health to death), the number of notes became enormous and would have taken hours to plow through.

No hospitalist was going to do that, and therefore in my opinion they missed what was really going on. Nor did they particularly care about a patient whom they barely saw – and would not be likely to see again after their days or week on that floor ended and they rotated out again. My distinct impression was that they wrote him off very early on and spent a great deal of time sending palliative care doctors to speak to me and try to convince me to write him off, too.

If I sound angry, it’s because I am.

The post MAiD in Canada (plus a few personal notes) appeared first on The New Neo.

I never liked roller coaster rides very much.

This morning the hospital called saying my ex had a big respiratory crisis and the doctor started asking me a bunch of end-of-life questions. I raced over to the hospital but by the time I arrived the crisis had abated, and he was back to merely being extremely sick.

So here I am, pecking this out on my cellphone. He is sleeping now, which is good, so I may try to crank out some posts and/or polish a draft. Forgive typos and errors- it’s much harder to proofread on a phone.

The post Another update on my ex appeared first on The New Neo.

However, the insult to his lungs that occurred during the surgery was profound, and he’s not a young man and has several co-morbidities. The doctors and nurses and respiratory therapists make no long-term predictions.

A great many relatives have come to visit, which has been pleasant for him but exhausting. Now there’s a lull.

In order to protect his privacy, I’m not going to go into much medical detail. But I plan to post periodic updates. I deeply thank all of you for your good wishes and prayers.

The post An update on my ex appeared first on The New Neo.

What might happen in a second trial? Perhaps a plea deal of some sort; it’s very hard to say.

However, I was surprised to read yesterday that there is apparently only a single juror who is holding out:

The trial of Lindsay Clancy — which has captivated the nation since July — took a bombshell turn on Thursday when it was revealed that there was one juror who disagreed with the rest following 36 hours of intense deliberation.

The news, which came via a note from the forewoman that a single holdout “refuses to listen to the law” on reasonable doubt, left Clancy’s lawyer Kevin Reddington visibly raging — and demanding the person be kicked off the 12-person jury and replaced with an alternate.

The judge did not grant that demand. But it sounds as though the holdout is for a guilty verdict and the rest are not – although, as I’ve said before, I don’t see how Clancy goes free and I don’t think she will, whatever the verdict.

The law in Massachusetts on this is very unusual – in fact, I think it is singular. This is how it works [emphasis mine]:

Once the defense raises the issue of the accused’s mental state at the time of the crime, prosecutors bear the burden of proving beyond a reasonable doubt that the defendant was criminally responsible, said Daniel Medwed, a university distinguished professor of law.

“In Massachusetts, we don’t typically use the term ‘insanity defense,’” Medwed said, citing the stigma that attaches to the word “insanity.” Instead, it’s referred to as “lack of criminal responsibility.” …

In Massachusetts, the defense may apply when a person’s mental condition prevents them from understanding or controlling their actions at the time of an alleged crime, including during an episode of psychosis. A qualifying mental disease or defect also need not fit a specific medical diagnosis.

You can see how this might lead to a situation in which a holdout juror refuses to listen to the law on reasonable doubt. That’s because the law on this in Massachusetts is very much tilted in favor of the defendant. In other states, the burden of proof for lack of criminal responsibility is different:

In many jurisdictions, insanity is an affirmative defense, meaning the burden falls on the defense to prove that a defendant had “a mental disease or defect” that prevented them from understanding the nature of their actions, Medwed said. But that is not the case in Massachusetts, he said.

Procedurally, that means the defense “doesn’t have to do as much” in the way of persuading jurors compared with other states, according to Medwed.

However, an affirmative defense doesn’t have to be proved beyond a reasonable doubt. It needs to be proved by a preponderance of the evidence or clear and convincing evidence, defending on the jurisdiction.

The state of things as I write these words is this:

The judge in Lindsay Clancy’s trial has given the defense one hour to make an emergency appeal before declaring a mistrial. …

A filing from Lindsay Clancy’s defense attorney has been submitted to the Massachusetts Supreme Judicial Court, according to the clerk’s office.

And the court is on lunch break.

The post The Clancy jury apparently will end in a mistrial appeared first on The New Neo.

Yesterday I was at the hospital much of the afternoon and came home around 8:30 PM, but he called me again at around 11:00 PM and sounded awful. I simply couldn’t relax about it, and since I live just a few minutes from the hospital I went back there to check it out.

Fortunately, he was asleep. And also fortunately, I had a long talk with the nurse and she reassured me about various things. He’s certainly not out of the woods, but she seemed competent and on top of things.

And then, when I returned home and got out of my car, I happened to look up to the sky. The moon looked very unusual, and it occurred to me that this might be a lunar eclipse. So I got out my trusty cellphone and sure enough, it was! Plus, just by chance I happened to be stepping out of my car at the exact peak minute of the eclipse.

So that’s the silver lining, I guess.

The post On my ex and the moon appeared first on The New Neo.

I am fairly certain she won’t be “getting off,” whatever the verdict. If she is found to have had diminished capacity due to psychosis, her stay in a mental hospital will be very long, IMHO. She brutally murdered her three young children. That is the reality, and they’re not just letting her out in a month. My guess is that she would be staying for many many years and perhaps even for life.

For example, Andrea Yates – who killed her 5 children in Texas in 2001, twenty-five years ago – and was found found guilty but ultimately found not guilty by reason of insanity (see this for the twistings and turnings of her legal situation), is still institutionalized in a mental hospital. Massachusetts is different than Texas of course, but here’s how it works in Massachusetts:

Massachusetts law says the court can order her hospitalized for up to 40 days for “observation and examination,” and prosecutors or hospital officials can then petition for involuntary commitment to a psychiatric facility.

If a judge determines Clancy is mentally ill and releasing her “would create a likelihood of serious harm,” she could be committed to a facility, the law states. The initial commitment is generally valid for six months and can be renewed in one-year periods.

“She’ll never be released unless there’s a finding by a judge that she doesn’t represent a danger to herself or others,” Rossman said.

She might never get out. Also, she’s probably still a suicide risk, although as a paraplegic she might have trouble accomplishing it.

If I had to guess, I’d predict the jury will be hung. But that’s 100% a guess.

The post Whatever the verdict, Lindsay Clancy is extremely unlikely to be getting out quickly appeared first on The New Neo.