The New Old Age Blog: Study Links Cognitive Deficits, Hearing Loss

There’s another reason to be concerned about hearing loss — one of the most common health conditions in older adults and one of the most widely undertreated. A new study by researchers at Johns Hopkins Medicine suggests that elderly people with compromised hearing are at risk of developing cognitive deficits — problems with memory and thinking — sooner than those whose hearing is intact.

The study in JAMA Internal Medicine was led by Dr. Frank Lin, a hearing specialist and epidemiologist who over the past several years has documented the extent of hearing problems in older people and their association with falls and the onset of dementia.

The physician’s work is bringing fresh, and some would say much-needed, attention to the link between hearing difficulties and seniors’ health.

In his new report, Dr. Lin looked at 1,984 older adults who participated over many years in the Health ABC Study, a long-term study of older adults conducted in Pittsburgh and Memphis. Participants’ mean age was 77; none had evidence of cognitive impairment when the period covered by this research began. In 2001 and 2002, they received hearing tests and cognitive tests; cognitive tests alone were repeated three, five and six years later.

The tests included the Modified Mini-Mental State exam, which is administered through an interview and yields an overall picture of cognitive status, and the Digit Symbol Substitution Test, a paper-only exercise that asks people to match symbols and numbers, which can reveal deficits in someone’s working memory and executive functioning.

Dr. Lin found that annual rates of cognitive decline were 41 percent greater in older adults with hearing problems than in those without, based on results from the Modified Mini-Mental State Exam. A five-point decline on that test is considered a “clinically significant” indicator of a change in cognition.

Using this information, Dr. Lin found that elderly people with hearing problems experienced a five-point decline on the exam in 7.7 years, compared with 10.9 years for those with normal hearing.

Results from the Digit Symbol Substitution Test showed the same downward trend, though not quite as steep: older people with hearing loss recorded a yearly rate of cognitive decline 32 percent greater on it than those with intact hearing. In both cases, the results showed an association only, with no proof of causality.

Still, given the fact that nearly two-thirds of adults age 70 and older have hearing problems, it is an important finding.

For caregivers and older adults, the bottom line is “pay attention to hearing loss,” said Kathleen Pichora-Fuller, a professor of psychology at the University of Toronto who was not involved in the study.

Most people seek medical attention for hearing difficulties 10 to 20 years after they first notice a problem, she said, because “there’s a stigma about hearing loss and people really don’t want to wear a hearing aid.” That means years of struggling with the consequences of impairment, without interventions that can make a difference.

One consequence that may help explain Dr. Lin’s findings is social isolation. When people have a hard time distinguishing what someone is saying to them, as is common in older age, they often stop accepting invitations to dinners or parties, attending concerts or classes, or going to family events. Over time, this social withdrawal can become a self-fulfilling prophecy, leading to the loss of meaningful relationships and activities that keep older people feeling engaged with others.

A substantial body of research by cognitive scientists has established that seniors’ cognitive health depends on exercising both body and brain and remaining socially engaged, and “now we have this intersection of hearing research and cognitive research lining up and showing us that hearing health is part of cognitive health,” said Dr. Pichora-Fuller, who originally trained as an audiologist.

Family physicians and internists, too, often dismiss older patients’ complaints about hearing, and should pay close attention to Dr. Lin’s research, she said.

“I hope this study will be a wake-up call to clinicians that auditory tests need to be part of the battery of tests they employ to look at an older person’s health,” agreed Patricia Tun, an adjunct associate professor of psychology at Brandeis University.

Although the tests are effective and cause no known harm, a panel of experts recently failed to recommend them for older adults because of a lack of supporting evidence, as I wrote last August.

Another potential explanation for Dr. Lin’s new finding lies in a concept known as “cognitive load” that Dr. Tun has explored through her research. Basically, this assumes that “we only have a certain amount of cognitive resources, and if we spend a lot of those resources of processing sensory input coming in — in this case, sound — it’s going to be processed more slowly and understand and remembered less well,” she explained.

In other words, when your brain has to work hard to hear and identify meaningful speech from a jumble of sounds, “you’ll have less mental energy for higher cognitive processing,” Dr. Tun said.

Even seniors who hear sounds relatively well often report that words sound garbled or mumbled, she noted, indicating a deterioration in hearing mechanisms that process complex speech.

Also, as yet unidentified biological or neurological pathways may affect both speech and cognition. Or hearing loss may exacerbate frailty and other medical conditions that older people oftentimes have in ways that are as yet poorly understood, Dr. Lin’s paper notes.

A limitation to his study is its reliance, in part, on the Modified Mini-Mental State exam, which asks older adults to respond to questions posed by an interviewer, according to Barbara Weinstein, a professor and head of the audiology program at CUNY’s Graduate Center.

Her research has shown that hearing-compromised seniors may not understand questions and answer incorrectly, confounding results. Another limitation arises from the failure to test participants’ hearing over time, as happened with cognitive tests, making associations more difficult to tease out.

Dr. Lin hopes to address this through another research project that would follow older adults over time and test whether interventions such as hearing aides help prevent the onset or slow the progression of cognitive decline. In the meantime, older people and caregivers should arrange for hearing tests if they have concerns, and consider getting a hearing aid if problems are confirmed.

Getting sound to the brain is the “first and most important step” in preventing sensory deprivation that can contribute to cognitive dysfunction, said Kelly Tremblay, a professor of speech and hearing science at the University of Washington.

