IHT Rendezvous: Gallery Stroll: Istanbul

ISTANBUL — Unpredictable weather means winter isn’t the most popular season for visiting Istanbul, but it is a great time for gallery-hopping: Many of the best museums and art spaces in the Beyoglu district have just opened compelling new exhibitions.

At Arter, the curator Emre Baykal has gathered mostly new works by Turkish artists to create the second installment of “Envy, Enmity, Embarrassment.” Here, the artist known as Canan presents the installation, “I beg you please do not speak to me of love,” a room plastered with erotic movie posters from the heyday of the Yesilcam porn industry of the 1970s. In a transparent case in one corner of the room is a seemingly innocent white bathrobe. Embroidered on its back is a suicide note.

Other interesting works include “Twin Goddess: The Sketch of an Encounter,” an embroidered collage by Nilbar Gures using ancient symbols from Anatolian archaeology, and “The Island” by Hera Buyuktasciyan, a look at taboos swept under the rug.

The most powerful piece in this show is Hale Tenger’s “I Know People Like This III.” Visitors who enter the gallery from Istiklal Caddesi walk through this chronological maze of x-ray prints, a sort of light-box labyrinth, that lays out traumatic images from Turkish political history, including public protests, the killing of journalists and scenes of violence that followed the 1980 military coup.

On the parallel street, Mesrutiyet Caddesi, the Pera Museum has just opened a double-barreled program. A retrospective of the works of the Hungarian-American photographer Nickolas Muray covers the dashing man-about-town’s early black-and-white art nudes as well as his color-saturated portraits of beauties like Marilyn Monroe, Elizabeth Taylor and a woman he adored, Frida Kahlo. On another floor, “Between Desert and Sea” presents a selection of 52 works from the Jordan National Gallery of Fine Arts, pieces that speak to topical issues like religion, the rights of women, and the impact of the Arab Spring revolutions.

At the Salt Galata, a 10-minute stroll away on Bankalar Caddesi, “1 + 8″ is an installation of large-screen videos by Cynthia Madansky and Angelika Brudniak, who traveled to the borders between Turkey and its eight neighbors: Greece, Bulgaria, Georgia, Armenia, Nakchivan, Iran, Iraq and Syria to tape local residents talking about their daily lives and hopes. In the case of Iran, just a black screen is shown: The artists were refused permission to film in Iran, but they managed to record audio of Iranians who had crossed into Turkey for personal or business reasons. None felt safe having their faces shown.

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Gadgetwise Blog: Is January the Time to Buy Electronics?

At the International Consumer Electronics Show in Las Vegas in early January, manufacturers tantalized consumers with new electronics soon to hit the shelves. But what does that do to the prices of current models that are being replaced? Is this a golden buying opportunity?

Yes and no. Yes for TVs, no for laptops. I’ll explain.

Decide.com, which tracks the price of electronics, studied what happened to the cost of TVs and laptops in past years after C.E.S.

What it found is that TV prices dip to near yearly lows after the show, matching holiday prices. With the average price of the top 250 TVs at $1,057, the post-show average is projected to drop an average of $211, to $846, based on data from previous  years. That is a 20 percent savings.

Laptops don’t drop so steeply. After the show, the 100 most popular laptops have historically been discounted 8 percent. This year that would mean the top 100 laptops, which average $780 in price, would be reduced $62, to $718.

Laptop price are lowest in late June through early July, right before the back to school sales, and during the last two weeks of September, after those sales, according to Decide.com’s data. At those times the discounts are typically 10 percent.

Of course, averages can be deceiving. Prices are volatile all year around, so a particular TV or computer you want could be discounted far more at any time.

There are a number of browser add-ons and apps that let you track prices of individual products, or you can use Decide.com – but it will cost you. Membership is $5 a month or $30 a year for full access.

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40 Years After Roe v. Wade, Thousands March to Oppose Abortion


Drew Angerer/The New York Times


Pro-life activists made their way down Constitution Avenue toward the Supreme Court during the March for Life in Washington on Friday.







WASHINGTON — Three days after the 40th anniversary of the decision in Roe v. Wade, the landmark Supreme Court case that legalized abortion, tens of thousands of abortion opponents from around the country came to the National Mall on Friday for the annual March for Life rally, which culminated in a demonstration in front of the Supreme Court building.




On a gray morning when the temperature was well below freezing, the crowd pressed in close against the stage to hear more than a dozen speakers, who included Tony Perkins, the president of the Family Research Council; Representative Diane Black, Republican of Tennessee, who recently introduced legislation to withhold financing from Planned Parenthood, and Senator Rand Paul, Republican of Kentucky; Cardinal Seán Patrick O’Malley of Boston; and Rick Santorum, the former senator from Pennsylvania and Republican presidential candidate.


Mr. Santorum spoke of his wife’s decision not to have an abortion after they learned that their child — their daughter Bella, now 4 — had a rare genetic disorder called Trisomy 18.


“We all know that death is never better, never better,” Mr. Santorum said. “Bella is better for us, and we are better because of Bella.”


Jeanne Monahan, the president of the March for Life Education and Defense Fund, said that the march was both somber and hopeful.


“We’ve lost 55 million Americans to abortion,” she said. “At the same time, I think we’re starting to win. We’re winning in the court of public opinion, we’re winning in the states with legislation.”


Though the main event officially started at noon, the day began much earlier for the participants, with groups in matching scarves engaged in excited chatter on the subway and gaggles of schoolchildren wearing name tags around their necks. Arriving on the Mall, attendees were greeted with free signs (“Defund Planned Parenthood” and “Personhood for Everyone”) and a man barking into a megaphone, “Ireland is on the brink of legalizing abortion, which is not good.”


The march came two months after the 2012 campaign season, in which social issues like abortion largely took a back seat to the focus on the economy. But the issue did come up in Congressional races in which Republican candidates made controversial statements about rape or abortion. In Indiana, Richard E. Mourdock, a Republican candidate for the Senate, said in a debate that he believed that pregnancies resulting from rape were something that “God intended,” and in Illinois, Representative Joe Walsh said in a debate that abortion was never necessary to save the life of the mother because of “advances in science and technology.” Both men lost, hurt by a backlash from female voters.


Recent polls show that while a majority of Americans do not want Roe v. Wade to be overturned entirely, many favor some restrictions. In a Gallup poll released this week, 52 percent of those surveyed said that abortions should be legal only under certain circumstances, while 28 percent said they should be legal under all circumstances, and 18 percent said they should be illegal under all circumstances. In a Pew poll this month, 63 percent of respondents said they did not want Roe v. Wade to be overturned completely, and 29 percent said they did — views largely consistent with surveys taken over the past two decades.


