Thursday Shorts: Antibiotics, mammograms, and eternal life
October 17, 2024
1. Antibiotic prescriptions decline
Antibiotic resistance continues to make many bacterial infections more deadly, and few novel antibiotics have been marketed over recent decades. Pharmaceutical companies recognize that new drugs that will be taken for life are likely to lead to higher profits than antibiotics taken for a short interval. Researchers reported in the American Journal of Epidemiology that antibiotic prescriptions declined between 2011-2019 by 13% (from 877 to 765 prescriptions per thousand people per year). Prescribing rates declined most among those under age 20 (down 25%). This decline in antibiotic use can help maintain effectiveness of existing antibiotics.
2. Mammograms can detect early heart disease
Mammograms can detect early breast cancer using a tiny dose of radiation and new research shows that mammograms augmented with artificial intelligence can detect calcium deposits in breast arteries that are an indicator of potential heart disease. About one quarter (23%) of women were found to have breast artery calcification, which was associated in this population with a three times higher rate of death. Higher levels of calcification were associated with higher rates of major adverse cardiovascular events and death. The test was especially helpful at refining estimates of risk of heart disease in younger women and nonsmokers.
This was a single study at a single health care delivery organization, and it will be good to see confirmatory studies. If these findings are confirmed, this will increase pressure on health plans to add coverage for AI add-ons. This will also encourage the adoption of a billing code for these services, which currently must be billed using a miscellaneous code. Here’s a post from early this year on AI augmentation of mammograms.
3. How long can we live?
Source: Olshansky, et al Nature Aging October 7, 2024
There has been substantial press coverage of a Nature Aging article this week that suggested that radical life extension in humans was “implausible.” The authors reviewed mortality statistics from the eight countries with the longest lifespan and Hong Kong and the US and found that only South Korea has had continued rapid increase in lifespan over the three-decade period, and South Korea started with a low average life expectancy and has had a remarkable increase in income per person. Hong Kong had a rapid increase in life expectancy in the first half of this period, associated with economic growth and decreased cigarette use.
This is in contrast to assertions by some scientists and influencers that we can essentially abolish mortality.
My take is that even if we might not be able to do much to help people lead healthy and meaningful lives over age 100 or 110, there is plenty that we can do to increase life quality and life expectancy right now. Here are some important “system” approaches to helping people live longer and better lives:
Improved maternity care to lower infant and maternal mortality.
Continued efforts to decrease tobacco use, which is still responsible for an estimated fifth of all cases of cancer.
Improved diet, with more vegetables and less ultra-processed foods.
Decreasing air pollution.
Increasing access to places to safely exercise, and increased infrastructure support for pedestrians and cyclists.
Decreasing economic insecurity, which is highly associated with premature death (see posts above about health disparities).
See this post by Patricia Toro about the likelihood that reported supercentenarians might have been younger than reported.