Read More..

The New Old Age Blog: Study Links Cognitive Deficits, Hearing Loss

There’s another reason to be concerned about hearing loss — one of the most common health conditions in older adults and one of the most widely undertreated. A new study by researchers at Johns Hopkins Medicine suggests that elderly people with compromised hearing are at risk of developing cognitive deficits — problems with memory and thinking — sooner than those whose hearing is intact.

The study in JAMA Internal Medicine was led by Dr. Frank Lin, a hearing specialist and epidemiologist who over the past several years has documented the extent of hearing problems in older people and their association with falls and the onset of dementia.

The physician’s work is bringing fresh, and some would say much-needed, attention to the link between hearing difficulties and seniors’ health.

In his new report, Dr. Lin looked at 1,984 older adults who participated over many years in the Health ABC Study, a long-term study of older adults conducted in Pittsburgh and Memphis. Participants’ mean age was 77; none had evidence of cognitive impairment when the period covered by this research began. In 2001 and 2002, they received hearing tests and cognitive tests; cognitive tests alone were repeated three, five and six years later.

The tests included the Modified Mini-Mental State exam, which is administered through an interview and yields an overall picture of cognitive status, and the Digit Symbol Substitution Test, a paper-only exercise that asks people to match symbols and numbers, which can reveal deficits in someone’s working memory and executive functioning.

Dr. Lin found that annual rates of cognitive decline were 41 percent greater in older adults with hearing problems than in those without, based on results from the Modified Mini-Mental State Exam. A five-point decline on that test is considered a “clinically significant” indicator of a change in cognition.

Using this information, Dr. Lin found that elderly people with hearing problems experienced a five-point decline on the exam in 7.7 years, compared with 10.9 years for those with normal hearing.

Results from the Digit Symbol Substitution Test showed the same downward trend, though not quite as steep: older people with hearing loss recorded a yearly rate of cognitive decline 32 percent greater on it than those with intact hearing. In both cases, the results showed an association only, with no proof of causality.

Still, given the fact that nearly two-thirds of adults age 70 and older have hearing problems, it is an important finding.

For caregivers and older adults, the bottom line is “pay attention to hearing loss,” said Kathleen Pichora-Fuller, a professor of psychology at the University of Toronto who was not involved in the study.

Most people seek medical attention for hearing difficulties 10 to 20 years after they first notice a problem, she said, because “there’s a stigma about hearing loss and people really don’t want to wear a hearing aid.” That means years of struggling with the consequences of impairment, without interventions that can make a difference.

One consequence that may help explain Dr. Lin’s findings is social isolation. When people have a hard time distinguishing what someone is saying to them, as is common in older age, they often stop accepting invitations to dinners or parties, attending concerts or classes, or going to family events. Over time, this social withdrawal can become a self-fulfilling prophecy, leading to the loss of meaningful relationships and activities that keep older people feeling engaged with others.

A substantial body of research by cognitive scientists has established that seniors’ cognitive health depends on exercising both body and brain and remaining socially engaged, and “now we have this intersection of hearing research and cognitive research lining up and showing us that hearing health is part of cognitive health,” said Dr. Pichora-Fuller, who originally trained as an audiologist.

Family physicians and internists, too, often dismiss older patients’ complaints about hearing, and should pay close attention to Dr. Lin’s research, she said.

“I hope this study will be a wake-up call to clinicians that auditory tests need to be part of the battery of tests they employ to look at an older person’s health,” agreed Patricia Tun, an adjunct associate professor of psychology at Brandeis University.

Although the tests are effective and cause no known harm, a panel of experts recently failed to recommend them for older adults because of a lack of supporting evidence, as I wrote last August.

Another potential explanation for Dr. Lin’s new finding lies in a concept known as “cognitive load” that Dr. Tun has explored through her research. Basically, this assumes that “we only have a certain amount of cognitive resources, and if we spend a lot of those resources of processing sensory input coming in — in this case, sound — it’s going to be processed more slowly and understand and remembered less well,” she explained.

In other words, when your brain has to work hard to hear and identify meaningful speech from a jumble of sounds, “you’ll have less mental energy for higher cognitive processing,” Dr. Tun said.

Even seniors who hear sounds relatively well often report that words sound garbled or mumbled, she noted, indicating a deterioration in hearing mechanisms that process complex speech.

Also, as yet unidentified biological or neurological pathways may affect both speech and cognition. Or hearing loss may exacerbate frailty and other medical conditions that older people oftentimes have in ways that are as yet poorly understood, Dr. Lin’s paper notes.

A limitation to his study is its reliance, in part, on the Modified Mini-Mental State exam, which asks older adults to respond to questions posed by an interviewer, according to Barbara Weinstein, a professor and head of the audiology program at CUNY’s Graduate Center.

Her research has shown that hearing-compromised seniors may not understand questions and answer incorrectly, confounding results. Another limitation arises from the failure to test participants’ hearing over time, as happened with cognitive tests, making associations more difficult to tease out.

Dr. Lin hopes to address this through another research project that would follow older adults over time and test whether interventions such as hearing aides help prevent the onset or slow the progression of cognitive decline. In the meantime, older people and caregivers should arrange for hearing tests if they have concerns, and consider getting a hearing aid if problems are confirmed.

Getting sound to the brain is the “first and most important step” in preventing sensory deprivation that can contribute to cognitive dysfunction, said Kelly Tremblay, a professor of speech and hearing science at the University of Washington.

