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Senior Citizen Health & Medicine
Harvard Med School's Top Health Stories of 2007 of
Critical Importance to Seniors
Avandia, sleep, pay-for-performance, better
mammogram, new ways to “see” inside the brain are tops with senior
citizens
 Dec. 4, 2007 - The editors of Harvard Medical
School's Harvard Health Letter have chosen the top 10 health stories of
2007, and, not surprisingly, most are of great important to senior
citizens. For example, number one is the problems found with Avandia,
the diabetes drug used by millions of older Americans, and number four,
the abundance of evidence supporting the critical importance of a good
night’s sleep.
Here are this year’s top ten newsmakers:
1. Drug safety failures.
This year, rosiglitazone (Avandia), a diabetes
drug, became the latest medication found to have serious side effects
that weren’t apparent when it was approved by the FDA. The FDA needs
more money and resources to conduct studies of drugs after they’ve been
approved for sale - and then the clout to take prompt action if safety
problems are identified.
2. Genome-wide association studies.
These studies take advantage of unique “flags”
flying in each “neighborhood” of the vast genome. Researchers find the
flags associated with disease and then conduct an intensive search for
genetic miscues just in that neighborhood. This process is a lot more
efficient than a dragnet through the entire genome. This year,
genome-wide association studies have identified genes associated with
type 2 diabetes, multiple sclerosis, and resistance to HIV infection, to
name a few examples.
3. Genome sequencing in a jiffy—and cheap.
Sequencing a genome—identifying all the chemical
base pairs of someone’s genes—is getting a lot faster and cheaper.
Scientists can now shatter the DNA of the genome into millions of pieces
and simultaneously sequence the letters. Then, computers knit the data
into a single sequence. Within a decade, the price of sequencing a
genome may drop to $1,000, say some experts. Cheap genome sequencing may
soon usher in a new era of personalized medicine, with health advice and
medical treatments tailored to each individual’s genes.
4. Waking up to a new health habit: Sleep.
The evidence has reached critical mass—getting
between seven and nine hours of sleep a night is one of the pillars of
good health, along with physical activity and eating a healthful diet.
Poor sleep has been linked to health problems ranging from diabetes to
heart disease to obesity.
5. Health is going global.
The trend toward globalization that has affected so
many aspects of the American economy is now changing American medicine.
Hospitals are creating global health residency programs. Philanthropic
organizations like the Bill and Melinda Gates Foundation are pouring
billions into efforts to combat disease on a global scale. This
worldwide outlook comes from more than just altruism—AIDS, avian flu,
and severe acute respiratory syndrome (SARS) have shown that many health
problems have little respect for borders.
6. Cooling off inflammation.
TNF-alpha blockers, drugs that interfere with a
protein that contributes to inflammation, have given doctors and
patients an important new treatment choice for conditions like
rheumatoid arthritis. Daunting price tags and serious side effects make
the TNF-alpha blockers less than ideal, but by tackling inflammation at
its roots, they may light the way for a new approach to treating many
diseases with an inflammatory component—even Parkinson’s and
Alzheimer’s.
7. Covering the uninsured.
With health care costs continuing to increase and
employers cutting back on coverage, lawmakers are filling in the gaps.
Illinois has created the All Kids program to cover children.
Massachusetts law mandates that everyone in the state must purchase
health insurance, and other states may follow suit.
The Medicare Part D
program, despite its flaws, has succeeded in extending prescription drug
coverage to seniors. Time will tell whether these incremental steps will
replace or merely delay more sweeping reform of a system that leaves 47
million Americans without insurance.
8. Tying reimbursement to quality health care.
Momentum is building for an array of incentives for
doctors and hospitals to provide higher-quality medical care. Medicare
this year started paying doctors a bonus for reporting certain quality
measures, and its experiment to pay hospitals performance bonuses is a
success, according to most experts.
Some health plans are using
quality-of-care disincentives by refusing to pay for care related to
complications from certain types of medical errors. And some providers
are instituting rigorous quality-of-care programs on their own—and
agreeing not to charge for care related to certain surgical
complications. Many details have yet to be worked out, but this approach
could both improve health outcomes and reduce costs.
9. A better mammogram?
Two studies this year found that magnetic resonance
imaging (MRI) scans are better than other techniques at identifying
breast cancers in high-risk women. The American Cancer Society revised
its screening recommendations to say that women at high risk for breast
cancer should get a breast MRI every year, in addition to a regular
mammogram.
10. Peeking into the brain for disease clues.
New imaging technologies are letting researchers
“see” inside the brain and watch its inner workings. The hope is these
tests will mean more certain diagnoses for many conditions and,
eventually, better treatments.
One example: University of Pittsburgh
researchers have developed a method of positron emission tomography
(PET) scanning that identifies beta amyloid, the protein fragment many
researchers believe is the main cause of Alzheimer’s disease. This may
provide a way to detect Alzheimer’s before symptoms appear, paving the
way for preventive treatments.
The Harvard Health Letter is published monthly by
Harvard Health Publications, the publishing division of Harvard Medical
School. Subscriptions are $28 per year. Subscribe at
http://www.health.harvard.edu/health or by calling 877-649-9457
(toll-free).
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