Last week Gary Busey passed a mandatory online financial management course in an attempt to convince a U.S. Bankruptcy court he'll start sensibly managing his money. The veteran actor recently filed for Chapter 7 bankruptcy. But in Hollywood, going broke is just about as as common as a leaked nude photos; just ask Toni Braxton, Larry Wilcox, Vince Neil, Mike Tyson, and Stephen Baldwin, all of whom have recently filed for bankruptcy. Not to mention Zsa Zsa Gabor’s husband, who was forced to put their Bel Air mansion on the market last year to pay the ailing star’s medical bills; Wesley Snipes, who was imprisoned for three tax-related misdemeanor convictions; and Nicolas Cage, who lost one of his homes to foreclosure and has been plagued by IRS issues. So how is it that some of the most well-paid people on the planet can end up with next to nothing? We talked to financial management experts and they ticked off the top five ways rich celebs lose it all (or close to it). 5. They have no idea how money management works. “Most celebrities have extremely creative minds. But in my experience, the most creative folks tend not to want to spend time dealing with business issues,” tax and business expert Joseph M. Doloboff, Partner at Blank Rome LLP in Los Angeles told FOX411’s Pop Tarts column. But don’t famous folks hire financial planners and business managers to take good care of their millions? “Most of them do, but at the end of the day, these accounts are still in a celebrities’ name, which gives them ultimate control over their wealth,” said Certified Financial Counselor for Financial Advice for the Artist, Erin Elizabeth Burns. Which can mean big spending, big mistakes and… 4. Bad advice. Pete Krainik, Founder and CEO of The CMO Club, a networking resource for top marketing executives, noted that some celebrities do not have the skill sets to identify and determine the right business/financial managers for their needs. “Because they don’t think of themselves as brands, they don’t put the efforts or plans in place to maximize their value for endorsement deals,” he explained. “They should have themselves significant additional revenue streams – it is not just about getting the next role, but getting the next deal.” But some such "additional revenue streams" can also run in the red.. Last year, the Las Vegas rendition of Beso – the restaurant/nightclub co-owned by Eva Longoria – filed for bankruptcy to restructure nearly $5.7 million in debt and other liabilities. Prior to that, the Jay-Z owned 40/40 sports bar in Sin City shut its doors a mere eight months after opening. Britney Spears’s southern-inspired Nyla Restaurant reportedly hit monetary blows before she also severed ties, and both Jennifer Lopez’s “Sweetface” clothing line and restaurant Madres went dark. 3. Theft and fraud. Hollywood's highest profile people are actually human, which means they too are susceptible to being screwed by business managers, badly worded deals and corrupt advisors. Just ask Kevin Bacon and wife Kyra Sedgwick, who were taken to the cleaners by Ponzi schemer Bernie Maddoff. Doloboff also said prominent factors in a celeb’s financial crumbling is their tendency to bring "friends" -- or family -- into the fray as business partners or employees. “Many professional athletes and entertainers want to help their friends while simultaneously helping themselves,” he said. “The best advice is to refrain from doing business with friends. True friends don’t condition their friendship upon doing business together.” Comedian Dan Cook will probably adhere to that – in 2010, his half-brother Darryl McCauley was ordered to pay the comic $12 million in restitution after pleading guilty to embezzling funds from him. McCauley allegedly stole $12,500 a month as Cook’s business manager. Friends and fraud – double whammy! 2. Drugs, booze, and bad habits. Stars are known to fall when the temptations of drugs/alcohol/hard partying turns into a dangerous addiction. It can also be more than an expensive habit, as addiction often impacts other areas. “You are far more likely to make poor decisions when under the influence of drugs or alcohol. When you’re dealing with celebrities, the problem is that their support groups, (friends, family, entourages, et al), often consist of enablers,” explained Richard Taite, the Founder and CEO of rehab center Cliffside Malibu. “It comes as no surprise that a successful celebrity can face financial destitution if they are abusing drugs or alcohol and are left to their own devices.” 1. Ridiculous overspending. Last but not least, some beautiful yet broke folks just lead foolishly fabulous lives (we're talking to you, MC Hammer) and refuse to accept that fame (and its fortune) can be fleeting. “Most celebrities have luxuries such as a cook, a driver, a personal stylist, a personal assistant etc.,” said Burns. “They become accustomed to this lifestyle, but when their contract isn’t renewed, or when the films offers stop coming in, they are still living this life of luxury with the expectation that they will always be in demand.” Yes, sadly, not every Hollywood tale has a happy ending. But with some good financial advise, the ending doesn't have to be tragic.