Read More..

DealBook: Microsoft May Back Dell Buyout

The effort to take Dell private has gained a prominent, if unusual, backer: Microsoft.

The software giant is in talks to help finance a takeover bid for Dell that would exceed $20 billion, a person briefed on the matter said on Tuesday. Microsoft is expected to contribute up to several billion dollars.

An investment by Microsoft — if it comes to pass — could be enough to push a leveraged buyout of the struggling computer maker over the goal line. Silver Lake, the private equity firm spearheading the takeover talks, has been seeking a deep-pocketed investor to join the effort. And Microsoft, which has not yet made a commitment, has more than $66 billion in cash on hand.

Microsoft and Silver Lake, a prominent investor in technology companies, are no strangers. The private equity firm was part of a consortium that sold Skype, the online video-chatting pioneer, to Microsoft for $8.5 billion nearly two years ago. And the two companies had discussed teaming up to make an investment in Yahoo in late 2011, before Yahoo decided against selling a minority stake in itself.

A vibrant Dell is an important part of Microsoft’s plans to make Windows more relevant for the tablet era, when more and more devices come with touch screens. Dell has been one of the most visible supporters of Windows 8 in its products.

That has been crucial at a time when Microsoft’s relationships with many PC makers have grown strained because of the company’s move into making computer hardware with its Surface family of tablets.

Frank Shaw, a spokesman for Microsoft, declined to comment.

If completed, a buyout of Dell would be the largest leveraged buyout since the financial crisis, reaching levels unseen since the takeovers of Hilton Hotels and the Texas energy giant TXU. Such a deal is taking advantage of Dell’s still-low stock price and the abundance of investors willing to buy up the debt issued as part of a transaction to take the company private. And Silver Lake has been working with Dell’s founder, Michael S. Dell, who is expected to contribute his nearly 16 percent stake in the company to a takeover bid.

Yet while many aspects of the potential deal have fallen into place, including a potential price of up to around $14 a share, talks between Dell and its potential buyers may still fall apart.

Shares of Dell closed up 2.2 percent on Tuesday, at $13.12. They began rising after CNBC reported Microsoft’s potential involvement in a leveraged buyout. Microsoft shares slipped 0.4 percent, to $27.15.

Microsoft’s lending a hand to Dell could make sense at a time when the PC industry is facing some of the biggest challenges in its history. Dell is one of Microsoft’s most significant, longest-lasting partners in the PC business and among the most committed to creating machines that run Windows, the operating system that is the foundation of much of Microsoft’s profits.

But PC sales were in a slump for most of last year, as consumers diverted their spending to other types of devices like tablets and smartphones. Dell, the third-biggest maker of PCs in the world, recorded a 21 percent decline in shipments of PCs during the fourth quarter of last year from the same period in 2011, according to IDC.

In a joint interview in November, Mr. Dell and Steven A. Ballmer, Microsoft’s chief executive, exchanged friendly banter, as one would expect of two men who have been in business together for decades.

Mr. Dell said Mr. Ballmer had gone out of his way to reassure him that Microsoft’s Surface computers would not hurt Dell sales.

“We’ve never sold all the PCs in the world,” said Mr. Dell, sitting in a New York hotel room brimming with new Windows 8 computers made by his company. “As I’ve understood Steve’s plans here, if Surface helps Windows 8 succeed, that’s going to be good for Windows, good for Dell and good for our customers. We’re just fine with all that.”

Microsoft has been willing to open its purse strings in the past to help close partners. Last April, Microsoft committed to invest more than $600 million in Barnes & Noble’s electronic books subsidiary, in a deal that ensures a source of electronic books for Windows devices. Microsoft also agreed in 2011 to provide the Finnish cellphone maker Nokia billions of dollars’ worth of various forms of support, including marketing and research and development assistance, in exchange for Nokia’s adopting Microsoft’s Windows Phone operating system.

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DealBook: China’s Focus on Aerospace Raises Security Questions

TIANJIN, China — When Airbus executives arrived here seven years ago scouting for a location to assemble passenger jets, the broad, flat expanse next to Tianjin Binhai International Airport was a grassy field.

Now, Airbus, the European aerospace giant, has 20 large buildings and is churning out four A320 jetliners a month for mostly Chinese state-controlled carriers. The company also has two new neighbors — a sprawling rocket factory and a helicopter manufacturing complex — both producing for the Chinese military.

The rapid expansion of civilian and military aerospace manufacturing in Tianjin reflects China’s broader ambitions.

As Beijing’s leaders try to find new ways to invest $3 trillion of foreign reserves, the country has been aggressively expanding in industries with strong economic potential. The Chinese government and state-owned companies have already made a major push into financial services and natural resources, acquiring stakes in Morgan Stanley and Blackstone and buying oil and gas fields around the world.

Aerospace represents the latest frontier for China, which is eyeing parts manufacturers, materials producers, leasing businesses, cargo airlines and airport operators. The country now rivals the United States as a market for civilian airliners, which China hopes to start supplying from domestic production. And the new leadership named at the Party Congress in November has publicly emphasized long-range missiles and other aerospace programs in its push for military modernization.

If Boeing’s difficulties with its recently grounded aircraft, the Dreamliner, weigh on the industry, it could create opportunity. Chinese companies, which have plenty of capital, have been welcomed by some American companies as a way to create jobs. Wall Street has been eager, too, at a time when other merger activity has been weak.

