[dogmatism]

a) average age is 77

b) drugs cost a shitload (hundereds of thousands/yr) to extend lifespan by...months

c) only for ATTR (not AL) amyloidosis

d) the drive to diagnose and treat only really started after tafamidis (1st drug with any effectiveness) was marketed...hmmm

e) the dude in the article used as an example was probably helped more by treating his afib than by the fancy drugs

for sure there are some genetically transmitted younger patient for whom this is important. But there are a lot of frail older people who are getting diagnosed with wild-type ATTR amyloid for...questionable benefit at massive cost. IMO, the jury is still out

[quantumwoke]

What's with the kneejerk takedown?

a) Yes, it's more common in older people. A lot of old people end up in hospital

b) 30% fewer deaths and hospital admissions is a good thing in my book

c) The more common form according to my wife

[epcoa]

> The more common form according to my wife

Not sure what relevance the source has here, but it’s not correct. Primary (AL) is the most common in the developed world and secondary (AA) elsewhere. There are some foci of ATTR but it is by far not the most common.

[quantumwoke]

I should have mentioned my wife is a physician, apologies. The true prevalence of ATTR is not known since it's only been investigated for recently as described in the article. If you look up recent data you'll see a big difference.

[philwelch]

“Fewer deaths” is a meaningless concept. Every human being inevitably dies. If you prevent someone from dying today, you have only delayed the inevitable. In some cases this is extremely valuable; if you save a newborn baby, that baby could live eighty more years. If you save a 77 year old, they will not live eighty more years. And if you repeatedly save elderly people from natural conditions that could easily kill them, their quality of life gets worse and worse over time as their bodies wear out and decay and the side effects of these interventions build up. Which is why the vast majority of doctors have DNR’s.

[jaybrendansmith]

It's all incremental statistical improvements, and that's a good thing. We used to live to 35 on average, now we live to 75 on average. That's amazing. It was done not by solving any one illness, but by solving them all in aggregate.

[philwelch]

When the life expectancy was 35, nobody was dying of old age at 35. There were still septuagenarians. To provide an intentionally simplified example, a population where half of the people die of old age at 70 and the other half die in childbirth at age 0 has a life expectancy of 35. Even adding ten years to the life of every adult in that population only improves life expectancy by five years. Reducing infant mortality was a much better investment, though (fortunately!) we’ve been so successful at it that we may be at a point of diminishing returns.

[jaybrendansmith]

All correct points that do not impact the core of the argument. It is all of it, in aggregate, that improves life expectancy. If you read literature, people who were older than 40 or 50 were 'wise old men', and 80 was a rare Methuselah, who was described as 100s of years old. Thanks to statins, and various cancer treatments, and stints, and blood thinners, and many other remedies, living to 80 is not rare, and most people who live beyond it can best be described as people who listen to their doctor and take their meds on time.

[philwelch]

Even in today’s tech industry, people who are older than 40 or 50 are considered wise old men when they can get hired at all. But yes, we have extended adult lifespans, just not by 40 years which is the naive assumption many people make from the observation that life expectancy used to be 35. Also, I would expect that most of the extension in adult lifespan has less to do with old people having better medication than with broad declines in smoking and alcohol consumption. How long into your eighties and beyond you will live is largely determined by lifestyle decisions made in your teens, twenties, and thirties (though it is never too late to quit smoking!)

[lokrian]

While this is logical, the more diseases of old age we cure the longer and better the quality of life the elderly get, and treating amyloidosis is one small step towards that.

[philwelch]

It depends; for instance there are a lot of cancer treatments that effectively replace a quicker and potentially comfortable death with a prolonged period of suffering. And my argument isn’t that these treatments are universally worthless, but that it’s perfectly fair to observe that their benefits are marginal at best.

[dnautics]

if you can't afford Tafamidis, you could probably get away with taking

- Flufenamic acid

- Valtoren (Diclofenac)

- Diflunisal

off-label.

https://www.benthamdirect.com/content/journals/cdtcnsnd/10.2...

IANAD but I believe that Valtoren has the least side effects, but in general since they're all NSAIDs they have been tested for long-term analgesic use, so they're relatively safe and quite inexpensive.

[jamiek88]

NSAIDs absolutely aren’t for long term use.

[cake-rusk]

NSAIDs can kill your kidneys.

[epcoa]

And your stomach lining. Even better if you’re already on a DOAC for Afib.