At least four people, including three children, were killed, when a man on a scooter opened fire outside a Jewish school in Toulouse in southwestern France
At least four people, including three children, were killed, when a man on a scooter opened fire outside a Jewish school in Toulouse in southwestern France on Monday, officials said. The attack also left several injured, two of them seriously, and followed the killing of three soldiers in two separate shootings in the same region last week by a man who escaped on a scooter. BFM TV news channel said that the gun used in the attack at the Ozar Hatorah school was of the same calibre as that used in the soldiers’ shootings, but a spokesman for the interior ministry could not immediately confirm this. President Nicolas Sarkozy cancelled other appointments and was on his way to Toulouse on Monday morning, accompanied by Education Minister Luc Chatel and the president of the CRIF French Jewish association, Richard Prasquier. “I saw two people dead in front of the school, an adult and a child … Inside, it was a vision of horror, the bodies of two small children,” a distraught father whose child attends the school told RTL radio. “I did not find my son, apparently he fled when he saw what happened. How can they attack something as sacred as a school, attack children only sixty centimetres tall?” Several other people were injured, two of them seriously. A rabbi at the school, identified as Rahamim Sabag, told Israel’s channel two television that the dead were a 30-year old rabbi who taught at the school, the rabbi’s five-year-old son and two eight-year old children, one of them the daughter of the school’s principal. A spokesman for Israel’s foreign ministry, Yigal Palmor, expressed outrage at the killings: “We are following with great shock reports coming from Toulouse and we trust the French authorities will solve this crime and bring those responsible to justice.” A spokesman for the interior ministry said that security was being tightened at all Jewish schools in the country. About 50 investigators are already looking into the killings of two soldiers on Thursday in the town of Montauban, close to Toulouse, as they tried to withdraw money from a cash machine close to the barracks of the 17th parachute regiment. A third soldier was killed the previous weekend in Toulouse. Investigators had already confirmed on Friday that the same weapon had been used in both incidents.
Spanish regional savings banks Unicaja and Caja Espana have merged following the government's recent requirement that banks raise substantially their provisions set aside to cover toxic real estate exposure. The merger, in which Banco Caja Espana-Duero (Banco Ceiss) is effectively absorbed into Unicaja Banco, creates a group with approximately (EURO)80 billion ($104.9 billion) in total assets and a turnover of (EURO)120 billion ($157.4 billion), according to a joint statement released late Friday. The deal must first receive Finance Ministry and central bank approval and would require (EURO)850 million ($1114.86 million) of state aid, which is added to (EURO)525 million ($688.59 million) already injected into Caja Espana in 2010 by the Bank of Spain's restructuring fund (FROB).
German taxpayer would be obliged to subsidise the wages of Lionel Messi and Cristiano Ronaldo.