Washington is trying to figure out what to do about China’s deal-making broadly. “Many of these transactions raise important security issues for our country,” said Michael R. Wessel, a member of the U.S.-China Economic and Security Review Commission, which was created by Congress to monitor the bilateral relationship. “China’s interest in promoting these investments isn’t necessarily consistent with our own interests, and it’s appropriate to thoroughly examine the transactions.”

In aerospace, the Chinese deal-makers have deep ties to the military, raising additional issues for American regulators. The main contractor for the country’s air force, the state-owned China Aviation Industry Corporation, known as Avic, has set up a private equity fund to purchase companies with so-called dual-use technology that has civilian and military applications, with the goal of investing as much as $3 billion. In 2010, Avic acquired the overseas licensing rights for small aircraft made by Epic Aircraft of Bend, Ore., using lightweight yet strong carbon-fiber composites — the same material used for high-performance fighter jets.

Provincial and local government agencies in Shaanxi Province, a hub of Chinese military aircraft testing and production, have set up another fund of similar size for acquisitions. Last month, a consortium of Chinese investors, including the Shaanxi fund, struck a $4.23 billion deal with the American International Group to buy 80 percent of the International Lease Finance Corporation, which owns the world’s second-largest passenger jet fleet.

“There has always been an obvious cross-fertilization of ideas, expertise and money between the civilian and military,” said Martin Craigs, a longtime aerospace executive in Asia who is now the chairman of the Aerospace Forum Asia, a nonprofit group in Hong Kong. He added that Chinese companies had been actively hiring senior American and European aerospace engineers, so national security concerns could be quelled some by hiring the right people.

The push into aerospace coincides with growing worries in the West and across Asia about China’s increasingly assertive territorial claims, including the dispatch of Chinese warships to waters long patrolled by Japan, the Philippines and Vietnam.

Coincidentally, hours after the A.I.G. deal was announced, two Chinese navy destroyers and two frigates showed up in disputed waters patrolled by Japan. China and Japan have stepped up public criticisms of each other since. And the Obama administration has begun a strategic “pivot,” shifting military forces from the Mideast back to the western Pacific, a move that Chinese officials have criticized as an attempt to contain their country.

Such confrontations in the region are drawing attention to China’s deal-making ambitions.

In October, a $1.79 billion bid by a business linked to Beijing’s municipal government to acquire the corporate jet and propeller plane operations of bankrupt Hawker Beechcraft in Wichita, Kan., fell apart over national security concerns in Washington. Executives found it hard to disentangle the civilian operations from the company’s military contracting business.

But many aerospace experts predict that Chinese investors and companies will find ways to appease American regulators. “There will be concerns undoubtedly and generally quite valid, but the commercial imperatives are such that people will find a way around them,” said Peter Harbison, the chairman of CAPA-Center for Aviation, a global aerospace consulting firm.

The sale of A.I.G.’s leasing business is expected to face scrutiny by the Committee on Foreign Investment in the United States, the government panel that reviews the national security implications of deals involving foreign buyers.

The group’s customers include many of the largest carriers in the United States, and the federal government has long counted on being able to use civilian passenger jets to transport troops overseas during a national emergency. When Saddam Hussein sent the Iraqi army into Kuwait in 1990, the Defense Department relied on the emergency mobilization of civilian jetliners to ferry 60 percent of the soldiers sent to and from the Mideast during the first Persian Gulf war and a quarter of the cargo, according to a RAND study.

Henri Courpron, the chief executive of A.I.G.’s International Lease Finance Corporation, said that he did not believe the United States should be concerned that the acquisition would prevent civilian aircraft from being available in a future crisis. Only 8 percent of the company’s aircraft are currently leased to American air carriers, and most of these are narrow-body aircraft that lack the range to ferry troops across oceans.

“It’s really a nonissue — we have 900-plus aircraft in our fleet, and there are only 11 wide bodies” currently being leased to American carriers, he said in a telephone interview. He added that the carriers have control over the aircraft during the leases. Executives from the consortium buying the stake in the leasing company declined repeated requests for interviews.

Chinese suitors in the aerospace industry understand the concerns. In part, they watched the experience in the natural resources industry. The China National Offshore Oil Corporation failed in its 2005 bid to acquire Unocal after intense political opposition. After that, Chinese energy giants have been more cautious, pursuing minority stakes in the United States and limiting their outright acquisitions.

Chinese companies are taking a similar tack in aerospace, pursuing joint ventures and technical cooperation agreements alongside acquisitions. For example, Avic is working with General Electric and other American aerospace companies on the production of a civilian jetliner, the C919. Beijing envisions the narrow-body C919 as the next step toward building a domestic aerospace business that can compete with Boeing and Airbus.

Western companies and their advisers say that they are acutely aware that technology transfers could help China strengthen its military and develop more competitive civil airplanes, and are taking precautions to protect trade secrets and national security. “You transfer the part that is most easily reverse engineered, or easily dissected,” said a lawyer with detailed knowledge of these transactions.

But many in the aerospace sector are more skeptical that the West can avoid losing control of technology. “The mentality is, they’re going to find a way to get there anyway, and we may as well get there with them,” Mr. Harbison of the CAPA-Center for Aviation said.

