[Opinion] Diagnosing Dementia in the Dark: Who Really Tests Koreans ...

http://english.hani.co.kr/arti/english_edition/e_opinion/532695.html

Home > Opinion

All Editorial Opinion National North Korea International Business Arts & Entertainment Hot issue

[Opinion] Diagnosing Dementia in the Dark: Who Really Tests Koreans for CJD and Alzheimers?

By Mark D. Whitaker Who really tests Koreans for neurological diseases like prion diseases of CJD and

Introduction Sister Journals Historic Frontpages Advertising

Alzheimers? No one. Given the U.S. mad cow beef scare in Korea, it is important to keep updated demographic information on changing dementia patterns in any population. This helps to determine if any particular beef consumption may be tied to human mad cow, otherwise known as Creutzfeldt-Jakob Disease, the human form of prion disease. However, at present it is possible to give correct diagnoses of many neurological diseases like CJD only via autopsy after death. The U.S. lacks required autopsies for neurological diseases to verify if any doctors diagnoses of dementia were correct. It is truly a diagnosis of dementia in the dark. In the U.S. real autopsy tests of neurological disease deaths are undertaken voluntarily, if at all. In the U.S., at one time autopsies were performed on about half of all corpses. However, by 2003 that percentage dropped to 15% or less. In 1995, the U.S. National Center for Health Statistics even stopped collecting autopsy data at all. In Korea, it is the same. There are no laws requiring verification of any diagnoses of neurological diseases to see if what doctors claim people are dying of is true. Why is this important? It is important because classification error and incorrect diagnoses can hide a lot of CJD this way. In fact, there is evidence that such misdiagnosis of neurological disease is widespread in the USA. A total of three different peer-reviewed studies find a lot of human mad cow (CJD) in the USA when autopsies actually are done and the false diagnoses of Alzheimers are revealed. It is scandalous to keep ignoring it. Three studies have found classification error hiding CJD in the USA. First, as long ago as 1989, a Yale team finally did systematic autopsies on those in the U.S. diagnosed as Alzheimers-and diagnosed found 13% really had really CJD. had www.vegsource.com/articles a Third, a TSE much disease. larger /bse_editorial.htm. In a second smaller investigation, the result was similar: 3 of 12 with Alzheimers www.organicconsumers.org/madcow/andrew1804.cfm. 5%,...estimated at 200,000 CJD in the U.S. per year. To elaborate one study, Laura Manuelidis, chief of surgery of the Neuropathology Department of Yale University in 1989 study found 13% U.S. Alzheimers patients really had CJD. Several studies including hers found autopsies show 3% to 14% of patients falsely diagnosed with Alzheimers or dementia really suffered from CJD. Those numbers might sound low, but there are 5.4 million Alzheimers cases, hundreds of thousands of dementia cases in the U.S. by 2011, and up to 200,000 early onset Alzheimers in the USA by 2011. They argued that a small percentage of these can be up to 120,000 or more CJD cases undetected, not included in official statistics.
Most viewed Artcles

[Editorial] How can we ex.. Tallest Lego building New Hope for high schoo.. Hyundai Motors resisting .. Korean fishing vessels ac..

University of Pittsburgh study found the [U.S. prion disease] misdiagnosis rate of

1 of 4

5/14/2012 5:38 PM

[Opinion] Diagnosing Dementia in the Dark: Who Really Tests Koreans ...