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When faced with the prospect of the Spanish government waiving the collective €752m debt the nation's football clubs owe to the country's tax authorities, the reaction in Europe last week was one of outrage. The German tabloid Bild even asked how long the German taxpayer would be obliged to subsidise the wages of Lionel Messi and Cristiano Ronaldo. What they meant was that while the European Union members bailed out the Spanish economy, successful Spanish clubs were failing to meet their own tax obligations. Strictly speaking, Real Madrid have no tax debt among the €170m debt that the club carry, but Barcelona owe €48m of their overall €364m debt to the Spanish taxman. Uli Hoeness, the outspoken president of Bayern Munich, got to the point rather more quickly when asked about the proposal to excuse Spanish clubs their tax debt. "This is unthinkable," he said. "We pay them hundreds of millions to get them out the shit and then the clubs don't pay their debts." It is a uniquely modern European dilemma, encompassing EU bail-out funds and the competitiveness of the continent's respective leading clubs, all of which ultimately adds another fiendishly complex element to the concept of Financial Fair Play, as proposed by Uefa president Michel Platini. It is further proof that while Spanish football is undoubtedly top dog in Europe, with five teams in the quarter-finals of the two Uefa competitions, it is not without problems. As The Independent's Pete Jenson reported in these pages on Saturday, a government report in Spain last week disclosed that the equivalent of £625m is owed by Spanish clubs to the country's public purse, with £353m of that due from 14 of the 20 clubs in the top division. This is not money owed to banks, investors or owners. It is owed to the Spanish people. On a sporting level it is "financial doping" at its very worse. On a social level it is nothing short of a disgrace in a country where youth unemployment currently runs at 50 per cent. Not all top Spanish clubs are culpable and it was reassuring to read in the breakdown of club debt by AS newspaper that Athletic Bilbao, the team of largely home-grown Basque stars who left English football spellbound with their schooling of Manchester United last week, do not owe the taxman a cent. So too Real Sociedad, Getafe, Villarreal and Sporting Gijon. On the other hand, Atletico Madrid, currently eighth in La Liga and drawn against Hannover 96 in the quarter-finals of the Europa League, owe the Spanish public purse €155m (£128m), more than any other club. The money from the €50m sale of Sergio Aguero to Manchester City last summer went straight to the tax authorities. Valencia, who play AZ Alkmaar in the same stage of the competition, owe €6m in unpaid tax. When Hoeness expressed German football's bitterness that their government is, indirectly, subsidising the success of Spanish clubs it is the likes of Hannover he was talking about. Atletico's big signing was Falcao from Porto last summer, a £33m signing financed by third-party ownership deals. Hannover bought Mame Biram Diouf from Manchester United. Enough said. No one would pretend that British football is the perfect financial model, especially given Rangers' and Portsmouth's debts to HMRC. Even the Germans have had their problems with Borussia Dortmund and Schalke. But unpaid taxes at a time when public services are being cut and jobs lost are particularly repugnant. Real Betis, Real Zaragoza, Racing Santander, Levante and Mallorca (denied a place in last season's Europa League because of their finances) owe a total of €118m to the Spanish tax authorities between them. There are also suggestions that unpaid social security contributions by some Spanish clubs rival those eye-watering figures for unpaid tax. In the past, Spanish football has been protected by the assumption that punishing badly-run clubs would cause such a backlash against government by voters that it would not be politically expedient. There is no points penalty in Spain for going into the equivalent of financial administration as there is in England. But attitudes are changing. The governing political group Partido Popular has described the situation as "intolerable". The government was forced to disclose the figures of unpaid tax because of an official request by Caridad Garcia of the Izquierda Unida (IU) party. A spokesman for IU, José Luis Centella, made the connection last week between the financial hardship felt by the Spanish people and the clubs' failure to pay. "This is bad news for all the people who have lost homes and suffered from the cutbacks while there is this tremendous generosity towards football." Wisely, the Spanish sports minister Miguel Cardenal announced last week that the government had dropped any consideration of giving football clubs a clean slate on their tax debts. There has even been a call from the centre-left party PSOE to ban clubs with tax debts from competing in the league, a rule that, already in place in Italian football, would change the face of La Liga overnight. Were the Spanish tax authorities to call in their debts tomorrow, Barcelona would surely be able to find, or borrow, the €48m they owe. Atletico, on the other hand, would find themselves in the kind of dire situation currently enveloping Rangers. There is a lesson for English football that in the risky game of investment and borrowing that most clubs enter as they attempt to fulfil the ambitions of supporters and owners, there are certain obligations that are non-negotiable. Football clubs command such loyalty and affection that they are too often cut slack, but, as the situation in Spain is starting to show, there is always a limit. Ridicule of Richards the last straw Down the years, Sir Dave Richards has given every appearance of being invulnerable to criticism or error of judgement. He has survived adversaries in the Football Association such as Lord Triesman and Ian Watmore in recent years. The financial problems of Sheffield Wednesday, where he was chairman, do not seem to have had an impact on his reputation. He walked out on the 2018 World Cup bid in a huff and it all blew over. Which makes it all the more incredible that an ornamental fountain, and a slightly unhinged but largely irrelevant speech on football, should prove his undoing. It just goes to shows that a divisive figure in football administration can survive a great deal but once their mistakes start to make people laugh – it's over. Will City seize their chance to get Mourinho? When Manchester City meet Chelsea on Wednesday, the shadow of one man falls over both clubs. Jose Mourinho is the last card that the most ambitious football club owners can play. If all else fails, then give Mourinho the job and if that does not bring success then you really are out of options. In Spain, the mood is that Mourinho may stay at Real Madrid in the penultimate year of his contract next season or he may go back to England if the right job presents itself. Is that Chelsea or could it be City? If Roberto Mancini fails to win the title this season and Mourinho is willing to come then it places an idea in the heads of City's owners. It is not as if he is available every summer.
