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Does Wealth Protect Kids from Psychological Disorders?
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If you select for some characteristic, and find that groups differ on other characteristics, it is natural to assume that the variable you selected might be causal. For example, if you select on the basis of genetics, and find differences, it would be understandable if you thought that genetics accounted for the other differences. Equally, if you select on wealth, it would be natural to imagine that any differences you find were due to differences in wealth.

Norway is a special case. It is very rich, and very Norwegian. No-one does fiords like they do. Norwegians are dying out, their total fertility below replacement, so they are of only historical interest, but serve to illustrate what a very rich country can provide its citizens in terms of very high-quality universal health care, and a sovereign wealth fund which hold 1.7% of the world’s wealth, equal to £175,000 (\$245,000) per citizen. Even poor Norwegians are extremely rich by global standards, and Norway tops the world in the Human Development Index. Most countries would have to create and save wealth for a century to reach the levels of poor Norwegians.

75% of citizens are genetic Norwegians, and the rest came in over “recent decades” which is a bit vague, but which makes sense for anyone able to look at Human Development statistics. Norwegians like collecting data, for which we should be grateful.

Parental income and mental disorders in children and adolescents: prospective register-based study

Jonas Minet Kinge, Simon Øverland, Martin Flatø, Joseph Dieleman, Ole Røgeberg, Maria Christine Magnus, Miriam Evensen, Martin Tesli, Anders Skrondal, Camilla Stoltenberg … Show more
International Journal of Epidemiology, dyab066, https://doi.org/10.1093/ije/dyab066

https://academic.oup.com/ije/advance-article/doi/10.1093/ije/dyab066/6274255

In this registry-based study of all children in Norway (n = 1 354 393) aged 5–17 years from 2008 to 2016, we examined whether parental income was associated with childhood diagnoses of mental disorders identified through national registries from primary healthcare, hospitalizations and specialist outpatient services.

There were substantial differences in mental disorders by parental income, except for eating disorders in girls. In the bottom 1% of parental income, 16.9% of boys had a mental disorder compared with 4.1% in the top 1%. Among girls, there were 14.2% in the lowest, compared with 3.2% in the highest parental-income percentile. Differences were mainly attributable to attention-deficit hyperactivity disorder in boys and anxiety and depression in girls. There were more mental disorders in children whose parents had mental disorders or low education, or lived in separate households. Still, parental income remained associated with children’s mental disorders after accounting for parents’ mental disorders and other factors, and associations were also present among adopted children.

Conclusions
Mental disorders were 3- to 4-fold more prevalent in children with parents in the lowest compared with the highest income percentiles. Parents’ own mental disorders, other socio-demographic factors and genetic confounding did not fully explain these associations.

The authors analysed immigrants separately, and excluded those with incomes in the bottom 2% as well. They could also look at adopted children, which was a useful way at looking at genetic factors. They had full data on actual earnings, and calculated family income as the after tax earnings of both spouses, adjusted for inflation. They had health data from official sources, so this study gets round all the problems of self-report. It is also a full representation of massive population size, which puts most other studies in the shade.

Fig 1
Poorer families had more disturbed children. Boys were more disturbed than girls.

Fig 2
However, boys seem to stabilize as they grow older.

Fig 3
Boys are very prone to attention-deficit hyperactivity.

Fig 5
Single parents, parents without degrees, and parents with mental disorder, have disordered children.

Higher parental income was associated with lower prevalence of children’s mental disorders, also in the international adoptee subgroup, although with a less pronounced association, compared with the Norwegian-born. For every decile increase in parental income, there were 0.25% fewer adoptees diagnosed with mental disorders compared with 0.66% fewer per decile in Norwegian-born children. Except for eating disorders, international adoptees had ∼1.5–2 times higher prevalence of any mental disorders compared with Norwegian-born children.

So, adoptees from abroad were more mentally disturbed, but less influenced by Norwegian wealth differences.

Three major conclusions can be drawn from this study. First, despite relatively equal access to health services, childhood mental disorders were found to decrease continuously with parental income and there was no dividing line above or below which additional income was no longer associated with mental disorders. The associations varied with child age and sex. Second, the association with parental income was present for all mental disorders except eating disorders and largest for ADHD. Third, the association of parental income with mental disorders could partly, but not fully, be attributed to parental mental disorder and socio-demographic factors. In addition, the associations were present, but less pronounced, in children genetically unrelated to their parents.