http://english.hani.co.kr/arti/english_edition/e_opinion/532695.html

Thus the fact is that probably a lot of Americans--and many others worldwide--have died due to American beef infected with prions, leading to human Creutzfeldt-Jakob disease (CJD). There is evidence connecting prion-tainted food intakes to even CJD, particularly Dr. Jean-Philippe Deslys work at the French Atomic Energy Commissions medical research laboratory, or Prof. Richard Marshs work (his grant proposals to test more U.S. cattle for what he found were routinely turned down). So there is evidence that human forms of CJD are indeed linked to under-researched forms of animal BSE. There is related evidence that neurological diseases in the USA continue to be falsely classified as Alzheimers disease (that is exploding in the United States) instead of classified by actual tests to show how much of it is really CJD. Dementia is rising in Korea as well, and not all of it can be attributed to an aging population. I anticipate that the Korean Alzheimers rate will soon go up in a politically convenient fashion unless something is done to set up medical tests to discriminate accurately between the scale of actual Alzheimers and actual CJD in Korea. Three facts are important here. First, the import of US beef was banned in South Korea and elsewhere in the world after a case of BSE was discovered in a U.S. cow in 2003. At the time, South Korea was one of the worlds biggest consumers of U.S. beef with an estimated market value of $815 million. Second, Alzheimers has indeed been going up in Korea since 2005. You might say that an aging population causes this, and it is bound to happen. However, these Korean Alzheimers diagnoses are growing among those whom you least expect it--young adults in their 30s. As reported in the Korea Times recently (30-Somethings Vulnerable to Dementia? [5-07-2012]), The National Health Insurance Corporation notes that since 2005 patients with pre-senile diseases have been steadily rising particularly among those in their 30s. Those in their 30s account for about 9 percent of patients suffering from illnesses such as early onset Alzheimers. They report that dementia among the elderly additionally shot up bizarrely high since 2005 as well. From 2005 to 2010, those in the 75 to 84 age group who acquired the dementia causing diseases rose more than twofold, reaching 309,000. An age-adjusted dementia rate more than doubled in this elderly group in just five years. From 2005 they measured a similar onset of dementia in among people in their 30s as well. Theres something special about that year. What happened from 2005? Is it only better testing or is this actually dementia, Alzheimers, or CJD after short-term incubation in human brains? The only way to tell is via brain autopsy after death. Any other diagnosis of living dementia patients by doctors is without this data, and doctors are merely guessing with a diagnosis in the dark. As reported by the International Journal of Geriatric Psychiatry in 2006, South Korea is already one of the places where by 2002 there was a growing cost in elderly dementia patients. How many of these might be CJD? Does the money that Korea saves by importing cheaper beef actually cost the government and public far more in health care later on? For my suggestions on Korean policy improvement, we can update science and public policy to test every Korean neurological patient via autopsy when they die (to catch misdiagnoses of Alzheimers and other neurological problems--that may be CJD/mad cow in humans). Soon there may be an alternative test, a better way to test for CJD called the Surround Optical Fiber Immunoassay (SOFIA) first tested in New York in 2010. With this technique, doctors could test for CJD in the living instead of having to wait for autopsy to verify which diagnoses of human dementia are correct. However

2 of 4

5/14/2012 5:38 PM

[Opinion] Diagnosing Dementia in the Dark: Who Really Tests Koreans ...

http://english.hani.co.kr/arti/english_edition/e_opinion/532695.html

autopsy is currently still the only accurate test for verifying dementia diagnoses. My other suggestion is to test every cow for BSE (U.S. and Korean cows), and my suggestion is to use the Western Blotting test. Japan (from 2001-2005) and the European Union test all cows. US and Canada test less than 1%. Moreover the so-called Gold Standard test (real name) that the USA has chosen for its mad cow test is an immunohistochemical screening test. This choice of test (intentionally?) doesnt get its results back for several weeks. So by that time, is any tested beef already processed and likely in a consumer stomach or in another industrial food product? The Japanese call the mad cow test the Western Blotting test. It is a protein-based test for prions. Japans choice of Western Blotting is a much cheaper and quicker test. It takes only hours to test a cows brains so the Japanese can remove all BSE-tainted meat easily while it is still in the factory. Noted from a scandal in 2001, the Japanese Western Blotting test seems to be a better gold standard since it is more sensitive to cases of BSE that the U.S.s chosen so-called Gold Standard test that misses them. So despite this already low international standard of regulation and prion testing across North America for beef, the USDA testing for mad cow has been reduced even lower--by 90% since 2005. Which regulation system do you think produces the better product as a result, and which one has less systemic health problems you have to worry about? The best solution is to encourage a more sound local food supply that can at least be regulated by the Korean government with potential checks and balances of national politics--unlike the Melamine Roulette game from China, or the Mad Cow Roulette from the USA and Canada. Take the high road: regulate your own industry at home better, and the whole world will want and trust Korean safer products. South Korea could develop a reputation for producing the worlds safest food. If the low road is taken, no one wins except the prions. Mark D. Whitaker has taught environmental sociology at Ewha Womans University and Kookmin University. He is also the author of Toward a Bioregional State (2005), the first book on green constitutional engineering, and Ecological Revolution (2009). The views presented in this column are the writers own, and do not necessarily reflect those of The Hankyoreh. Please direct questions or comments to [englishhani@hani.co.kr]

Posted on : May.14,2012 11:41 KST

Modified on : May.14,2012 15:48 KST

2006 The Hankyoreh Media Company. All rights reserved. No part of this material may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, mimeographical, in recorded form or otherwise for commercial use, without the permission of the Hankyoreh Media Company.

3 of 4

5/14/2012 5:38 PM