“Most Americans want some restrictions on abortion,” Ms. Monahan said. “We see abortion as the human rights abuse of today.”


Speaker John A. Boehner of Ohio, who spoke via a recorded video, called on the protest group, particularly the young people, to make abortion “a relic of the past.”


“Human life is not an economic or political commodity, and no government on earth has the right to treat it that way,” he said.


The crowd was dotted with large banners, many bearing the names of the attendees’ home states and churches and colleges. Gary Storey, 36, stood holding a handmade sign that read “I was adopted. Thanks Mom for my life.” Next to him stood his adoptive mother, Ellen Storey, 66, who held her own handmade sign with a picture of her six children and the words “To the mothers of our four adopted children, ‘Thank You’ for their lives.”


Mr. Storey said he was grateful for the decision by his biological mother to carry through with her pregnancy. “Beats the alternative,” he joked.


Last week, the Planned Parenthood Federation of America started a new Web site, and on Tuesday, its president, Cecile Richards, released a statement supporting abortion rights.


“Planned Parenthood understands that abortion is a deeply personal and often complex decision for a woman to consider, if and when she needs it,” she said. “A woman should have accurate information about all of her options around her pregnancy. To protect her health and the health of her family, a woman must have access to safe, legal abortion without interference from politicians, as protected by the Supreme Court for the last 40 years.”


This article has been revised to reflect the following correction:

Correction: January 25, 2013

A summary that appeared on the home page of NYTimes.com with an earlier version of this article misstated the day of the march. It took place on Friday, not Thursday.



Read More..

40 Years After Roe v. Wade, Thousands March to Oppose Abortion


Drew Angerer/The New York Times


Pro-life activists made their way down Constitution Avenue toward the Supreme Court during the March for Life in Washington on Friday.







WASHINGTON — Three days after the 40th anniversary of the decision in Roe v. Wade, the landmark Supreme Court case that legalized abortion, tens of thousands of abortion opponents from around the country came to the National Mall on Friday for the annual March for Life rally, which culminated in a demonstration in front of the Supreme Court building.




On a gray morning when the temperature was well below freezing, the crowd pressed in close against the stage to hear more than a dozen speakers, who included Tony Perkins, the president of the Family Research Council; Representative Diane Black, Republican of Tennessee, who recently introduced legislation to withhold financing from Planned Parenthood, and Senator Rand Paul, Republican of Kentucky; Cardinal Seán Patrick O’Malley of Boston; and Rick Santorum, the former senator from Pennsylvania and Republican presidential candidate.


Mr. Santorum spoke of his wife’s decision not to have an abortion after they learned that their child — their daughter Bella, now 4 — had a rare genetic disorder called Trisomy 18.


“We all know that death is never better, never better,” Mr. Santorum said. “Bella is better for us, and we are better because of Bella.”


Jeanne Monahan, the president of the March for Life Education and Defense Fund, said that the march was both somber and hopeful.


“We’ve lost 55 million Americans to abortion,” she said. “At the same time, I think we’re starting to win. We’re winning in the court of public opinion, we’re winning in the states with legislation.”


Though the main event officially started at noon, the day began much earlier for the participants, with groups in matching scarves engaged in excited chatter on the subway and gaggles of schoolchildren wearing name tags around their necks. Arriving on the Mall, attendees were greeted with free signs (“Defund Planned Parenthood” and “Personhood for Everyone”) and a man barking into a megaphone, “Ireland is on the brink of legalizing abortion, which is not good.”


The march came two months after the 2012 campaign season, in which social issues like abortion largely took a back seat to the focus on the economy. But the issue did come up in Congressional races in which Republican candidates made controversial statements about rape or abortion. In Indiana, Richard E. Mourdock, a Republican candidate for the Senate, said in a debate that he believed that pregnancies resulting from rape were something that “God intended,” and in Illinois, Representative Joe Walsh said in a debate that abortion was never necessary to save the life of the mother because of “advances in science and technology.” Both men lost, hurt by a backlash from female voters.


Recent polls show that while a majority of Americans do not want Roe v. Wade to be overturned entirely, many favor some restrictions. In a Gallup poll released this week, 52 percent of those surveyed said that abortions should be legal only under certain circumstances, while 28 percent said they should be legal under all circumstances, and 18 percent said they should be illegal under all circumstances. In a Pew poll this month, 63 percent of respondents said they did not want Roe v. Wade to be overturned completely, and 29 percent said they did — views largely consistent with surveys taken over the past two decades.


“Most Americans want some restrictions on abortion,” Ms. Monahan said. “We see abortion as the human rights abuse of today.”


Speaker John A. Boehner of Ohio, who spoke via a recorded video, called on the protest group, particularly the young people, to make abortion “a relic of the past.”


“Human life is not an economic or political commodity, and no government on earth has the right to treat it that way,” he said.


The crowd was dotted with large banners, many bearing the names of the attendees’ home states and churches and colleges. Gary Storey, 36, stood holding a handmade sign that read “I was adopted. Thanks Mom for my life.” Next to him stood his adoptive mother, Ellen Storey, 66, who held her own handmade sign with a picture of her six children and the words “To the mothers of our four adopted children, ‘Thank You’ for their lives.”


Mr. Storey said he was grateful for the decision by his biological mother to carry through with her pregnancy. “Beats the alternative,” he joked.


Last week, the Planned Parenthood Federation of America started a new Web site, and on Tuesday, its president, Cecile Richards, released a statement supporting abortion rights.


“Planned Parenthood understands that abortion is a deeply personal and often complex decision for a woman to consider, if and when she needs it,” she said. “A woman should have accurate information about all of her options around her pregnancy. To protect her health and the health of her family, a woman must have access to safe, legal abortion without interference from politicians, as protected by the Supreme Court for the last 40 years.”


This article has been revised to reflect the following correction:

Correction: January 25, 2013

A summary that appeared on the home page of NYTimes.com with an earlier version of this article misstated the day of the march. It took place on Friday, not Thursday.



Read More..

Labor Relations Board Rulings Could Be Undone



By ruling that Mr. Obama’s three recess appointments last January were illegal, the federal appeals court ruling, if upheld, would leave the board with just one member, short of the quorum needed to issue any rulings. The Obama administration could appeal the court ruling, but no announcement was made on Friday.