The influence of a genetic component is also suggested. Children of parents with mental illness are at a higher genetic and environmental risk of developing psychopathology. Low income can be a consequence of psychopathology in parents. The largest income difference was found for ADHD, a mental disorder with a strong heritable component, which is also associated with reduced income in adulthood. In contrast, the difference across the income spectrum was smaller for anxiety, which has been shown to have a large environmental component. These differences suggest confounding by underlying genetic susceptibility on the relationship between parental income and offspring mental disorders. In addition, the associations between parental income and mental disorders in adopted children were weaker compared with children living with their biological parents. The differences in the associations with parental income observed among adopted children and Norwegian-born children were also greater for ADHD than for anxiety disorders.

No intelligence test data seem to have been available, which is a pity. No DNA either, but that could be collected now, to greatly increase our understanding of genetic contributions. I have described the effects as due to wealth, but the measure actually collected was parental income. That usually translates into wealth, but strictly speaking what is being studied is the family income as children are being brought up, which may be the most important thing.

The results show some apparent effects of wealth differences, even when controlling for education. The authors speculate that the effects of income differences might be bigger in other countries. Perhaps so, but I think that the real message is that most countries will never be as rich as Norway, and even in Norway, when family income is used as an indicator, there are differences in children’s mental states which are probably nothing to do with poverty as such.

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• Category: Science • Tags: Mental Illness, Wealth 
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  1. dearieme says:

    Parents’ own mental disorders, other socio-demographic factors and genetic confounding did not fully explain these associations.

    The sceptic would wonder whether the psychiatrists are perhaps likelier to decide that badly behaved poor children are loony while rich children are just spoiled brats.

    Put otherwise, it’s often hard to know what to make of psychiatric diagnoses.

    I have described the effects as due to wealth, but the measure actually collected was parental income.

    I’ve decided that if I were to write about such things I’d apply “affluent” to those with high incomes, “wealthy” for those with lots of capital, and “rich” for those who have both.

    • Replies: @dearieme
  2. Altai says:

    So, adoptees from abroad were more mentally disturbed, but less influenced by Norwegian wealth differences.

    In the modern era with plenty of contraceptives/abortion and virtually no family being forced to give up children because they can’t feed them, children who end up in adoption are going to be massively disproportionately the children of males with extreme dark triad traits and mothers with BPD.

    It makes sense that the international adoptees would be highly loaded for innate temperaments relating to being ‘disturbed’. This depends on how old the child was too since they could have become psychologically stressed or disturbed from being in an orphanage and abandoned by their parents.

    So it makes some sense that they would be less influenced by nurture.

    Though I’m curious about the adoptees from abroad demographics since there were a lot of Vietnamese babies sent to the Nordic countries, so that could feasibly constitute almost all of the middle aged cohort who could count as ‘international adoptees’. And a lot of them were genuine orphans with dead parents and babies of the middle class who gave them up so probably a very different psychological profile.

    • Replies: @James Thompson
  3. @Altai

    international adoptees from China, South Korea and Columbia aged 5–17 years in Norway for 2008–2016, excluding individuals with the lowest 2% income (5698 children).

    The differences between China/South Korea and Columbia seemed so big I didn’t look at the details any further.

  4. @Godfree Roberts

    Thanks. The authors use Gini corrections in some of their data analyses.
    The depicted Gini scores you show make the Norwegian results even more startling: even in that egalitarian setting the earnings differences indicate other differences which impact child disorder.

    • Replies: @Godfree Roberts
  5. @James Thompson

    I hope the Chinese Academy is keeping track of stuff like child disorders.

    Beijing aims to get their Gini down to Finland’s level by 2049 and it would be great to track the impact that makes on a host of social indicators as it falls. I see many PhDs…

  6. ADHD seems to be a measure of how much a little, rambunctious lad can stand being made to sit and read for 6.5 hours a day at a cramped desk in a classroom overseen by overbearing women.

    All of this is garbage because it proposes as an ideal model for boy behavior everything that any red-blooded boy hates. We’ve an education system–now an entire society–designed and implemented by noxious women.

    There’s too much Tom Sawyer or Huck Finn in me to have ever made much of a mark in today’s world, irrespective of my native talents or abilities. I suspect that there’s lots of other men out there who fall into the same category. We will die out (unmourned) because we’re just of too little or no use to what passes for civilization today.

    ADHD is another name for a boy who would rather be outdoors learning by doing than cooped up with Mother hens and held to the same standards as well-behaved, compliant girls.