Savage cuts to the Greek health service have seen the country's HIV and Tuberculosis rates soar - sparking fears it is becoming a third world nation.
Aid agencies said the cutting of hospital budgets by an astonishing 40 per cent had also led to a sharp rise in the number of citizens being diagnosed with Malaria.
In the south, they said, it is reaching near endemic levels not seen since 1970s.
The scrapping of needle exchange services has seen the number of HIV and Aids sufferers in central Athens rise by 1,250 per cent in 2011 alone.
There are more prostitutes on the streets selling their bodies to make ends meet, while heroin addicts are finding it harder to come by anti-retroviral treatments.
There is also the first instances ever of the two illnesses being transmitted between mother and child - something usually equated with sub-Saharan Africa and not Europe.
Médecins sans Frontières Greece's Reveka Papadopoulos said the health service cuts, which saw widespread job losses, were putting social services 'under very severe strain'.
She added: 'If not in a state of breakdown. What we are seeing are very clear indicators of a system that cannot cope'. She said the 40 per cent cuts were on top of a 24 per cent increase in 2011 in demand for medical services.
This, she said, was 'largely because people could simply no longer afford private healthcare. The entire system is deteriorating'.
On the rise: The number of HIV and Aids sufferers in Greece is soaring
She added: 'There has also been a sharp increase in cases of tuberculosis in the immigrant population.
'Cases of Nile fever - leading to 35 deaths in 2010 - and the reappearance of endemic malaria in several parts of Greece.
'The simple fact of the reappearance of malaria, with 100-odd cases in southern Greece last year and 20 to 30 more elsewhere, shows barriers to healthcare access have risen.
'Malaria is treatable, it shouldn't spread if the system is working.'
Good news: Greece is set to receive the next tranche of eurozone bailout cash next week
The news comes as it was revealed Greece will get €5.9billion in new bailout money on Monday. It is the first slice of a new rescue package meant to keep the country afloat while it overhauls its economy.
Greece stands to receive a total of €172.7 billion from its partners in the 17-nation eurozone and the International Monetary Fund until 2016.
IS SPAIN THE NEXT GREECE? NATION SINKS FURTHER INTO MIRE
Spain now owes more money than it has done in the last 20 years, the Bank of Spain said.
For 2011 the country's public debt was 68.5 percent of gross domestic product, up from 61.2 per cent in 2010.
While it is a relatively low ratio, compared with its 16 eurozone peers who have an average 87.7 per cent, it has almost doubled from 36.3 per cent in 2007.
This is because there is a lack of economic impetus since the credit-and-construction bubble burst in 2008.
Spain has been ordered by the European Commission to cut its budget shortfall from 8.5 per cent of GDP in 2011 to 5.3 per cent this year and 3 per cent in 2013.
It has forced Prime Minister Mariano Rajoy to hunt for savings worth around €60billion.
This year's target is a compromise after Rajoy defied Brussels by ditching a much tighter goal of 4.4 per cent of GDP agreed by the previous government.
But the task will be made tougher as the economy is thought to already be in its second recession in three years, with the government expecting output to shrink 1.7 per cent in 2012.
The cuts has led to the closure of 27 publicly run companies, some of which were duplicates - such as a water company.
Others included a loss-making entity tasked with stimulating Spain's small housing rental market and one created to back the Barcelona Olympics in 1992.
The central bank also said Spain's 17 autonomous regions, blamed for the lion's share of the fiscal slippage last year, ran debt up by 17.3 per cent in 2011 to €140billion.
