BUSINESSWEEK ONLINE : JULY 17, 2000 ISSUE
COVER STORY

Keeping Old Age from Acting Up
As life spans lengthen, new medicines tackle the aches and pains

With heart disease and cancer no longer automatic killers, Americans are living longer than ever. But of course, there's bad news: Our bodies were just not designed to last 9 or 10 decades: Bones decay, joints creak, eyesight fails, hearing fades, the bladder weakens, and the heart gets tired of pumping, no matter how well we take care of ourselves.

The pharmaceutical industry knows a growing market when it sees one: Nearly 200 drugs for geriatric diseases are in development. No one's come up with a cure, but there is some relief from suffering available if you develop any of these chronic ailments:

ARTHRITIS. Four out of five people age 75 and older suffer from osteoarthritis, the most common form of this painful deterioration of cartilage lining the joints. An improved way to treat the pain are the COX-2 inhibitors, Celebrex and Vioxx, approved two years ago. They work much like aspirin but without gastrointestinal side effects.

About 2 million Americans suffer from rheumatoid arthritis, a more serious inflammation that attacks the hands, wrists, and feet. Recently approved Enbrel and Remicade target a chemical in the body thought to play a major role in the inflammation.

OSTEOPOROSIS. Weak bones afflict some 28 million older Americans. Doctors recommend that people begin eating calcium-rich foods and exercising regularly as children to avoid leg and hip fractures in old age. The next best thing is estrogen replacement therapy as women reach menopause, when bones start rapidly losing mass. But estrogen can have side effects, including a slightly higher risk of breast cancer. An alternative is one of the so-called designer estrogens approved in the past three years, such as Raloxifene. These mimic estrogen's bone-building role without the danger.

URINARY INCONTINENCE. Some 17 million Americans suffer from weak bladder control--including 50% of the nursing home population--and 85% of the sufferers are women. Pelvic exercises are the most common treatment, but one of the first drugs for urinary incontinence, Detrol, was approved in 1998. The drug blocks a chemical in the bladder that contributes to the urge to urinate. Doctors are also trying out minimally-invasive surgery.

FAILING EYESIGHT. The most serious type is age-related macular degeneration, the leading cause of blindness among people over 50. Visudyne, a drug approved this April, strangles the blood vessel growth under the retina that causes many cases of macular degeneration. For farsightedness, which usually starts after age 40, Hyperion LTK laser surgery--similar to the method used to correct nearsightedness--is expected to be approved this summer.

DEAFNESS. Some 30 million Americans suffer some hearing loss, but only 6 million use a hearing aid. To make these devices more appealing, Songbird Medical just introduced a $39 disposable hearing aid that delivers superb sound quality but is meant to last only 40 days. Songbird uses softer, more comfortable plastics that wouldn't hold up in a product meant to last years.

CONGESTIVE HEART FAILURE. This progressive weakening of the heart muscle afflicts 5 million Americans. Two pacemaker-like devices by Medtronic and Guidant, called ventricle resynchronizers, are in the final stages of testing and could reach the market next year. The implants may not prolong life, but they can keep the heart beating in sync, enabling patients to have a much better quality of life. And that may be what matters most when you're 95.

By CATHERINE ARNST

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