If the Supreme Court were to uphold Friday’s ruling, issued by the United States Court of Appeals for the District of Columbia Circuit, it would mean that the labor board did not have a quorum since last January and that all its rulings since then should be nullified.


Many Republicans and business groups applauded Friday’s ruling. They often assert that the appointments Mr. Obama made to the board have transformed it into a tool of organized labor. But many Democrats and labor unions say Mr. Obama’s appointments restored ideological balance to the board after it was tipped in favor of business interests under President George W. Bush


Mark G. Pearce, the board’s chairman, issued a statement saying the board disagreed with the ruling and suggested that other appeals courts hearing cases about the constitutionality of Mr. Obama’s appointments could reach a different conclusion.


“In the meantime, the board has important work to do,” said Mr. Pearce, whose agency oversees enforcement of the laws governing strikes and unionization drives. “We will continue to perform our statutory duties and issue decisions.”


Unless the Senate confirms future nominees to the board — Senate Republicans have blocked several of Mr. Obama’s board nominees — Mr. Pearce will be the only member left if Friday’s ruling is upheld. The board has five seats.


Representative Darrell Issa, a California Republican who is the chairman of the Oversight and Government Reform Committee, issued a statement that urged the recess appointees to “do the right thing and step down.” He added, “To avoid further damage to the economy, the N.L.R.B. must take the responsible course and cease issuing any further opinions until a constitutionally sound quorum can be established.”


The three disputed recess appointees included two Democrats, Sharon Block, deputy labor secretary, and Richard Griffin, general counsel to the operating engineers’ union; and one Republican, Terence Flynn, a counsel to a board member. Mr. Flynn resigned last May after being accused of leaking materials about the group’s deliberations. Another Republican member, Brian Hayes, stepped down when his term expired last month.


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Syrian Refugees Entering Jordan in Record Numbers, U.N. Says





GENEVA — Syrians are fleeing into Jordan in record numbers to escape escalating violence and destruction that is making it increasingly difficult for civilians to survive, the United Nations refugee agency said on Friday.




More than 4,000 Syrians arrived at a camp in Zaatari in northern Jordan on Thursday and another 2,000 people overnight, Melissa Fleming, the spokeswoman for the United Nations High Commissioner for Refugees, said.


The influx, consisting mainly of families led by women, brought to more than 30,000 the number of Syrians reaching Zaatari this month, close to double the number who arrived in December, Ms. Fleming said.


Many had come from the city and suburbs of Daraa, Ms. Fleming said, and described a “real day-to-day struggle to survive” in the face of combat damage, the closure of medical facilities and shortages of food, water and electricity.


The Zaatari camp, which opened in July, already has some 65,000 people and the agency said it is working with Jordanian authorities to open a second camp by the end of the month to initially accommodate 5,000 refugees and eventually serve some 30,000 people.


Many families arrive with young children or babies, and Zaatari has recorded seven to 10 babies born every day over the past month, according to Ms. Fleming. Many Syrians arrived sick because of the collapse of medical services. Three children died in the camp this week, including a two-day old infant, she said.


The refugee agency reported it is also working double shifts to try to register Syrians who are living elsewhere in Jordan and expects to have 50,000 on its books by the end of February but it noted that Jordanian authorities say 300,000 Syrians have now entered the country.


Jordan’s fears for the impact of this influx on its own stability surfaced last week when Prime Minister Abdullah Ensour said that if the Syrian government collapsed it would not allow refugees to cross its border, but that it would use its military to create safe havens inside Syria for those displaced by conflict.


The number of Syrian refugees in the region is approaching 700,000, the refugee agency said, with 221,000 registered as refugees in Lebanon, 156,000 in Turkey and 76,000 in Iraq.


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Apple Labor Audits Uncover Underage Workers



SAN FRANCISCO — Apple stepped up audits of working conditions at major suppliers last year, discovering multiple cases of employment of underage workers, discrimination and wage problems.


The company, which relies heavily on Asia-based partners like Foxconn Technology Group of Taiwan to assemble its devices, said Thursday that it had conducted 393 audits, up 72 percent from 2011, reviewing sites where more than 1.5 million workers make its gadgets.


In recent years, Apple has faced accusations of building its profits on the backs of poorly treated and severely underpaid workers in China.


That criticism came to the fore around 2010, after reports of suicides at Foxconn drew attention to the long hours that migrant laborers frequently endured, often for a pittance in wages and in severely cramped living conditions.


Foxconn is the trading name of Hon Hai Precision Industry. The company employs 1.2 million workers across China.


Under Tim Cook, who took over as chief executive from Steve Jobs in 2011, Apple has taken steps to improve its record and increase transparency, with measures like the extensive audits of its sprawling supply chain. Last year, it agreed to separate audits by the independent Fair Labor Association.


In an interview Thursday, the senior vice president of operations at Apple, Jeff Williams, said the company had increased its efforts to solve two of the most challenging issues: ensuring there are no underage workers in its supply chain and limiting work time to 60 hours a week.


Apple is now investigating its smaller suppliers — which typically face less oversight on such issues — to bring them into compliance, sometimes even firing them.


“We go deep in the supply chain to find it,” Mr. Williams said. “And when we do find it, we ensure that the underage workers are taken care of, the suppliers are dealt with.”


In one case, Apple terminated its relationship with a component maker after discovering 74 cases in which underage workers were being employed. Apple also found that an employment agency had forged documents to allow children to work illegally at the supplier.


Apple reported both the supplier and the employment agency to the local authorities, the company said in its latest annual report on the conditions in its supply chain.


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The New Old Age Blog: Time to Recognize Mild Cognitive Disorder?

The Diagnostic and Statistical Manual of Mental Disorders, published and periodically updated by the American Psychiatric Association, is one of those documents few laypeople ever read, but many of us are affected by.

It can make it easier or harder to get an insurance company or Medicare to cover treatments, for example. It factors into a variety of legal and governmental decisions.

And on a personal basis, a psychiatric diagnosis may be welcome (having a name and a treatment plan for what’s bothering us can be comforting) or not (are we really suffering from a mental disorder if we seem depressed after a family member dies?).

That last question refers to a change in the new DSM5, to be published in May, that has generated considerable controversy and that I discussed in an earlier post: the removal of the “bereavement exclusion,” once part of the diagnosis of Major Depressive Disorder.

Another element of the revised DSM could also affect readers: It will include something called Mild Neurocognitive Disorder. The task force revising the manual wanted to align psychiatry with the rest of medicine, which has already begun to distinguish between levels of impairment, said its chairman, David Kupfer, a University of Pittsburgh psychiatrist.