  7. I would like to think that attention deficit disorder is just natural rebellion at teachers, but it is a feature of behaviour which shows up early, and is easily detectable at age 3, as shown in the Dunedin studies.

    • Replies: @ThreeCranes
  8. dearieme says:
    @dearieme

    On second thoughts, I’ll use “rich” for people with lots of capital and “wealthy” for those with both lots of capital and lots of income. (Because of the obvious mnemonic advantage.)

  9. @James Thompson

    The school environment is the occasion in which it manifests itself glaringly, since all are expected to adhere to the same standard, and a rather constricting one at that.

    Forcing human animals to sit in stalls for 8 hours a day is a bit unnatural, N’est-ce Pas? Normal animals rebel at such restrictions. We humans had to have been either or both psychically deadened and/or physically defeated to bow down and submit to such conditions. I suppose that as time passes, socialization pressures genetically select for meek compliance. The outlier is deemed ADHD. Who knows but that their restlessness wouldn’t have been an asset in a bygone era.

    One thing about frontier societies such as that of the American West circa 1885 is that they provided a venue to which the marginally disabled could find their way and in which they could somewhat function. How did Twain put it?

    “But I reckon I got to light out for the territory ahead of the rest, because Aunt Sally she’s going to adopt me and sivilize me, and I can’t stand it. I been there before.”

    Or, as Nietzsche said, “Inside every real man a child is hidden who wants to play.”

  10. @ThreeCranes

    ” . . . We’ve an education system–now an entire society–designed and implemented by noxious women.”

    Eighty percent of public school teachers are women. And. of course, they’re steeped in feminism and political correctness, so I see what you mean. . . .

  11. Adoptive mothers of children that look nothing like themselves………………..likely mental issues.

  12. unwoke says:

    “Norwegians are dying out, their total fertility below replacement, so they are of only historical interest, but serve to illustrate what a very rich country can provide its citizens in terms of very high-quality universal health care, and a sovereign wealth fund…”

    So, this is probably the most interesting point. Why are Norwegians “dying out”? Does Norway serve to illustrate that a very rich country can provide its citizens with almost everything that money can buy – everything except a will to live? Are Norwegians having too good a time to want to be tied down with children or don’t they believe in their own future anymore? Do any affluent white people believe in themselves anymore? [And no country historically, has been more white than Norway (even when it was part of Sweden)]. Is that a “mental disorder”?

  13. What came first?

    Mental ‘disorders’?

    Or expensive psychological ‘specialists’ with vested financial interest in finding more mental disorders’?

    Hey, everyone gotta earn a living, right? Therapy, research grants, pills, it’s a hell of an industry. All you have to do is open a whole new profitable area of disorder and bingo! Ka-Ching, Ka-Ching, ring the register. Monetize it and they will come.

  14. The fertility rate is partly due to issues raised by Dutton in his recent article namely native women are having kids later in life because of education and careers. It’s not really childlessness.

    The drift towards urban areas has also been linked to fewer large families.

    Finland faces the same dilemma and is in worse shape.

  15. dearieme says:

    Contraception lets you divorce heughmagandie from pregnancy. The rest follows.

  16. @ThreeCranes

    No. Take out a group of cubs or scouts and the ones with ADHD still stand out even when allowed to run loose. Anecdotally, I do not recover such behaviour from my peers when i was young.

  17. I find myself surprised at the result but then, my attitudes were formed in the 1970’s or earlier when poor people weren’t indulged with psychological diagnoses other than for extreme conditions. obviously poverty is more stressful but access to healthcare even in a UK context is/was easier for the better off. I appreciate that the point about the Norwegian situation is that serious poverty other than individual failure to cope does not exist. So we are seeing the stresses of inequality rather than deprivation? And of course the genetic sorting argument.

    Eating disorders. especially anorexia, are the leading cause of death (usually suicide) amongst the mentally ill. Anorexia has been common in my family. I am prepared to believe it is genetic.

    • Replies: @dearieme
  18. dearieme says:
    @Philip Owen

    Anorexia has been common in my family. I am prepared to believe it is genetic.

    And yet I don’t remember its existing when I was young.

    It reminds me of the mystery of obesity. In part it’s genetic, yet as a youngster I never saw the sort of land whales you see nowadays.

    So presumably both are the result of a combination of genetics and the environment. Presumably also the evidence for which parts of the environment matter will be inconclusive (except to the sort of people who write in the Guardian obviously).

