Considering the very early effects of dementia start to impact people sometimes decades before it becomes bad enough that they are diagnosed, it's certainly possible that extreme coffee consumption is some kind of self-medication mechanism.
Anecdotally, I've seen this a lot with adults with undiagnosed ADHD (including myself until 26). Caffeine can be a (very shitty) alternative to proper stimulant medication that people don't realise they actually need because of a medical issue. So the end up drinking 4-5 coffees a day instead.
> Anecdotally, I've seen this a lot with adults with undiagnosed ADHD (including myself until 26). Caffeine can be a (very shitty) alternative to proper stimulant medication that people don't realise they actually need because of a medical issue. So the end up drinking 4-5 coffees a day instead.
ADHD medication is among the hardest to get in the first place, and to maintain in many places.
I was diagnosed as a child, and still couldn't get regular medication until 3 years ago (I'm 37 now). Doctors will try to push off-label treatments, often SSRIs, which do nothing for ADHD. They will push people to try ineffective talk therapy and describe actual medication as "only a last resort".
My cousin can't get it because his insurance says you only have ADHD if you were diagnosed as a child, and he spent his childhood in another country where the roads were barely maintained.
ADHD meds reduce the chances someone will abuse drugs according to research, but many docs will cancel prescriptions if you are honest about cannabis use.
In the wake of the opiate scandal new restrictions also place limits on how much a pharmacy can dispense, even if everyone has a valid prescription. That's part of the reason for the medication shortages in some areas.
It's been a miracle medication for me, but if you don't have money and luck it can be next to impossible to find someone to help you. Those that do often require thousands in fees.
To add: At least for methylphenidate, there are several studies showing neuronal long term improvements, "brain normalisation", in people with ADHD. That's rare in psychopharmacology...
I do understand hesitation about immediate release amphetamine, but the retarded formulations are also quite hard to abuse. If you do more than prescribed, you won't get high, you will have a bad time. "Getting high", requires a sudden onset, rush, and sharp peak, which retarded meds won't induce.
Denying people with ADHD to try stims, is really, really unethical considering our knowledge on their effectiveness treating the condition.
True. That's a whole nother can of worms. You often only get something like 30 days worth of pills per prescription before you have to visit your doctor again. For someone with poor time and tasks management, those 2-3 hours lost (and adding the "resources" spent on mental overhead/stress/anxiety), are actually a significant burden.
Not far fetched at all, seems there's been studies showing a correlation between ADHD and Dementia between genrations. A big question for me is if the ADHD was always even in the older generations there but was non-diagnosed?
> A big question for me is if the ADHD was always even in the older generations there but was non-diagnosed?
Also could the absence of treatment be causal?
Undiagnosed people suffer immensely trying to cope and adapt to a neurotypical life. Depression and anxiety disorders are commonly found as comorbidities. The above-normal stress default by itself could probably explain all sorts of aging associated disease and symptoms, I presume.
Then you typically find issues with sleep, regular food and water intake ...
And yeah, in context, people with undiagnosed ADHD are much, much more likely to abuse drugs, or "self-medicate". Especially smoking and coffee.
What are you talking about? Especially vitamin D is researched to death. You think scientists are stupid? If there is a incidence difference along the north-south axis, it's the first hypothesis investigated.
Thing is, intervention usually doesn't prove very effective. That's why doctors aren't that hysterical about it.
Then some vitamin supplement studies have shown actually harmful, eg. vitamin A as antioxidant. Vitamin D is a hormone and regulates many processes in the body, e.g. a large dose suppresses the immune system similar to steroids... caution is definitely warranted, instead of blanket recommendations of the "Just take 5000IU/d! #YOLO" you find online frequently.
I didn't say researchers, I said in a medical context. If you do a search on pubmed or Google Scholar, you can find a lot of research on how vitamin D supplementation proved beneficial for patients in different contexts.
Also, I found your reply really jarring. Perhaps it's the immediate ad-hominem attack, but I just wanted to note that for your reference, it really didn't motivate me to want to engage any further with you.
Good thing I also mentioned doctors, who are, of course, applying the concluded result of research. But maybe you are talking about another "medical context".
I threw your "vitamin D supplementation proved beneficial" into Google and this Nature review article on vitamin D supplementation was the first result:
The vitamin/supplements industry makes billions while the pharma industry makes trillions.
The pharma industry is financially shaped around big "hit" patented medications that rake in megaprofits. They are literally too big to play in the vitamin-selling market.
It's kind of like how you and I might be able to spin up a profitable SaaS or other project that pulls in a few hundred grand or even a few million per year. A nice sum! Meanwhile, FAANG companies can't even consider such projects. They are not going to keep the lights on by pursuing 100,000 different niche projects that each make $100,000 profit per year. That would still only be 20% of their current revenue.
The big pharma companies shape how things are done. They fund the studies, they have direct access to doctors, etc.
In terms of actual influence the supplement industry might as well not even exist, just like our theoretical SaaS would have zero industry influence.
A quick search tells me the markets are much closer than that. R&D cost is lower and regulation isn't as strict so I wouldn't be surprised if selling vitamins is the more lucrative business. The pharma companies haven't missed this and they are also in the business.
The point is that relative to pharma, the supplements industry has essentially zero regulation and essentially zero barrier to entry.
Anybody can get into that game, and they do, judging by the thousands of different supplement peddlers one sees on Amazon and at the local CVS. Some of them even stick around for more than a year or two.
It can be a profitable business, but it's sort of a race to the bottom. I'm a fan of supplements, but if you think that selling Vitamin D pills at Safeway can gave you power and money on par with an international pharma company selling lifesaving cancer treatments at $10,000 a pop or whatever then what are you doing talking to me on HN? Go bottle some pills and think about what kind of superyacht you'll be buying.
I drink two cups a day, but I must have them. Self medication. I can't imagine five cups, I wouldn't have time to fit them in. Perhaps I'm a lite-weight.
Anecdotally, I've seen this a lot with adults with undiagnosed ADHD (including myself until 26). Caffeine can be a (very shitty) alternative to proper stimulant medication that people don't realise they actually need because of a medical issue. So the end up drinking 4-5 coffees a day instead.