True enough, as we have reported before. Neurologists call it Mild Cognitive Impairment, a stage where cognitive decline becomes noticeable enough to affect daily functioning, yet people can still live independently and have not progressed to dementia.

In fact, a large proportion of people with mild cognitive problems never will develop dementia — but doctors and researchers cannot yet determine who will and who won’t. Biomarkers that could identify the biological brain changes that presage dementia are still years away.

Will it be helpful, then, for health professionals using the DSM5 — most of them not psychiatrists, but primary care doctors — to begin diagnosing Mild Neurocognitive Disorder? Particularly as there is no treatment that can reverse it or reliably slow its progression, if it would progress?

Dr. Ronald Petersen, director of the Mayo Clinic’s Alzheimer’s Disease Research Center and a member of the working group that developed the new DSM5 criteria, said he thought the newly recognized disorder would be useful. “The predementia phase is becoming increasingly important,” he told me in an interview.

Counseling could help people compensate for the memory loss and other deficits they are experiencing, for example. With a DSM-recognized diagnosis, those approaches are more likely to be covered by insurers.

Besides, “one argument against Alzheimer’s therapies is that we wait too late, when there’s too much damage to the central nervous system to repair,” Dr. Petersen said, referring to several recent disappointing drug trials. In the future, with earlier diagnoses, “you may be able to intervene, stop the process and forestall the dementia.”

But as we have seen with screening tests for other diseases, early detection does not always lead to better health or longer lives. It can, however, lead to unnecessary treatments and procedures involving risks of their own. Could that happen with Mild Neurocognitive Disorder?

“It will lead to wild overdiagnosis,” predicted Allen Frances, an emeritus professor of psychiatry at Duke and the chairman of the task force that developed the previous DSM edition. Indeed, about a quarter of people initially diagnosed with mild cognitive impairment are later determined to be normal, a prominent researcher told my colleague Judy Graham last year.

“People will get unnecessary tests and start getting weird treatments that have no proven efficacy,” said Dr. Frances, who has criticized a number of DSM5 changes. “They’re going to worry like crazy about being demented.”

Dr. Petersen agreed that it was a legitimate concern, but “by and large, we’re becoming better at distinguishing between the normal cognitive effects of aging and disease.” (The American Psychiatric Association will publish a specialized DSM for primary care physicians, Dr. Kupfer pointed out, to help guide them through diagnoses.)

It is hard for patients and families to know how to react when experts disagree. But keep in mind that contemporary health care aims for what is called shared decision-making. That means patients and professionals discuss options and weigh the risks and benefits of treatments and procedures, their likely outcomes, patients’ preferences, and come to agreement on how to proceed. This essay in the New England Journal of Medicine calls shared decision-making “the pinnacle of patient-centered care.”

So when Dr. Frances refers to the DSM5 as “a guide, not a bible,” and urges skepticism about some of its diagnoses, he is advocating an approach that patients and families should probably bring to any medical decision.

Seeking further information, asking questions, assessing options — those are reasonable responses if, a few weeks after a loved one’s death, a doctor says you may have major depression. Or if she thinks your memory loss could mean Mild Neurocognitive Disorder.

“The shorter the evaluation, the less the person knows you, the less he or she can explain and justify the diagnosis, the more tests and treatments that will result, the more a person should be cautious and get a second opinion,” Dr. Frances said.

Whatever the DSM5 says, it’s hard to argue with that.

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: Time to Recognize Mild Cognitive Disorder?

The Diagnostic and Statistical Manual of Mental Disorders, published and periodically updated by the American Psychiatric Association, is one of those documents few laypeople ever read, but many of us are affected by.

It can make it easier or harder to get an insurance company or Medicare to cover treatments, for example. It factors into a variety of legal and governmental decisions.

And on a personal basis, a psychiatric diagnosis may be welcome (having a name and a treatment plan for what’s bothering us can be comforting) or not (are we really suffering from a mental disorder if we seem depressed after a family member dies?).

That last question refers to a change in the new DSM5, to be published in May, that has generated considerable controversy and that I discussed in an earlier post: the removal of the “bereavement exclusion,” once part of the diagnosis of Major Depressive Disorder.

Another element of the revised DSM could also affect readers: It will include something called Mild Neurocognitive Disorder. The task force revising the manual wanted to align psychiatry with the rest of medicine, which has already begun to distinguish between levels of impairment, said its chairman, David Kupfer, a University of Pittsburgh psychiatrist.

True enough, as we have reported before. Neurologists call it Mild Cognitive Impairment, a stage where cognitive decline becomes noticeable enough to affect daily functioning, yet people can still live independently and have not progressed to dementia.

In fact, a large proportion of people with mild cognitive problems never will develop dementia — but doctors and researchers cannot yet determine who will and who won’t. Biomarkers that could identify the biological brain changes that presage dementia are still years away.

Will it be helpful, then, for health professionals using the DSM5 — most of them not psychiatrists, but primary care doctors — to begin diagnosing Mild Neurocognitive Disorder? Particularly as there is no treatment that can reverse it or reliably slow its progression, if it would progress?

Dr. Ronald Petersen, director of the Mayo Clinic’s Alzheimer’s Disease Research Center and a member of the working group that developed the new DSM5 criteria, said he thought the newly recognized disorder would be useful. “The predementia phase is becoming increasingly important,” he told me in an interview.

Counseling could help people compensate for the memory loss and other deficits they are experiencing, for example. With a DSM-recognized diagnosis, those approaches are more likely to be covered by insurers.

Besides, “one argument against Alzheimer’s therapies is that we wait too late, when there’s too much damage to the central nervous system to repair,” Dr. Petersen said, referring to several recent disappointing drug trials. In the future, with earlier diagnoses, “you may be able to intervene, stop the process and forestall the dementia.”

But as we have seen with screening tests for other diseases, early detection does not always lead to better health or longer lives. It can, however, lead to unnecessary treatments and procedures involving risks of their own. Could that happen with Mild Neurocognitive Disorder?

“It will lead to wild overdiagnosis,” predicted Allen Frances, an emeritus professor of psychiatry at Duke and the chairman of the task force that developed the previous DSM edition. Indeed, about a quarter of people initially diagnosed with mild cognitive impairment are later determined to be normal, a prominent researcher told my colleague Judy Graham last year.

“People will get unnecessary tests and start getting weird treatments that have no proven efficacy,” said Dr. Frances, who has criticized a number of DSM5 changes. “They’re going to worry like crazy about being demented.”