    • Replies: @James Thompson
  19. dearieme says:

    Recently we had a discussion of the effect of lead on … IQ? Crime? Anyway, something interesting.

    This caught my eye at Astral Codex Ten.

    • Thanks: res
    • Replies: @James Thompson
    , @Factorize
  20. @dearieme

    Yes, saw it earlier today. Makes sense.

  21. @dearieme

    First described by Sir William Gull in 1873. I spent a lot of time treating anorexic patients 1968-1971.

    • Replies: @dearieme
  22. dearieme says:
    @James Thompson

    That’s interesting. Am I right in my impression that it wasn’t common in the 50s and 60s? Or is that a rosey-hued picture of childhood and youth, further biased by going to a rural school? Or maybe biased by my being unobservant?

    • Replies: @Philip Owen
  23. Factorize says:
    @dearieme

    Thank you very much for returning to lead. I am largely convinced of the validity of the lead hypothesis: I am an eleadist now. The evidence is simply near conclusive. Even the article that you cited has notable lead researchers who advocate ZERO BLLs because they feel that no level of lead is safe. I would not have previously believed this position, though the near disappearance of Juvenile Property Crime in the US has convinced me. A conversation about the dramatic change in the mental health of modern society in relation to the removal of lead neuropathology should begin. Without such a conversation things will just happen and it will all seem so mysterious. Considering the near end of crime it really should not be a big mystery as to why mass arrests of largely peaceful protesters has become such a common occurrence.

    {These top researchers must be frustrated to have their work interpreted in the way it is in the article. I am sure that I would be. They have spent decades researching lead and they have been correct for decades: lead is a central neurotoxin that explains much of our social pathology. Yet, the article is able to reverse this main finding of decades of research.

    As a suggestion, I think that different research groups could craft statements of common understanding (such as was done with psychometrics in the Wall Street Journal in relation to the claims made in The Bell Curve about human intelligence). So, for lead, a statement could be crafted and then this statement could be uploaded to pubmed. When someone read an article about lead and crime, they could then access the researcher’s personal stated position about the topic (perhaps for convenience their position could be color coded or given some brief numerical score). The idea would be to allow a reader to rapidly see how fairly an article is interpreting a researcher’s work. One could effortlessly determine what quoted experts felt about their research findings without having to read through decades worth of journal articles. Basically, make the findings of their research much more accessible }

    What has happened in the last 20 years that has resulted in a 99% reduction in early teen crime? The latest lead measurements suggest that we are in store for even lower crime rates in the years ahead. It is stunning! Do they publish any early development measures on a national scale for the US? As it is now we have to wait ~20 years to know what lead did to the brains of infants. Given how critically important neuro-development is, it would be highly advantageous to have early development markers perhaps as early as kindergarten or grade 2-3. Why wait 20 years to find out how the future will turn out when we can know now!

    It is funny, when I look at the picture at the start of this article, I don’t see IQ or income; I see a low lead environment.

  24. @Factorize

    The point is that your conviction about the effects of lead may be based on publication bias. For a time I was convinced that early childhood intervention had beneficial effects on behaviour (though not really on intelligence). That too turned out to be based on publication bias.

  25. @Factorize

    There was crime before lead returned to the general human environment. (Returned because the Romans had lead pipes).

  26. @dearieme

    All those medieval saints, especially female, known for fasting.

    • Replies: @dearieme
  27. dearieme says:
    @Philip Owen

    That’s an interesting parallel. Is it a case that fasting is a vogue that comes and goes? Did 18th and 19th century women do it, for instance? Do any of the novelists mention cases?

    • Replies: @Philip Owen
  28. @dearieme

    Good question. Not so far as I am aware, even indirectly, even for, say, laudanum addicts but I am not that well read in 19th C novelists. Such novels are of course full of young ladies in difficult situations but resort to fasting does not seem to appear or perhaps was too commonplace to mention? That said none of the older 19th C photos of my female relatives (but they are not from the anorexic working class side of the family), show emaciated figures. No female suicides either. Two professional singers generations apart appear to have been positively plump.

    The modern term Eating Disorder also includes bulimia and obesity of course.

  29. @Factorize

    I forget. There is a line of plumbers in my family. My grandfather was speckled with blue spots from lead contamination. Some plumbers did go didorath early. However

    1) He kept his wits and sharpness until he died at 84.
    2) Plumbers do not have a reputation for criminality or violence.
    3) Neither did lead miners (I knew a few ex lead miners in Mid Wales). Sober and chapel going compared to colliers.