The data showed the country's wealthiest region of Catalonia, was the most indebted, closely followed by Valencia. Both had debt-to-GDP ratios of around 20 per cent compared to an average of 13.1 per cent.
Tighter controls over regional budgets imposed by the central government aim to bring their spending back under control this year, even if analysts retain doubts over their future compliance and banks' balance sheets.
The sum includes money left over from the country's first rescue package and a new €130billion programme.
The disbursement was approved earlier this week, said Matthias Mors, the European Commission representative to the troika - the debt inspectors from the European Union, the European Central Bank and the IMF who are managing the Greek bailout.
The bailout, on its own, will not be enough to ease the country's financial woes.
An EU report released today said Greece must make a sustained effort to attract future investment and support export-led growth as it seeks to recover from a recession that is now in its fifth year.
But the report, prepared by the European Commission and the ECB, also said a bond swap deal with private creditors has made the country's debt load far more sustainable in the long-term.
The news has had a positive effect on European financial markets.
The FTSE 100 is today 0.45 per cent up at 5,967.43; France's CAC 40 is 0.54 per cent up at 3,599.37; and Germany's DAX is 0.33 per cent up at 7,168.37.
The report projects that, assuming interim targets are met, Greece's debt-to-GDP ratio will decline to below 117 per cent in 2020 and to below 90 per cent in 2030.
It was as high as 160 per cent of GDP before the debt relief deal was agreed with private creditors.
While progress has been made in reforming the economy, significant concerns remain, including inflation, a lack of credit available to households and business, and the need to regain competitiveness by reducing labor costs, Mors said.
'One of the priorities of this second program is the recapitalization of banks,' Mors said.
For one thing, bank deposits have fallen, he said. For another, the agreement to write down private debt 'will leave holes in the balance sheets of banks, because they held government bonds,' he added.
He said the new program includes €50 billion for bank recapitalisation. 'This is an enormous amount,' he said. Mors also warned that significant more belt-tightening lies ahead.
'The target for this year is a primary deficit of 1 per cent,' he said, referring to the budget balance before interest payments.
'And the programme target for 2014 is a surplus of 4.5 per cent. And therefore people have to be aware that, in terms of fiscal adjustment, there's still a long way to go.' He said the Greek government will have to identify before this summer how it plans to close that gap.
Premier League footballer Fabrice Muamba is in intensive care after collapsing during an FA Cup tie.
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The 23-year-old was said to be critically ill in the London Chest Hospital after falling to the ground at White Hart Lane in front of millions of television viewers watching the sixth round tie between Tottenham Hotspur and his club, Bolton Wanderers. Outside the hospital, the club's manager Owen Coyle said the following 24 hours were "absolutely crucial" and urged people to pray for the player's recovery. A Bolton spokesman said: "Bolton Wanderers can confirm that Fabrice Muamba has been admitted to the heart attack centre at London Chest Hospital where he is currently in a critically ill condition in intensive care. No further information will be issued at this stage. The club has requested the media to respect his family's privacy at this time." A packed White Hart Lane looked on with a worldwide audience watching live coverage on ESPN as the Trotters midfielder suddenly fell to the floor. Confusion turned to horror as medics sprinted on to the pitch to begin resuscitating the young man. Players looked shocked and watched in disbelief as the former England Under 21 star was treated with a defibrillator for several minutes before being stretchered off wearing an oxygen mask and taken to hospital. World Cup referee Howard Webb abandoned the game. As the message was relayed around the stadium with the score at 1-1, the fans applauded and chanted Muamba's name. Premier League chief executive Richard Scudamore said: "The thoughts of the Premier League, its clubs and players are with Fabrice Muamba, his family and Bolton Wanderers. We would like to praise the players, match officials, coaching staff and medical teams of both clubs at White Hart Lane for their swift actions in attending Fabrice. "The league would also like to commend the compassion shown by the fans of Bolton Wanderers and Tottenham Hotspur. We hope to hear positive news about Fabrice who is and has been a wonderful ambassador for the English game and the league at Arsenal, Birmingham City and Bolton Wanderers." Manchester United star Rio Ferdinand wrote on Twitter: "Come on Fabrice Muamba, praying for you." England striker Wayne Rooney wrote: "Hope fabrice muamba is ok. Praying for him and his family. Still in shock." Muamba's team-mate Stuart Holden, added: "Still praying for Fab, the guy is a fighter on and off the field. We love you bro."