Dr. Petersen agreed that it was a legitimate concern, but “by and large, we’re becoming better at distinguishing between the normal cognitive effects of aging and disease.” (The American Psychiatric Association will publish a specialized DSM for primary care physicians, Dr. Kupfer pointed out, to help guide them through diagnoses.)

It is hard for patients and families to know how to react when experts disagree. But keep in mind that contemporary health care aims for what is called shared decision-making. That means patients and professionals discuss options and weigh the risks and benefits of treatments and procedures, their likely outcomes, patients’ preferences, and come to agreement on how to proceed. This essay in the New England Journal of Medicine calls shared decision-making “the pinnacle of patient-centered care.”

So when Dr. Frances refers to the DSM5 as “a guide, not a bible,” and urges skepticism about some of its diagnoses, he is advocating an approach that patients and families should probably bring to any medical decision.

Seeking further information, asking questions, assessing options — those are reasonable responses if, a few weeks after a loved one’s death, a doctor says you may have major depression. Or if she thinks your memory loss could mean Mild Neurocognitive Disorder.

“The shorter the evaluation, the less the person knows you, the less he or she can explain and justify the diagnosis, the more tests and treatments that will result, the more a person should be cautious and get a second opinion,” Dr. Frances said.

Whatever the DSM5 says, it’s hard to argue with that.

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

Read More..

DealBook: S.E.C. Pick Is Ex-Prosecutor, in Signal to Wall Street

9:13 p.m. | Updated

The White House delivered a strong message to Wall Street on Thursday, taking the unusual step of choosing two former prosecutors as top financial regulators.

But translating that message into action will not be easy, given the complexities of the market and Wall Street’s aggressive nature.

At a short White House ceremony, President Obama named Mary Jo White, the first female United States attorney in Manhattan, to run the Securities and Exchange Commission. Mr. Obama also renominated Richard Cordray as the director of the Consumer Financial Protection Bureau, a position he has held for the last year under a temporary recess appointment without Senate approval.

With the appointments, the president showed a renewed resolve to hold Wall Street accountable for wrongdoing, extolling his candidates’ records as prosecutors.

Ms. White spent more than a decade as a top federal prosecutor in New York City, overseeing the prosecution of the crime boss John Gotti and those responsible for the 1993 World Trade Center bombing. As an Ohio prosecutor, Mr. Cordray filed lawsuits against Bank of America and the American International Group.

“It’s not enough to change the law,” Mr. Obama said. “We also need cops on the beat to enforce the law.”

Still, Ms. White and Mr. Cordray face their own challenges.

While Ms. White, 65, is best known as an aggressive prosecutor, she also built a lucrative legal practice defending Wall Street executives, a potential concern for consumer advocates. And she lacks experience in the financial minutiae central to a regulatory role.

Mr. Cordray, 53, presents another potential problem for the White House. The Senate last year declined to confirm him in the face of Republican and Wall Street opposition to the newly created consumer bureau. Several Republicans on Thursday again voiced their concerns.

“There’s absolutely no excuse for the Senate to wait any longer to confirm him,” Mr. Obama said.

Both Midwestern natives, Ms. White and Mr. Cordray arrived in Washington as outsiders. A five-time “Jeopardy” champion from Ohio, Mr. Cordray became the consumer bureau’s enforcement chief after losing re-election for state attorney general. As Ohio’s top prosecutor, he became known as the Midwestern sheriff of Wall Street.

Ms. White, who was born in Kansas City, Mo., changed career paths after graduating with a master’s degree in psychology. She obtained a law degree from Columbia University in 1974, and a few years later, began her first stint as a federal prosecutor in Manhattan.

She ultimately became the United States attorney in Manhattan, earning a reputation as a tenacious prosecutor with an independent streak. Ms. White embraced the often-repeated joke that her office was the United States attorney for the “sovereign,” rather than Southern, district of New York.

In 1997, aides to Manhattan District Attorney Robert M. Morgenthau accused her of trying to thwart a state insider trading investigation by allowing a defendant charged by the district attorney’s office to plead guilty to federal charges. Doing so effectively ended Mr. Morgenthau’s case, but Ms. White was unapologetic. “To prosecute such crimes under only state law diminishes their seriousness,” she said at the time.

As the chief federal prosecutor in Manhattan, Ms. White pursued white-collar crime and Wall Street fraud. She secured a $340 million fine against Daiwa Bank for illegally covering up trading losses and other crimes.

She distinguished her career with a series of terrorism cases. She supervised the original investigation into Osama bin Laden and Al Qaeda, and oversaw six major trials, including those stemming from the 1993 World Trade Center bombing and a plot to blow up New York landmarks.

Patrick J. Fitzgerald, the former United States attorney in Chicago who previously worked under Ms. White, called her “a force of nature.”

She also trained a generation of federal prosecutors. Two former assistants became high-level S.E.C. officials: Robert S. Khuzami, the departing enforcement chief, and George S. Canellos, his deputy. Preet Bharara, the current United States attorney in Manhattan, whom Ms. White hired in 1999, emphasized her “legendary work ethic,” citing her 1 a.m. e-mail dispatches. Her philosophy, Mr. Bharara said, was that prosecuting wrongdoing was “not just about earning notches on your belt.”

While former employees described her as “no nonsense,” she was often spotted sipping a Bud Light at a weekly social gathering for junior prosecutors. And despite being barely 5 feet tall, she also was an exuberant point guard in a local lawyers’ basketball league, and once arrived at a tennis match on a red motorcycle, while Helen Reddy’s “I Am Woman” blared loudly.

With her prosecutorial victories and independent political status, Ms. White is expected to receive broad support on Capitol Hill. Senator Charles E. Schumer of New York joined a chorus of Democratic enthusiasm on Thursday, declaring that Ms. White was a “tough-as-nails prosecutor.”

But she could face questions about her command of Wall Street arcana.

Regulatory chiefs are often market experts or academics. If confirmed, Ms. White will succeed Elisse B. Walter, a longtime S.E.C. official, who took over as chairwoman after Mary L. Schapiro stepped down as the agency’s leader in December. Ms. Schapiro, a seasoned policy maker and specialist in market structure, overhauled the agency after it was blamed for missing the warning signs of the financial crisis. Ms. White, in contrast, built her career on the law-and-order side of the securities industry, with just a brief stint as a director of the Nasdaq.

