Another Alzheimer’s clue

With amyloid protein no longer the only game in town when it comes to Alzheimer’s causes, researchers are opening up other avenues. For example, scientists at Oregon Health & Science University have uncovered a new connection involving iron.

Microglia are the body’s cleaning ladies, removing damaged cells. But sometimes people have excess iron in their brains’ myelin. When those myelin cells are damaged, the microglia that come along to clean them are are killed by being exposed to the iron — it’s called ferroptosis^*.

Dead microglia can’t do their job, and that means damaged myelin builds up like trash in an office building when a lot of the cleaning staff is gone. And that, they think, could lead to the development of Alzheimer’s and vascular dementia.

“We’ve missed a major form of cell death in Alzheimer’s disease and vascular dementia,” one researcher said. “We hadn’t been giving much attention to microglia as vulnerable cells.”

^* Fantasy-novel readers can make their own comments about death by cold iron.

Comparing Part D plans can save big

Patients may not realize it, but finding the right Medicare Part D plan can make a huge difference in what they spend on meds. Looking just at treatments for prostate cancer, University of Michigan researchers used the federal Medicare plan finder^* to see how much of a difference it made.

One example: “Out-of-pocket costs for abiraterone prescriptions ranged from $1,379 to $13,274 among all Part D plans.” Yeah, that’s almost $12,000 difference. (Enzalutamide ranged from $9,854 to $13,061 out of pocket.)

Medicare open enrollment runs October 15 through December 7.

^* Medicare.gov/plan-compare

The secret painkiller algorithm

Back in 2021 we told you about how AI is being used behind the scenes to deny people access to pain meds based on what’s called a Narx score, named for the company that provides the service — but that doesn’t reveal how it calculates that score.

It’s been a while, but the issue is getting some more coverage, this time by KFF Health News (by Andy Miller of Georgia). Once again, the issue isn’t just that a computer is making decisions about people’s lives, but that the company refuses to disclose how those decisions are calculated.

Lacking the ability to see inside these systems leaves only clues to their potential impact. Some patients say they have been cut off from needed care. Some doctors say their ability to practice medicine has been unfairly threatened.

Almost a Captain Obvious story

If you permit it, they will use it. UMass research: “States that enacted laws permitting children to carry and apply sunscreen at school experienced an increased interest in sun protection and a higher rate of sunscreen use.”

But seriously: There are states (Georgia is one) where schools or school districts can ban the use of sunscreen or require students to get a doctor’s note to use it. It’s not that these states are against allowing sunscreen, it’s just that no one has pushed to have a law passed.

By passing statewide laws allowing sunscreen use, more people read up on sunscreen and more kids start using it. That kind of law not only tends to have broad bipartisan support, it’s “linked to an 8.3% increase in sunscreen use by high school students.”

Short Takes

Is it safe to kiss your pet?

Yes, almost certainly. (Except for turtles or chickens.)

Vaping shrinkage

Good news for male rats whose underwear is too tight.

Elsewhere

In Texas

Texas no longer considers menstrual pads and baby diapers to be “luxury items” and thus will not tax them as such. (Side note: 16 of the 174-member Texas legislature voted to keep the tax.)

In several states

Not content to wait for the federal government’s drug price negotiations to take place, states are starting to pass their own limits on what their Medicaid programs will pay for certain drugs, as well as what state-regulated commercial and employer plans are allowed to pay.

(What’s not clear is whether they’re limiting what co-pays plans can charge, or whether they’re looking to limit what the plans can pay drugmakers for these meds.)