Airbus executives say that they are being prudent. They add that there are few trade secrets about the A320 manufactured here, an aircraft that was designed in 1986. “The A320 is well known all over the world,” said Jean-Luc Charles, the general manager of Airbus’s operations here.

A tour of the main assembly area, a hangar with gray steel walls and large red cranes overhead, suggests that it may be possible to protect the technology. The seats are installed here and the aircraft painted, but the factory is largely assembling planes from kits imported from Europe. Entire fuselages, with green protective coatings, are brought by ship from Hamburg, Germany. Even the stepladders and freight elevators give weight limits in German, and the tool boxes are labeled in English, not Chinese.

Mr. Charles said that 95 percent of the parts are still imported, and that it would take many years for that amount to shrink. “One by one, we start to give them the parts,” he said. “But each subassembly is a complex project — it takes five years.”

A version of this article appeared in print on 01/22/2013, on page B1 of the NewYork edition with the headline: China Looks to the Sky.

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Media Decoder: Pew Survey Finds Reliance on Libraries for Computers and Internet

Free access to computers and the Internet is now nearly as important to library patrons as borrowing books, according to a new survey.

The survey, released Tuesday by the Pew Research Center’s Internet & American Life Project, found that 80 percent of Americans said book borrowing was a “very important” library service, but 77 percent said the same thing about computers and the Internet.

The study also found that library patrons were open to having even more technological options.

“In the past generation, public libraries have reinvented themselves to become technology hubs in order to help their communities access information in all its new forms,” Kathryn Zickuhr, a research analyst with Pew and a co-author of a report on the survey’s findings, said in a written statement.

Pew questioned 2,252 Americans ages 16 and older via cellphones and landlines from Oct. 15 to Nov. 10 last year, in both English and Spanish. More than half of those surveyed said that they wanted more e-book selections in their public libraries, and would be likely to check out e-readers already loaded with books — a significant increase from a survey a year ago.

Roughly 69 percent said they would like to be able to try new technology devices through libraries, and 63 percent said they would like to receive customized book and music recommendations from their libraries as they do from online retailers like Amazon.com.

Some library users seemed willing to support even more changes. When asked whether libraries “should move some printed books and stacks out of public locations to free up space for tech centers, reading rooms, meeting rooms, and cultural events,” 20 percent of respondents said yes and 39 percent said maybe.

Still, of the 53 percent of respondents who had actually visited a library or mobile book location in the last year, 73 percent said they went in order to borrow print books, and only 49 percent said they visit libraries “to sit, read, and study, or watch or listen to media.”

As a result of these conflicting messages, Ms. Zickuhr said, “Many libraries are torn between expanding their digital offerings on the latest platforms and still providing quality resources for patrons who may lack experience with technology or the means to own the latest devices.”

A version of this article appeared in print on 01/22/2013, on page B3 of the NewYork edition with the headline: Survey Finds Rising Reliance on Libraries as a Gateway to the Web.

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The New Old Age Blog: The Brutal Truth of 'Amour'

It has been a few days since I left the movie theater in a bit of a daze, and I’m still thinking about “Amour.”

So much of this already much-honored film rings utterly true: the way a long-married Parisian couple’s daily routines, their elegant life of books and music and art, can be upended in a moment. The tender care that Georges (Jean-Louis Trintignant) provides for Anne (Emmanuelle Riva) as multiple strokes claim her body and her mind, and the inexorable way that care wears them both down. Their withdrawal into a proud dyad that seeks and accepts little help from outsiders, even family. “We’ve always coped, your mother and I,” Georges tells their daughter.

The writer and director Michael Haneke’s previous movies, which I haven’t seen, tend to be described as shocking, violent, even punitive. “Amour,” which Times critic Manohla Dargis called a masterpiece, includes one brief spasm of violence, but the movie remains restrained, not graphic. It’s brutal only because life, and death, can be brutal.

Is popular culture paying more attention to aging and caregiving? In the last couple of years, I have written about these subjects surfacing in a YouTube series (“Ruth & Erica”), in movies like “The Iron Lady,” in novels like Walter Mosley’s “The Last Days of Ptolemy Grey.”

A couple of weeks back, watching a play called “The Other Place,” starring the remarkable Laurie Metcalfe, I suddenly realized that the dynamic physician and businesswoman onstage had some sort of early-onset dementia. Dementia seems a particularly popular subject, in fact. Intrinsically dramatic, it suffuses the Mosley novel and Alice LaPlante’s “Turn of Mind,” and some of my favorite movies about aging, “Away From Her,” “Iris” and “The Savages.”

“Kings Point,” Sari Gilman’s compelling documentary about a retirement community in Florida where nobody seemed to expect to grow old, just won an Oscar nomination for best short-subject documentary and will be shown on HBO in March. And “Amour,” which won the Palme d’Or at Cannes, is up for five Academy Awards, including best picture, best director and a best actress nomination for the 85-year-old Ms. Riva. (Academy voters: Just give it to her.)

A number of these artists, Mr. Haneke included, have spoken about their own experiences with aged relatives. Perhaps, as the population ages and more people confront the consequences, the stories our culture tells itself have evolved to include more old people, more caregivers. Or maybe I just want that to be true.

“Do not go see this,” my movie-going buddy had been warned, probably because her mother has dementia and friends who had seen the film wanted to spare her. I know some people found “Amour” too slow-paced or claustrophobic — like many elderly couples’ lives, it basically takes place in four rooms — or too grim. (If you’ve seen it, tell us what you thought.)