The gaps in her résumé could complicate Ms. White’s agenda in the face of fierce Wall Street lobbying. Under the next chairman, the agency must write dozens of rules to carry out the Dodd-Frank act, a regulatory overhaul passed in response to the crisis. The agency also must grapple with the increasingly complex markets and rapid-fire trading that dominate Wall Street.

People close to the S.E.C. note, however, that her husband, John W. White, is a veteran of the agency. From 2006 through 2008, he was head of the S.E.C.’s division of corporation finance.

Ms. Schapiro also argued that Ms. White’s outsider status could inject new life into the agency. “Nobody comes in an expert across the board,” Ms. Schapiro said. “A fresh look on some of these policy issues might be exactly what we need.”

Ms. White could face additional questions about her career, a revolving door in and out of government. In private practice, she defended some of Wall Street’s biggest names, including Kenneth D. Lewis, a former chief of Bank of America. As the head of litigation at Debevoise & Plimpton, she also represented JPMorgan Chase and the board of Morgan Stanley.

Barbara S. Jones, who retired recently from the federal bench in Manhattan and now practices law at the firm Zuckerman Spaeder, said Ms. White, a close friend, would benefit from both prosecuting and defending executives over her career. “She has been on both sides,” Ms. Jones said. “She will be tough when she has to be, but she’ll be fair.”

At the White House on Thursday, Ms. White spoke only briefly, saying she would work “to protect investors and to ensure the strength, efficiency and the transparency of our capital markets.” Mr. Obama noted that Ms. White, whose 43rd wedding anniversary fell on Thursday, was a childhood fan of “The Hardy Boys,” as he was, adding that she “built a career the Hardy boys could only dream of.” “You don’t want to mess with Mary Jo,” he said.

Peter Baker and Kitty Bennett contributed reporting.

A version of this article appeared in print on 01/25/2013, on page A1 of the NewYork edition with the headline: Sign to Wall St. In Obama’s Picks For Regulators.
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India Ink: India Rape Trial Starts With Renewed Ban on Media Coverage

The trial of five men accused in the gang rape of a 23-year-old woman in a moving bus in New Delhi is being watched closely as a symbol of India’s commitment to justice for women, but information about the ongoing court proceedings may be scarce.

As court proceedings began Thursday, the presiding judge said  there would be a blanket ban on reporting on the trial. The judge, Yogesh Khanna,  also warned defense lawyers, who have been openly speaking about the case, not to provide information about the proceedings to the press.

The five men accused in the Dec. 16 rape and murder of a physiotherapy student were ushered into the special fast-track court in South Delhi on Thursday at noon, flanked by policemen, with their faces were covered with gray woolen caps. During the two-hour court proceedings, the prosecution used the opening arguments to lay out charges against the men, which include gang rape, murder, robbery and destruction of evidence.

The police allege that the five accused men and a sixth teenager, who is being tried as a juvenile, committed a premeditated, vicious crime that included plans to kill their victim. The woman died nearly two weeks after the rape from injuries suffered during the attack, which included an assault with an iron rod. Her companion, a 29-year-old man, was also beaten, and is expected to testify  at the trial.

The court proceedings took place in room 305 of the Saket District Court complex, a small wood-paneled chamber. The next hearing will be on Monday, when the defendants’ lawyers will respond to the charges the prosecution has laid out.

The new fast-track court will try only cases related to crimes against women, and once trials have started, they will not adjourn for weeks or months, as is common in other courts. Several fast-track courts have already  been set up in Delhi to hear crimes against women in the wake of the Delhi gang rape, which brought thousands of protesters to the streets demanding justice for the victim and other victims of sexual assault.

Judge Khanna ordered  Monday that all court proceedings in ths current case would take place “in camera,” allowing only those directly connected with the case to be present in the courtroom, reiterating an earlier magistrate’s order on the case. He also renewed a blanket ban Monday on the printing or publishing of any information relating to the case’s proceedings.

Defense lawyers were instructed by the court during the proceedings to “honor the spirit” of the gag order, they said, after the special public prosecutor Dayan Krishnan said he would file a petition of contempt of court if lawyers for the defendants continued to brief the media on developments.

V. K. Anand, the lawyer for Ram Singh, one of the accused, confirmed Thursday that he would now also represent Mr. Singh’s brother Mukesh. Mr. Anand and Vivek Sharma, a second lawyer for accused, told the media after Thursday’s court proceedings that they could not answer any further questions.

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Bits Blog: Keeping the Internet Safe From Governments

Even before the World Conference on International Telecommunications took place last month in Dubai, Internet activists anticipated trouble. So did Congress, which issued a resolution calling it “essential” that the Internet remain “stable, secure and free from governmental control.”

The worries proved prescient. The conference, which supposedly was going to modernize some ancient regulations, instead offered a treaty that in the eyes of some critics would have given repressive states permission to crack down on dissent. The United States delegate refused to sign it. Fifty-four other countries, including Canada, Peru, Japan and most of Western Europe, voted no as well.

The OpenNet Initiative estimates that about a third of Internet users live in countries that engage in “substantive” or “pervasive” blocking of Internet content. They tended to be among the 89 countries that signed the treaty, including Russia, Cambodia, Iran, China, Cuba, Egypt and Angola.

Those in favor of a free and open Internet have long had a problem with the International Telecommunication Union, the affiliate of the United Nations that ran the conference. They see the I.T.U., which dates back to 1865, as longing for the pre-Internet era, when its influence and fortunes were greater. As a result, activists think, the I.T.U. has become aligned with, and a tool of, countries that desire more governmental control over public speech.

In the wake of the Dubai meeting, there are renewed calls to scale back United States financing of the I.T.U. drastically. The logic is, why are taxpayers supporting an organization whose motives they oppose?

“Paying for both sides of a conflict is unsustainable and illogical, and should simply be corrected,” says the De-Fund the I.T.U. Web site, which has posted a petition on the White House Web site.

The De-Fund site notes that the petition is not asking the United States government to take an unprecedented first step. “Many of our free-market democratic allies, led by Germany, France, Spain and Finland, have already de-funded the I.T.U. Likewise, right-thinking American companies like I.B.M., Cingular, Microsoft, Fox, Agilent, Sprint, Harris, Loral and Xerox, and others, have already withdrawn their private-sector contributions from the I.T.U.”

The petition was the brainchild of Bill Woodcock, the Berkeley-based research director of Packet Clearing House, a nonprofit institute. “This is really about whether people should be allowed to say what they think,” Mr. Woodcock said. “The Internet enables free speech, and that makes it very dangerous to countries that try to control public discourse.”