Researchers have established a direct link between the number of friends you have on Facebook and the degree to which you are a "socially disruptive" narcissist, confirming the conclusions of many social media sceptics. People who score highly on the Narcissistic Personality Inventory questionnaire had more friends on Facebook, tagged themselves more often and updated their newsfeeds more regularly. The research comes amid increasing evidence that young people are becoming increasingly narcissistic, and obsessed with self-image and shallow friendships. The latest study, published in the journal Personality and Individual Differences, also found that narcissists responded more aggressively to derogatory comments made about them on the social networking site's public walls and changed their profile pictures more often. A number of previous studies have linked narcissism with Facebook use, but this is some of the first evidence of a direct relationship between Facebook friends and the most "toxic" elements of narcissistic personality disorder. Researchers at Western Illinois University studied the Facebook habits of 294 students, aged between 18 and 65, and measured two "socially disruptive" elements of narcissism – grandiose exhibitionism (GE) and entitlement/exploitativeness (EE). GE includes ''self-absorption, vanity, superiority, and exhibitionistic tendencies" and people who score high on this aspect of narcissism need to be constantly at the centre of attention. They often say shocking things and inappropriately self-disclose because they cannot stand to be ignored or waste a chance of self-promotion. The EE aspect includes "a sense of deserving respect and a willingness to manipulate and take advantage of others". The research revealed that the higher someone scored on aspects of GE, the greater the number of friends they had on Facebook, with some amassing more than 800. Those scoring highly on EE and GG were also more likely to accept friend requests from strangers and seek social support, but less likely to provide it, according to the research. Carol Craig, a social scientist and chief executive of the Centre for Confidence and Well-being, said young people in Britain were becoming increasingly narcissistic and Facebook provided a platform for the disorder. "The way that children are being educated is focussing more and more on the importance of self esteem – on how you are seen in the eyes of others. This method of teaching has been imported from the US and is 'all about me'. "Facebook provides a platform for people to self-promote by changing profile pictures and showing how many hundreds of friends you have. I know of some who have more than 1,000." Dr Viv Vignoles, senior lecturer in social psychology at Sussex University, said there was "clear evidence" from studies in America that college students were becoming increasingly narcissistic. But he added: "Whether the same is true of non-college students or of young people in other countries, such as the UK, remains an open question, as far as I know. "Without understanding the causes underlying the historical change in US college students, we do not know whether these causes are factors that are relatively specific to American culture, such as the political focus on increasing self-esteem in the late 80s and early 90s or whether they are factors that are more general, for example new technologies such as mobile phones and Facebook." Vignoles said the correlational nature of the latest study meant it was difficult to be certain whether individual differences in narcissism led to certain patterns of Facebook behaviour, whether patterns of Facebook behaviour led to individual differences in narcissism, or a bit of both. Christopher Carpenter, who ran the study, said: "In general, the 'dark side' of Facebook requires more research in order to better understand Facebook's socially beneficial and harmful aspects in order to enhance the former and curtail the latter. "If Facebook is to be a place where people go to repair their damaged ego and seek social support, it is vitally important to discover the potentially negative communication one might find on Facebook and the kinds of people likely to engage in them. Ideally, people will engage in pro-social Facebooking rather than anti-social me-booking."
