Wednesday, 28 January 2015

Do common drugs really cause dementia?

I am starting to wonder whether to believe anything we hear on the news these days. One day things are bad for us, then the next they are not sure if they got the information correct in the first place

Media reports of a recent study suggesting a wide variety of common drugs can increase the chances of getting dementia are more sensationalism than science
Woman takes a pill, Symbolic picture for: Medicine, medicine costs, pharmaceutics.
Side effects may include widespread neurological degeneration. Or not. Photograph: Ulrich Baumgarten/U. Baumgarten via Getty Images

If you looked at the news at all yesterday, you will likely have heard about a new study that claims an alarming range of common drugs - including Nytol and over-the-counter hayfever pills - can increase the risk of developing dementia in people over 65. The mainstream media have shown a disconcerting enthusiasm for reporting this finding, despite the fact that much of the coverage and claims made can be described as exaggerated at best, scaremongering at worst.
For example, the researcher speaking about the study on the BBC Radio 4’s Today programme earlier emphasised how antidepressants can cause a 50% increase in risk of dementia. But this only applies to a very old class of antidepressants known as “tricyclic”. Some people still get these in certain cases, but the vast majority of antidepressants prescribed today are more modern SSRIs, and no connection between these and dementia is made, so the simple claim that “antidepressants cause dementia” is somewhat alarmist.
There are plenty of other critiques to be made, such as how depression and dementia actually occur in the same person very often, so you’d almost expect older people on anti-depressants to be more likely to develop dementia. But perhaps more concerning than any issues with the research, is how can a scientific study with questionable claims, that many scientists would dispute, end up with widespread mainstream coverage, while countless more thorough and valid experiments get ignored?
Here’s a confession that you won’t normally see in a popular science blog, but if you’re not directly involved, most scientific studies are actually quite dull. Perhaps science in films and TV dramas has led people to believe that your typical scientific experiment produces unexpected or shocking results, leading the (suspiciously attractive) lead scientist to gasp and say something like “This changes everything!”
In truth, most studies last for weeks/months/years, and once the reams upon reams of data produced are thoroughly analysed (usually by sleep-deprived postgrads) the eventual conclusion is more like: “That overlooked minor process that is one of hundreds of elements of a more complex system? Well, it turns out it works slightly differently to what we thought”. You can see how such a discovery might be difficult to get publicity for.
So it may be understandable that we see scientists, or perhaps more accurately their institutions, exaggerating and emphasising the results of studies to gain attention, especially if their jobs depend on it. However, this drive for scientists to get publicity for research is increasingly criticised, and can go too far.
But scientists wanting the publicity is only half the problem; why do so many media sources seem so keen to cover stories like this? There are many possible explanations, many of which are quite cynical.
The simplest explanation is that on slow news days a science story can get a great deal more attention than you’d normally expect. It’s not like the latter half of January isn’t known for media focus on ridiculous, depression-related claims…
But in a more practical sense, a study of this nature is easily related to the general public that media outlets rely on to make money. It’s not about some unknown or poorly understood corner of science, it’s about common and everyday drugs that practically everyone will have taken at some point in their lives, and linking them to a well-known but deeply alarming neurological condition. Thus, it is relatable, and people will be keener to read about it as they believe it applies to them.
If we’re being generous, it could be argued that the extensive coverage of this story is the result of a sense of public duty. If you discover that a common substance is dangerous, the decent thing to do would be to warn as many people as possible, and surely the media wouldn’t hesitate to encourage the general public to stop any behaviour that might harm them, no matter how slim the actual risks?
That noise you can hear right now is the sound of every credible climate scientist on Earth laughing bitterly.
Sadly, you can’t rule out the likelihood of the classic tactic of scaremongering. It seems like nothing sells papers/generates traffic like striking fear into the populace, and it seems that’s happening with coverage of this story.
The study itself is rarely, if at all, linked to in any of the reports, but the general gist is that a wide variety of anticholinergic drugs show possible links to increased risk of dementia. But most reports decide to single out a specific type, as if nobody can agree which drug is the most innocuous and therefore most worrying in this context. Sleep remedies? Hayfever pills? Or perhaps just emphasising the “over-the-counter” nature of some of the drugs, despite most of the subjects being on prescription medicines for chronic conditions.
What’s the harm in any of this? So a few column inches/web pages were filled with not-strictly-accurate science, so what? Well, you could say exactly that about the MMR/autism “study” that got such widespread coverage, and now we’ve got an outbreak of a potentially-lethal virus in the happiest place on Earth.
This is what happens when supposedly trustworthy news sources opt for sensationalism over accuracy. Not everyone trusts “the papers”, but enough people do that they still wield considerable influence. Hopefully this story won’t trigger some sort of anti-drug movement comparable to the anti-vaccination ones, but it still has the potential to do great harm. People could be reluctant to take medications they genuinely need, already beleaguered GPs could end up with constant demands for alternative drugs and second opinions, and in the long term this could lead to dementia being viewed as somewhat self-inflicted. As friend and superior intellect Professor O’Neill of Ulster University points out, this sort of reporting serves to further shame and silence those with mental health issues. And these people don’t really need any more of that.

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