If you’re a full-time caregiver or you’re coping with a relative with dementia, perhaps you would prefer to spend your 2 hours 7 minutes of precious time off watching something funny. Escapism has its virtues.

But I found “Amour” unflinching and provocative and beautiful.

Paula Span is the author of “When the Time Comes: Families With Aging Parents Share Their Struggles and Solutions.”

Read More..

The New Old Age Blog: The Brutal Truth of 'Amour'

It has been a few days since I left the movie theater in a bit of a daze, and I’m still thinking about “Amour.”

So much of this already much-honored film rings utterly true: the way a long-married Parisian couple’s daily routines, their elegant life of books and music and art, can be upended in a moment. The tender care that Georges (Jean-Louis Trintignant) provides for Anne (Emmanuelle Riva) as multiple strokes claim her body and her mind, and the inexorable way that care wears them both down. Their withdrawal into a proud dyad that seeks and accepts little help from outsiders, even family. “We’ve always coped, your mother and I,” Georges tells their daughter.

The writer and director Michael Haneke’s previous movies, which I haven’t seen, tend to be described as shocking, violent, even punitive. “Amour,” which Times critic Manohla Dargis called a masterpiece, includes one brief spasm of violence, but the movie remains restrained, not graphic. It’s brutal only because life, and death, can be brutal.

Is popular culture paying more attention to aging and caregiving? In the last couple of years, I have written about these subjects surfacing in a YouTube series (“Ruth & Erica”), in movies like “The Iron Lady,” in novels like Walter Mosley’s “The Last Days of Ptolemy Grey.”

A couple of weeks back, watching a play called “The Other Place,” starring the remarkable Laurie Metcalfe, I suddenly realized that the dynamic physician and businesswoman onstage had some sort of early-onset dementia. Dementia seems a particularly popular subject, in fact. Intrinsically dramatic, it suffuses the Mosley novel and Alice LaPlante’s “Turn of Mind,” and some of my favorite movies about aging, “Away From Her,” “Iris” and “The Savages.”

“Kings Point,” Sari Gilman’s compelling documentary about a retirement community in Florida where nobody seemed to expect to grow old, just won an Oscar nomination for best short-subject documentary and will be shown on HBO in March. And “Amour,” which won the Palme d’Or at Cannes, is up for five Academy Awards, including best picture, best director and a best actress nomination for the 85-year-old Ms. Riva. (Academy voters: Just give it to her.)

A number of these artists, Mr. Haneke included, have spoken about their own experiences with aged relatives. Perhaps, as the population ages and more people confront the consequences, the stories our culture tells itself have evolved to include more old people, more caregivers. Or maybe I just want that to be true.

“Do not go see this,” my movie-going buddy had been warned, probably because her mother has dementia and friends who had seen the film wanted to spare her. I know some people found “Amour” too slow-paced or claustrophobic — like many elderly couples’ lives, it basically takes place in four rooms — or too grim. (If you’ve seen it, tell us what you thought.)

If you’re a full-time caregiver or you’re coping with a relative with dementia, perhaps you would prefer to spend your 2 hours 7 minutes of precious time off watching something funny. Escapism has its virtues.

But I found “Amour” unflinching and provocative and beautiful.

Paula Span is the author of “When the Time Comes: Families With Aging Parents Share Their Struggles and Solutions.”

Read More..

DealBook: China’s Focus on Aerospace Raises Security Questions

TIANJIN, China — When Airbus executives arrived here seven years ago scouting for a location to assemble passenger jets, the broad, flat expanse next to Tianjin Binhai International Airport was a grassy field.

Now, Airbus, the European aerospace giant, has 20 large buildings and is churning out four A320 jetliners a month for mostly Chinese state-controlled carriers. The company also has two new neighbors — a sprawling rocket factory and a helicopter manufacturing complex — both producing for the Chinese military.

The rapid expansion of civilian and military aerospace manufacturing in Tianjin reflects China’s broader ambitions.

As Beijing’s leaders try to find new ways to invest $3 trillion of foreign reserves, the country has been aggressively expanding in industries with strong economic potential. The Chinese government and state-owned companies have already made a major push into financial services and natural resources, acquiring stakes in Morgan Stanley and Blackstone and buying oil and gas fields around the world.

Aerospace represents the latest frontier for China, which is eyeing parts manufacturers, materials producers, leasing businesses, cargo airlines and airport operators. The country now rivals the United States as a market for civilian airliners, which China hopes to start supplying from domestic production. And the new leadership named at the Party Congress in November has publicly emphasized long-range missiles and other aerospace programs in its push for military modernization.

If Boeing’s difficulties with its recently grounded aircraft, the Dreamliner, weigh on the industry, it could create opportunity. Chinese companies, which have plenty of capital, have been welcomed by some American companies as a way to create jobs. Wall Street has been eager, too, at a time when other merger activity has been weak.

Washington is trying to figure out what to do about China’s deal-making broadly. “Many of these transactions raise important security issues for our country,” said Michael R. Wessel, a member of the U.S.-China Economic and Security Review Commission, which was created by Congress to monitor the bilateral relationship. “China’s interest in promoting these investments isn’t necessarily consistent with our own interests, and it’s appropriate to thoroughly examine the transactions.”