    People from the Mendips are exposed to high levels of lead and cadmium in the soil. The Mendips are not notorious for high crime levels. So if lead exposure leads to crime, it must be acting on genetically susceptible individuals, not everyone.

    • Replies: @dearieme
    , @Factorize
  30. dearieme says:
    @Philip Owen

    Could the form of the lead matter? I take it that the lead from (olden times) petrol is likely to take the form of lead atoms dispersed in aerosol droplets. I can picture those being more easily inhaled than some other forms.

    On the other hand, the lead hypothesis has a hurdle to overcome in that it sounds like excuse-making.

    “Not my fault, guv, it wuz the lead wot dunnit.”

  31. Factorize says:
    @Philip Owen

    Philip, my current position is that lead was the prime agent of social collapse in the 20th Century. Anything bad that happened (especially newly emerging badness) in the previous century was caused by lead. Not my fault it was lead is pretty much a blanket pass for everything bad that happened more than twenty years ago. This is not entirely some far fetched radical position; the current stance by grownups in the US medical establishment is that there is no safe level of lead. The quoted article that found that lead did not cause the majority of the crime problem etc. went far out of its way to caution against the extreme dangers of lead. It too noted that there is no safe level of lead.

    The publication bias idea is not overly persuasive for me. They included the Swedish moss study. Basically, take moss samples as a proxy for the BLL for thousands of school children. The Australian air sample study basically measured the lead content of the air and observed the response in crime 2 decades later. Admittedly this is good value for the research dollar, though in terms of probing the finer details of the lead story much more exact methods are needed. Doing a study and then calling it publication bias overlooks the methodological bias that is present: Measuring lead levels in moss etc. introduces substantial bias to accepting the null.

    Most nations have taken the moss study approach to avoid excessive cost. America is the only nation that has spent large money on population scale lead testing. These studies have reported very impressive results. In a quasi-experimental study, when they treated children with high BLLs (> 10 microgram/deciliter) their subsequent rate of crime fell by ~70%. Other ~experimental designs have confirmed large effects. With the proper scientific tools the devastating social consequences of lead become all too self-apparent. When an exhaustive list of other possible variables were investigated only lead showed large effects. With such strong science one could ask questions such as: Why did this child commit a crime and not some other child in what might seem the exactly same circumstance? One could look at genetics; perhaps even looking at what floor the children lived on (as this might affect lead exposure), etc. . The potential of the American research to provide highly insightful answers is overwhelming.

    America is the ultimate test laboratory for lead exposure because it had such a wide range of exposures. In the cited Swedish study, they noted that there was alarm over the rise in lead levels 50 years ago and an action plan was developed at that time to counter the threat. Swedish BLLs in school children began to decline in the 1970s (~ 7 mcg/dL) after removal of lead from gas, while other sources of lead had been banned decades before. US urban BLLs in adults in the 1970s were measured ~30 mcg/dL which is almost beyond imagination. The current American action level is approaching 2.5 mcg/dL. The homicide rate in some low-income neighborhoods in Chicago was measured per 1,000 population, while in low crime nations it is approaching per 1,000,000 population .

    With respect to your family experience, it is important to keep in mind that early childhood lead exposure has been found to be the most profoundly dangerous. Exposure during those critical ages restructures the neuroanatomy of the prefrontal cortex: the prefrontal cortex is the organ of civilization. Without the organ of civilization, you wind up with the decivilization of the 1960s, 1970s, 1980s, and 1990s (not what we have seen during the 2000s, 2010s or 2020s).

    There are other spurts in neurodevelopment, though the early age period (<5 years) appears to be the most critical. Those cohorts that have recently developed during low lead exposure are exhibiting very different patterns of crime and other behavior. The emerging generation do not commit crime, they are performing at a high academic level, don't take drugs, are nice … the genius generation. Apparently, the big problem that has emerged is that their parents who grew up with high lead exposure now have higher crime rates. It is not known how to repair this brain damage from lead in the early years (though I am thinking of buying 7,8 dihydroxyflavone as this might help with certain aspects of brain damage from lead).

  32. dearieme says:

    “It too noted that there is no safe level of lead.”

    How odd: usually ‘the poison is in the dose’.

    Anyway, it’s good to know that lead is subject to the principles of homeopathy.