One day in 1999 Duane Graveline, then a 68-year-old former NASA astronaut, returned home from his morning walk in Merritt Island, Fla., and could not remember where he was. His wife stepped outside, and he greeted her as a stranger. When Graveline’s memory returned some six hours later in the hospital, he racked his brain to figure out what might have caused this terrifying bout of amnesia. Only one thing came to mind: he had recently started taking the statin drug Lipitor. Cholesterol-lowering statins such as Lipitor, Crestor and Zocor are the most widely prescribed medications in the world, and they are credited with saving the lives of many heart disease patients. But recently a small number of users have voiced concerns that the drugs elicit unexpected cognitive side effects, such as memory loss, fuzzy thinking and learning difficulties. Hundreds of people have registered complaints with MedWatch, the U.S. Food and Drug Administration’s adverse drug reaction database, but few studies have been done and the results are inconclusive. Nevertheless, many experts are starting to believe that a small percentage of the population is at risk, and they are calling for increased public awareness of the possible cognitive side effects of statins—symptoms that may be misdiagnosed as dementia in the aging patients who take them. Fat and the Brain It is not crazy to connect cholesterol-modifying drugs with cognition; after all, one quarter of the body’s cholesterol is found in the brain. Cholesterol is a waxy substance that, among other things, provides structure to the body’s cell membranes. High levels of cholesterol in the blood create a risk for heart disease, because the molecules that transport cholesterol can damage arteries and cause blockages. In the brain, however, cholesterol plays a crucial role in the formation of neuronal connections—the vital links that underlie memory and learning. Quick thinking and rapid reaction times depend on cholesterol, too, because the waxy molecules are the building blocks of the sheaths that insulate neurons and speed up electrical transmissions. “We can’t understand how a drug that affects such an important pathway would not have adverse reactions,” says Ralph Edwards, former director of the World Health Organization’s drug-monitoring center in Uppsala, Sweden. Two small trials published in 2000 and 2004 by Matthew Muldoon, a clinical pharmacologist at the University of Pittsburgh, seem to suggest a link between statins and cognitive problems. The first, which enrolled 209 high-cholesterol subjects, reported that participants taking placebo pills improved more on repeated tests of attention and reaction time taken over the course of six months—presumably getting better because of practice, as people typically do. Subjects who were on statins, however, did not show the normal improvement—suggesting their learning was impaired. The second trial reported similar findings. And a study published in 2003 in Reviews of Therapeutics noted that among 60 statin users who had reported memory problems to MedWatch, more than half said their symptoms improved when they stopped taking the drugs. But other studies have found no significant link between statins and memory problems. Larry Sparks, director of the Laboratory for Neurodegenerative Research at the Sun Health Research Institute in Sun City, Ariz., goes so far as to say that “you’ve got a better chance of buying a winning lottery ticket, walking outside and getting hit by lightning and dying” than you do of suffering a cognitive side effect from statins. Vulnerable Genes? Many experts agree that for most people the risk is quite low, but they are beginning to believe the effects are real. “A subset of the population is vulnerable,” argues Joe Graedon, co-founder of the consumer advocacy Web site the People’s Pharmacy, which has collected hundreds of reports of cognitive-related statin side effects in the past decade. Some researchers believe these people have a genetic profile that puts them at risk.
When the US Food and Drug Administration told the makers of cholesterol-lowering statins to add new side effect warnings to their labels last week, many of the 40 million statin users may have been unaware of the extent of the risks associated with these drugs that have been touted by some cardiologists to be safer than aspirin. No question, statins -- which include Lipitor (atorvastatin), Zocor (simvastatin), and Crestor (rosuvastatin) -- are relatively safe drugs, and they’ve saved thousands of lives over the past 20 years, particularly in men with established heart disease. But like any drug they can cause problems in some, including muscle aches, an increased risk of diabetes, and, gaining recent attention, memory loss. University of California-San Diego researcher Beatrice Golomb published a paper two years ago describing 171 statin users who reported that they had developed memory problems and dementia-like symptoms that the statin users attributed to their use of the medications. The vast majority experienced an improvement in their symptoms after stopping the drugs and many saw their symptoms return after going back on statins. Robert Grindell, a state employee from Makinen, Minn., told me his short-term memory began to deteriorate after he started taking Zocor in his early 50s. (He contacted Golomb after hearing about her research.) “My co-workers told me I was coming in to ask them the same question three times in one day,” he said. “I had a CT scan to determine if I had a stroke, but it came back fine; the next day, I couldn’t even remember where I had the test performed.” After learning that Zocor caused memory problems, Grindell decided to go off it and said within a few days he noticed an improvement in his memory, not