In aerospace, the Chinese deal-makers have deep ties to the military, raising additional issues for American regulators. The main contractor for the country’s air force, the state-owned China Aviation Industry Corporation, known as Avic, has set up a private equity fund to purchase companies with so-called dual-use technology that has civilian and military applications, with the goal of investing as much as $3 billion. In 2010, Avic acquired the overseas licensing rights for small aircraft made by Epic Aircraft of Bend, Ore., using lightweight yet strong carbon-fiber composites — the same material used for high-performance fighter jets.

Provincial and local government agencies in Shaanxi Province, a hub of Chinese military aircraft testing and production, have set up another fund of similar size for acquisitions. Last month, a consortium of Chinese investors, including the Shaanxi fund, struck a $4.23 billion deal with the American International Group to buy 80 percent of the International Lease Finance Corporation, which owns the world’s second-largest passenger jet fleet.

“There has always been an obvious cross-fertilization of ideas, expertise and money between the civilian and military,” said Martin Craigs, a longtime aerospace executive in Asia who is now the chairman of the Aerospace Forum Asia, a nonprofit group in Hong Kong. He added that Chinese companies had been actively hiring senior American and European aerospace engineers, so national security concerns could be quelled some by hiring the right people.

The push into aerospace coincides with growing worries in the West and across Asia about China’s increasingly assertive territorial claims, including the dispatch of Chinese warships to waters long patrolled by Japan, the Philippines and Vietnam.

Coincidentally, hours after the A.I.G. deal was announced, two Chinese navy destroyers and two frigates showed up in disputed waters patrolled by Japan. China and Japan have stepped up public criticisms of each other since. And the Obama administration has begun a strategic “pivot,” shifting military forces from the Mideast back to the western Pacific, a move that Chinese officials have criticized as an attempt to contain their country.

Such confrontations in the region are drawing attention to China’s deal-making ambitions.

In October, a $1.79 billion bid by a business linked to Beijing’s municipal government to acquire the corporate jet and propeller plane operations of bankrupt Hawker Beechcraft in Wichita, Kan., fell apart over national security concerns in Washington. Executives found it hard to disentangle the civilian operations from the company’s military contracting business.

But many aerospace experts predict that Chinese investors and companies will find ways to appease American regulators. “There will be concerns undoubtedly and generally quite valid, but the commercial imperatives are such that people will find a way around them,” said Peter Harbison, the chairman of CAPA-Center for Aviation, a global aerospace consulting firm.

The sale of A.I.G.’s leasing business is expected to face scrutiny by the Committee on Foreign Investment in the United States, the government panel that reviews the national security implications of deals involving foreign buyers.

The group’s customers include many of the largest carriers in the United States, and the federal government has long counted on being able to use civilian passenger jets to transport troops overseas during a national emergency. When Saddam Hussein sent the Iraqi army into Kuwait in 1990, the Defense Department relied on the emergency mobilization of civilian jetliners to ferry 60 percent of the soldiers sent to and from the Mideast during the first Persian Gulf war and a quarter of the cargo, according to a RAND study.

Henri Courpron, the chief executive of A.I.G.’s International Lease Finance Corporation, said that he did not believe the United States should be concerned that the acquisition would prevent civilian aircraft from being available in a future crisis. Only 8 percent of the company’s aircraft are currently leased to American air carriers, and most of these are narrow-body aircraft that lack the range to ferry troops across oceans.

“It’s really a nonissue — we have 900-plus aircraft in our fleet, and there are only 11 wide bodies” currently being leased to American carriers, he said in a telephone interview. He added that the carriers have control over the aircraft during the leases. Executives from the consortium buying the stake in the leasing company declined repeated requests for interviews.

Chinese suitors in the aerospace industry understand the concerns. In part, they watched the experience in the natural resources industry. The China National Offshore Oil Corporation failed in its 2005 bid to acquire Unocal after intense political opposition. After that, Chinese energy giants have been more cautious, pursuing minority stakes in the United States and limiting their outright acquisitions.

Chinese companies are taking a similar tack in aerospace, pursuing joint ventures and technical cooperation agreements alongside acquisitions. For example, Avic is working with General Electric and other American aerospace companies on the production of a civilian jetliner, the C919. Beijing envisions the narrow-body C919 as the next step toward building a domestic aerospace business that can compete with Boeing and Airbus.

Western companies and their advisers say that they are acutely aware that technology transfers could help China strengthen its military and develop more competitive civil airplanes, and are taking precautions to protect trade secrets and national security. “You transfer the part that is most easily reverse engineered, or easily dissected,” said a lawyer with detailed knowledge of these transactions.

But many in the aerospace sector are more skeptical that the West can avoid losing control of technology. “The mentality is, they’re going to find a way to get there anyway, and we may as well get there with them,” Mr. Harbison of the CAPA-Center for Aviation said.

Airbus executives say that they are being prudent. They add that there are few trade secrets about the A320 manufactured here, an aircraft that was designed in 1986. “The A320 is well known all over the world,” said Jean-Luc Charles, the general manager of Airbus’s operations here.

A tour of the main assembly area, a hangar with gray steel walls and large red cranes overhead, suggests that it may be possible to protect the technology. The seats are installed here and the aircraft painted, but the factory is largely assembling planes from kits imported from Europe. Entire fuselages, with green protective coatings, are brought by ship from Hamburg, Germany. Even the stepladders and freight elevators give weight limits in German, and the tool boxes are labeled in English, not Chinese.