The United States government contributes about 8 percent of the I.T.U.’s budget. The 55 countries that voted against the treaty contribute about three-quarters of it. If the White House receives 25,000 signatures by Feb. 10, it will review and quite possibly act on the petition. As of Tuesday, it had about 600 signatures with minimal publicity.

A spokesman for the I.T.U., which is based in Switzerland, did not respond to an e-mail seeking comment.

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The New Old Age Blog: Grief Over New Depression Diagnosis

When the American Psychiatric Association unveils a proposed new version of its Diagnostic and Statistical Manual of Mental Disorders, the bible of psychiatric diagnoses, it expects controversy. Illnesses get added or deleted, acquire new definitions or lists of symptoms. Everyone from advocacy groups to insurance companies to litigators — all have an interest in what’s defined as mental illness — pays close attention. Invariably, complaints ensue.

“We asked for commentary,” said David Kupfer, the University of Pittsburgh psychiatrist who has spent six years as chairman of the task force that is updating the handbook. He sounded unruffled. “We asked for it and we got it. This was not going to be done in a dark room somewhere.”

But the D.S.M. 5, to be published in May, has generated an unusual amount of heat. Two changes, in particular, could have considerable impact on older people and their families.

First, the new volume revises some of the criteria for major depressive disorder. The D.S.M. IV (among other changes, the new manual swaps Roman numerals for Arabic ones) set out a list of symptoms that over a two-week period would trigger a diagnosis of major depression: either feelings of sadness or emptiness, or a loss of interest or pleasure in most daily activities, plus sleep disturbances, weight loss, fatigue, distraction or other problems, to the extent that they impair someone’s functioning.

Traditionally, depression has been underdiagnosed in older adults. When people’s health suffers and they lose friends and loved ones, the sentiment went, why wouldn’t they be depressed? A few decades back, Dr. Kupfer said, “what was striking to me was the lack of anyone getting a depression diagnosis, because that was ‘normal aging.’” We don’t find depression in old age normal any longer.

But critics of the D.S.M. 5 now argue that depression may become overdiagnosed, because this version removes the so-called “bereavement exclusion.” That was a paragraph that cautioned against diagnosing depression in someone for at least two months after loss of a loved one, unless that patient had severe symptoms like suicidal thoughts.

Without that exception, you could be diagnosed with this disorder if you are feeling empty, listless or distracted, a month after your parent or spouse dies.

“D.S.M. 5 is medicalizing the expected and probably necessary process of mourning that people go through,” said Allen Francis, a professor emeritus at Duke who chaired the D.S.M. IV task force and has denounced several of the changes in the new edition. “Most people get better with time and natural healing and resilience.”

If they are diagnosed with major depression before that can happen, he fears, they will be given antidepressants they may not need. “It gives the drug companies the right to peddle pills for grief,” he said.

An advisory committee to the Association for Death Education and Counseling also argued that bereaved people “will receive antidepressant medication because it is cheaper and ‘easier’ to medicate than to be involved therapeutically,” and noted that antidepressants, like all medications, have side effects.

“I can’t help but see this as a broad overreach by the APA,” Eric Widera, a geriatrician at the University of California, San Francisco, wrote on the GeriPal blog. “Grief is not a disorder and should be considered normal even if it is accompanied by some of the same symptoms seen in depression.”

But Dr. Kupfer said the panel worried that with the exclusion, too many cases of depression could be overlooked and go untreated. “If these things go on and get worse over time and begin to impair someone’s day to day function, we don’t want to use the excuse, ‘It’s bereavement — they’ll get over it,’” he said.

The new entry for major depressive disorder will include a note — the wording isn’t final — pointing out that while grief may be “understandable or appropriate” after a loss, professionals should also consider the possibility of a major depressive episode. Making that distinction, Dr. Kupfer said, will require “good solid clinical judgment.”

Initial field trials testing the reliability of D.S.M. 5 diagnoses, recently published in The American Journal of Psychiatry, don’t bolster confidence, however. An editorial remarked that “the end results are mixed, with both positive and disappointing findings.” Major depressive disorder, for instance, showed “questionable reliability.”

In an upcoming post, I’ll talk more about how patients might respond to the D.S.M. 5, and to a new diagnosis that might also affect a lot of older people — mild neurocognitive disorder.

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

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The New Old Age Blog: Grief Over New Depression Diagnosis

When the American Psychiatric Association unveils a proposed new version of its Diagnostic and Statistical Manual of Mental Disorders, the bible of psychiatric diagnoses, it expects controversy. Illnesses get added or deleted, acquire new definitions or lists of symptoms. Everyone from advocacy groups to insurance companies to litigators — all have an interest in what’s defined as mental illness — pays close attention. Invariably, complaints ensue.

“We asked for commentary,” said David Kupfer, the University of Pittsburgh psychiatrist who has spent six years as chairman of the task force that is updating the handbook. He sounded unruffled. “We asked for it and we got it. This was not going to be done in a dark room somewhere.”

But the D.S.M. 5, to be published in May, has generated an unusual amount of heat. Two changes, in particular, could have considerable impact on older people and their families.

First, the new volume revises some of the criteria for major depressive disorder. The D.S.M. IV (among other changes, the new manual swaps Roman numerals for Arabic ones) set out a list of symptoms that over a two-week period would trigger a diagnosis of major depression: either feelings of sadness or emptiness, or a loss of interest or pleasure in most daily activities, plus sleep disturbances, weight loss, fatigue, distraction or other problems, to the extent that they impair someone’s functioning.

Traditionally, depression has been underdiagnosed in older adults. When people’s health suffers and they lose friends and loved ones, the sentiment went, why wouldn’t they be depressed? A few decades back, Dr. Kupfer said, “what was striking to me was the lack of anyone getting a depression diagnosis, because that was ‘normal aging.’” We don’t find depression in old age normal any longer.

But critics of the D.S.M. 5 now argue that depression may become overdiagnosed, because this version removes the so-called “bereavement exclusion.” That was a paragraph that cautioned against diagnosing depression in someone for at least two months after loss of a loved one, unless that patient had severe symptoms like suicidal thoughts.

Without that exception, you could be diagnosed with this disorder if you are feeling empty, listless or distracted, a month after your parent or spouse dies.

“D.S.M. 5 is medicalizing the expected and probably necessary process of mourning that people go through,” said Allen Francis, a professor emeritus at Duke who chaired the D.S.M. IV task force and has denounced several of the changes in the new edition. “Most people get better with time and natural healing and resilience.”