    • Replies: @Factorize
  33. Factorize says:
    @dearieme

    The problem seems to be that they used the lethal dose as the benchmark. Lethal dose of lead is ~70 mcg/dL. In urban America during the 1970s etc. children would experience seizures, coma and sometimes fatalities at these levels. Average BLLs in inner city American adults in 1970s were measured ~30 mcg/dL (i.e., ~50% of the lethal dose). Even Sweden allowed 7 mcg/dL (10% of the lethal dose) levels in their children in the ~1970s.

    Clearly these are not homeopathic doses. In modern toxicology the typical protocol seems to be to find the no observable effect level and then divide by a safety factor of 100 or more. Yet, the research from the cited article was finding observable effects from lead even ~2 mcg/dL (~1% of a lethal dose). Probably better to state BLL in units of nanograms per deciliter so 70 mcg = 70,000 ncg and 1 mcg= 1,000 ncg. Stating it in micrograms per deciliter gives the mistaken impression that the dosage level is harmless or even non-consequential: It isn’t. Using modern standards of toxicology, the target BLL perhaps could be set at 1 ncg/dL, though the NOE level has still not been established: the correct units might be picograms per deciliter. Lead apparently truly is that toxic. The goal of a 0.0 level seems well justified.

    Lead has caused such profound devastation. It should be no great surprise that most of the conflicts in the recent past (e.g., in Afghanistan, Iraq, etc.) involve some of the last nations to phase out leaded fuel.

  34. I assume you saw the recent Finnish cohort study that Steve Sailer mentioned:

    https://www.unz.com/isteve/finns-be-finns/

    https://academic.oup.com/ije/advance-article/doi/10.1093/ije/dyab099/6288123

    In this Finnish cohort study of 650 680 individuals, we initially found that increased family income was associated with lower risks of psychiatric disorders, substance misuse and arrest for a violent crime.

    However, once we compared siblings who grew up in the same household but were exposed to varying income levels at specific ages, the associations were no longer present.

    Associations between family income and subsequent psychiatric disorders, substance misuse and violent crime arrest were therefore explained by shared familial risks and were not consistent with a causal interpretation.

    Looks like a better way of adjusting for unknown/ unmeasured confounders than this one — assuming the math is correct.

    • Replies: @James Thompson
  35. @Godfree Roberts

    In other Gini coefficient news, the progressive utopia of California has a higher Gini coefficient than Mexico — and Guatemala.

    • Replies: @Godfree Roberts
  36. @James Forrestal

    The mix of Silicon Valley billionaires and Mexican immigrants pretty much guarantees that.

  37. Factorize says:

    Doctor Thompson, aducanumab has been approved by the FDA for Alzheimer’s disease. A world without dementia would be transformative for human society. I am interested in your perspective on this story.

    • Replies: @James Thompson
  38. @Factorize

    I saw that it had been approved, but don’t yet know why, when the trials had not given clear positive results. Are there studies I should see?

  39. @James Forrestal

    Amir is a very sound researcher, so I will read it and ponder.

  40. Factorize says:

    There is a great deal of background drama related to the aducanumab approval; perhaps one of the most dramatic of which was the phase 2 result for donanemab (another anti-amyloid antibody) in AD. It reported positive results on ~January 12, 2021 which were highly similar to those of aducanumab. This apparently caught the attention of the FDA. Two weeks later the FDA decided to postpone its regulatory decision for aducanumab until June (from March). What is especially notable about the donanemab study was that it included both an amyloid and a tau measure for patients. By selecting for both amyloid and tau, there was a 50% decline in progression in the treated group. Many of the other patients with too much or too little tau did not show any benefit.

    Another anti-amyloid antibody (lecanemab) result was published in April– also positive. Notably in this study there was a 99.2% probability that treatment was superior to placebo in APOE e4 carriers. There was also a 93.6% chance that these patients would have a clinically meaningful response (i.e., >25% benefit over placebo). APOE e4 carriers have appeared to respond better to antibody treatment. This result was all the more notable as only 45 patients were randomized to this treatment arm in the adaptive trial design. The European regulator prohibited further enrollment in this arm due to safety concerns.
    https://alzres.biomedcentral.com/articles/10.1186/s13195-021-00813-8

    Other amyloid-lowering treatments in AD have also recently reported: They were also positive.

    There are other promising late stage treatments that raise the potential for effective therapy for Alzheimer’s. Perhaps it might be worthwhile to consider the possibility of a super-aging society. What might life be like if people had another 20 or 30 years of high functioning cognitive ability? This might have considerable implications for immigration policy in Western nations.

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