Mr. Charles said that 95 percent of the parts are still imported, and that it would take many years for that amount to shrink. “One by one, we start to give them the parts,” he said. “But each subassembly is a complex project — it takes five years.”

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Cameron Reschedules Europe Speech for Wednesday

LONDON — Prime Minister David Cameron of Britain, who postponed a much-awaited address on his country’s future relations with Europe because of the Algeria hostage crisis, will deliver the speech in London on Wednesday, his office said Monday.

Mr. Cameron had planned to deliver the speech in the Netherlands on Friday but postponed it as the fate of British captives in Algeria seemed ever more dire. In a statement on Sunday, Mr. Cameron said three Britons had been confirmed killed, three were feared dead and a person usually resident in Britain had died.

Mr. Cameron’s initial choice of Amsterdam as the venue reflected a long tradition of using European cities as the platform for British pronouncements on Europe.

“We were planning to give it in Amsterdam. Unfortunately, that didn’t prove possible and Wednesday morning in London fits better with the prime minister’s schedule,” said a spokesman for Mr. Cameron, speaking in return for anonymity under departmental protocols.

“There is a debate going on across the E.U. There is also an active debate going on here in the U.K. The prime minister’s speech will be reflecting both those aspects,” the spokesman said.

On Friday, after Mr. Cameron postponed the speech, his office released excerpts suggesting that he had planned to deliver an explicit warning that Britain might leave the European Union unless the bloc changed the way it is run.

Mr. Cameron planned to say that there was “a gap between the E.U. and its citizens which has grown dramatically in recent years and which represents a lack of democratic accountability and consent that is — yes — felt particularly acutely in Britain.”

“If we don’t address these challenges, the danger is that Europe will fail and the British people will drift toward the exit,” Mr. Cameron planned to say.

“I do not want that to happen. I want the European Union to be a success, and I want a relationship between Britain and the E.U. that keeps us in it.”

Mr. Cameron’s views have drawn unusual public comment from American officials.

Last week, a White House spokesman quoted President Obama as telling Mr. Cameron in a telephone call that “the United States values a strong U.K. in a strong European Union, which makes critical contributions to peace, prosperity and security in Europe and around the world.”

That theme resurfaced Sunday when the American ambassador in London, Louis B. Susman, told Sky News that “we cannot imagine a strong E.U. without a vibrant partner in the U.K.”

“That is what we hope will come about, but it is up to the British people to decide what they want,” Mr. Susman said, according to the Press Association news agency.

Mr. Cameron is under pressure from members of his own Conservative Party to promise a referendum on Europe and he has signaled his readiness to hold one, although the precise question to be asked has not been made clear.

Liam Fox, a former defense secretary who is regarded as leading euroskeptic, said that he had been briefed on the content of the address and “if that is the speech that is finally delivered, a great many of us will think that it’s a speech that we’ve been waiting a long time for any prime minister to deliver.”

Foreign Secretary William Hague said Sunday there was a strong case for seeking “fresh consent” about the relationship between the European Union and Britain, which held a referendum approving membership in 1975.

“We want to succeed in the European Union — we want an outward-looking E.U. to succeed in the world, and for the United Kingdom to succeed in that,” he said.

“But we have to recognize that the European Union has changed a lot since the referendum of 1975, and that there have been not only great achievements to the E.U.’s name but some things that have gone badly wrong, such as the euro,” Mr. Hague said, referring to the protracted crisis over the bloc’s single currency. Britain does not participate in the single currency.

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Huawei Springs Back With 33% Rise in Net Profit

BEIJING — Huawei Technologies, one of the largest makers of telecommunications equipment in the world, bounced back from a disappointing 2011 with a 33 percent rise in net profit for 2012 and forecast stronger revenue growth, buoyed by smartphone sales and cloud computing.

Huawei’s chief financial officer, Cathy Meng, the daughter of the company’s founder, Ren Zhengfei, denied that U.S. security concerns would hamper the privately held company’s growth and said Monday that it would keep “an open mind” about a possible stock market listing.

“Cloud computing is a huge sector in the next five years,” Ms. Meng told a results presentation. “In the telecom industry, we are expecting a 5 percent increase in capital investments. Smartphone penetration is still way too low and there is a lot of room for growth. So these three areas will create a lot of opportunities for us.”

Huawei, which ranks behind only Ericsson of Sweden in telecommunications equipment, reported an unaudited net profit of 15.4 billion renminbi, or $2.5 billion, up from 11.6 billion renminbi in 2011, as new telecommunications projects and smartphones increased sales.

Revenue for the year rose 8 percent to 220.2 billion renminbi.

The results were in line with company guidance at the start of the year and came a day after ZTE, its rival, warned of a net loss of as much as 2.9 billion renminbi for 2012.

Huawei is making gains in the enterprise business, which sells networking equipment like routers and switches and has up to now been dominated by Cisco Systems.

Huawei, founded in 1987 by Mr. Ren, a former Chinese military officer, is known for aggressively gaining sales in the telecommunications equipment sector by edging out rivals like Alcatel-Lucent, Nokia Siemens Networks and ZTE.

While Huawei has increased sales and gained market share in Europe, Africa and Asia, it has also run into obstacles in countries including the United States and Australia because of national security and cyberespionage concerns.

The company has been barred from bidding for the rollout of a national broadband network in Australia, faces exclusion from the government network in Canada and is not allowed to sell telecommunications equipment to U.S. carriers.

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