having to glance down several times at a printed phone number as he dialed it to remember the digits. Unfortunately, the exact incidence of these memory problems isn’t known. Manufacturer-sponsored clinical trials show that they occur in fewer than 1 percent of users, but statin researcher Dr. Paul Thompson, chief of cardiololgy at Hartford Hospital, said the real incidence is probably much higher. He has a study expected to be published sometime this year that measured cognitive effects in statin users compared with those on placebos that he said will provide a better estimate; the findings can’t be disclosed until the study is published. The diabetes risks of statins are more well-established. One review study published last year calculated an extra two cases of type 2 diabetes in every 1,000 patients who took a high-dose statin (80 milligrams per day) compared with those who took a lower dose (20 to 40 milligrams). And one clinical trial found that statin users had about a 25 percent increased risk of developing diabetes over a two-year period compared with those who took placebos. Experts, though, agree that in people at high risk for heart disease, the increased diabetes risk is outweighed by the statin’s protection against heart attacks and deaths from any cause. The danger of muscle destruction from statins -- which can damage the liver and kidneys -- is also clear but slight. According to Thompson, about 1 in every 1,000 statin users will develop severely elevated levels of the enzyme creatine kinase, which indicates muscle death, and only 1 in 10 million die from developing an extremely severe case of the condition called rhabdomyolysis. Muscle aches are far more common: occuring in about 1 in 10 users, according to Thompson. “It seems to be more common in people who do a lot of exercise.” In fact, a study he conducted found that marathon runners taking statins developed a greater increase in creatine kinase right after their race compared with runners who weren’t on statins. “We also see more muscle aches in older people and women since they have less muscle mass,” he said. Lowering the statin dose or switching to a different statin doesn’t always help, Thompson said. “In our studies, those who develop statin myalgia tend to get it again and again; they’re body may get sensitized to statins.” There may also be a genetic component, with statin muscle aches occuring more often in those whose parents also had them. And there may be a link between memory loss and muscle aches. “In our database, the majority of patients who had cognitive problems also had muscle problems,” Golomb said. She recommends that those who are having memory loss or muscle aches speak to their doctor about going off statins -- especially if they’re not in a high-risk group for heart attacks. Those who get the most benefits are men under 65 who’ve already had a heart attack, she said. Women, elderly people, and those without heart disease get much smaller benefits from statins, and it’s unclear whether the drugs extend their lives. “Many patients have told me that their doctor said going off statins would kill them,” Golomb said, “but that’s not an accurate representation of the evidence.”
FOREIGN nationals not entitled to free treatment are said to owe Swansea Bay's ABM University Health Board more than £130,000 — the second highest figure in Wales. According to figures obtained by the Welsh Conservatives, only Cardiff and Vale UHB is owed more, at just over £200,000. Darren Millar AM The Welsh Government has now said it is looking at further measures to help health boards recoup their costs. Figures obtained by the Tories following a Freedom of Information request show the money owed to the NHS in Wales more than doubled between 2008 and 2011. Of the £380,000 that was unpaid, at least £199,311 is still outstanding to Wales's seven health boards, while a minimum of £185,700 was written off after bosses exhausted efforts to be reimbursed. Shadow Health Minister Darren Millar AM expressed concern at the figures, arguing the Welsh NHS was in no position to be owing substantial sums of money. He said: "There are strict guidelines in place for explaining details of charges to patients who are required to pay. "The Welsh Government should look carefully at how well these rules are followed. "Any money written off by the NHS is regrettable when budgets are being squeezed so hard. The big rise evident in these figures is of great concern." The figures show that, in 2008/09, £70,815 had not been paid back. In 2010/11 that had increased to £257,713. And the Tories also claim there was been a downward trend in the rate of collecting money owed, down from 71 per cent in 2008/09 to 43 per cent in 2010/11. Some treatments, such as medical emergencies at A&E or compulsory psychiatric care, remain free of charge for everyone in Wales — regardless of where they are from or how long they have lived in the country. Other procedures, which include non-life-threatening outpatient care, are supposed to be paid for by non-EU residents. But the process and guidelines are far from straightforward as some countries have signed healthcare agreements with the UK. This makes its citizens exempt from some charges. ABM officials could not be contacted for comment. A Welsh Government spokesman said: "All visitors to Wales requiring NHS treatment are assessed as to their eligibility for free NHS treatment. "All treatment received in an accident and emergency department is free to all. "We have issued clear guidance to NHS organisations which states that they should recover the cost of caring for overseas patients who are not entitled to free care. "We are looking at what further measures can be introduced to support NHS organisations recover costs."