If they are diagnosed with major depression before that can happen, he fears, they will be given antidepressants they may not need. “It gives the drug companies the right to peddle pills for grief,” he said.

An advisory committee to the Association for Death Education and Counseling also argued that bereaved people “will receive antidepressant medication because it is cheaper and ‘easier’ to medicate than to be involved therapeutically,” and noted that antidepressants, like all medications, have side effects.

“I can’t help but see this as a broad overreach by the APA,” Eric Widera, a geriatrician at the University of California, San Francisco, wrote on the GeriPal blog. “Grief is not a disorder and should be considered normal even if it is accompanied by some of the same symptoms seen in depression.”

But Dr. Kupfer said the panel worried that with the exclusion, too many cases of depression could be overlooked and go untreated. “If these things go on and get worse over time and begin to impair someone’s day to day function, we don’t want to use the excuse, ‘It’s bereavement — they’ll get over it,’” he said.

The new entry for major depressive disorder will include a note — the wording isn’t final — pointing out that while grief may be “understandable or appropriate” after a loss, professionals should also consider the possibility of a major depressive episode. Making that distinction, Dr. Kupfer said, will require “good solid clinical judgment.”

Initial field trials testing the reliability of D.S.M. 5 diagnoses, recently published in The American Journal of Psychiatry, don’t bolster confidence, however. An editorial remarked that “the end results are mixed, with both positive and disappointing findings.” Major depressive disorder, for instance, showed “questionable reliability.”

In an upcoming post, I’ll talk more about how patients might respond to the D.S.M. 5, and to a new diagnosis that might also affect a lot of older people — mild neurocognitive disorder.

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

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DealBook: Commerzbank to Cut Up to 6,000 Jobs

LONDON – Commerzbank, the second-largest lender in Germany, is planning to cut up to 6,000 jobs in a bid to increase earnings, joining other European banks that have announced restructuring plans in recent months.

The bank said on Thursday that it expected to eliminate 4,000 to 6,000 jobs by 2016, or 7 to 10 percent of its work force.

The layoffs will affect Commerzbank’s global operations, particularly a retail division that had expanded rapidly in recent years, according to a person with direct knowledge of the matter who spoke on condition of anonymity because he was not authorized to speak publicly.

In the wake of tougher capital requirements, sluggish economic growth and growing concerns about risky trading activity, several European banks have announced efforts to reduce their work forces, shed unwanted assets and increase capital reserves.

In October, the Swiss financial giant UBS said it would eliminate 10,000 jobs in its investment bank in a move to reduce exposure to risky trading activity and to focus on its wealth management division.

Barclays, which is to formally announce its own restructuring plan on Feb. 12, also started consulting with staff members in its investment banking unit this week over potential layoffs.

The expected job cuts at Barclays could result in up to a 10 percent reduction, or around 2,000 jobs, in the division, according to two people with direct knowledge of the matter who spoke on condition of anonymity because they were not authorized to speak publicly. On Thursday, Barclays started to reduce the size of its investment banking staff in Asia by 15 percent, or 70 jobs, according to one of the people.

On Jan. 17, the firm’s new chief executive, Antony P. Jenkins, told staff members they should leave the bank if they did not want to help rebuild its reputation. Barclays agreed last year to a $450 million settlement with American and British authorities over the manipulation of the London interbank offered rate, or Libor, a crucial benchmark rate.

The layoffs at Commerzbank come after efforts by the bank’s chief executive, Martin Blessing, to sell some of the firm’s 160 billion euros ($213 billion) of noncore assets, including shipping and real estate investments. The bank is also trying to reduce its exposure to European sovereign debt because of continuing volatility in countries like Spain and Greece.

Commerzbank said it would start negotiations with employee unions in early February to decide on the final number of layoffs. The announcement comes a day after Mr. Blessing was spotted at a party on Wednesday night at the luxury Belvedere hotel in Davos, whose attendees also included Deutsche Bank’s co-chief executive Anshu Jain. The Commerzbank chief is attending the World Economic Forum in the Swiss town.

Commerzbank received an 18.2 billion euro bailout from the German government in 2008 after its mistimed acquisition of a rival German bank, Dresdner, for 5.5 billion euros at the height of the financial crisis. As part of the deal, the German government still owns a 24 percent stake in Commerzbank.

Shares in Commerzbank bank rose less than 1 percent in morning trading in Frankfurt on Thursday.

European banks have been struggling through a series of recent financial scandals, mounting demands to increase capital reserves and growing political pressure to increase lending to stimulate local economies.

The Continent’s major financial institutions will begin reporting earnings next week, and analysts will be waiting to see if they will follow UBS’s lead in announcing major changes in response to these pressures.

“We believe that UBS has kicked off the much-awaited industry restructuring, even if each bank takes a different path,” Citigroup banking analysts told investors in a research note.

Neil Gough reported from Hong Kong. Jack Ewing contributed reporting from Davos.

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IHT Rendezvous: Taiwan's Diverse Literature and History on Show in Two New Museums

TAINAN — Two new museums in Tainan, a city in Taiwan’s south, say much about how the island’s people have worked in recent years to build an unusually inclusive cultural identity, a model for Chinese-speaking societies, as I write in my Letter from Taiwan this week.

At the National Museum of Taiwan Literature, founded in 2003, exhibits explore the writing, film and music of indigenous cultures such as the Siraya, and of speakers of Taiyu, Holo and Hakka. (The name “Taiwan” is widely believed to come from the Sirayan word for a port in the south of the island, Tayovan.)

Another exhibit, “The Inner World of Taiwan Literature,” shows diverse voices from both before and after the Chinese Nationalists moved their seat of government to Taiwan in 1949.

Page Two

Posts written by the IHT’s Page Two columnists.

The National Museum of Taiwan History opened at the end of 2011. Its vision is “To protect Taiwan, our homeland, and to creating a single diverse and harmonious society,” as it says on its Web site, and offers exhibits such as “Taiwan Memories: A Century of Life,” and “On the Tracks of Anthroplogists,” an exhibit of Taiwan anthropology.

At the museum’s opening, its director, Lu Li-cheng, noted its tens of thousands of objects of local cultural life, and the museum’s emphasis on the interactions among ethnic groups in Taiwan through history.

“Of particular note is the collection of historic maps, charts and documents that the museum has obtained from foreign collectors,” Taiwan Today reported, quoting Mr. Li: “They will provide us with different viewpoints from which to look at Taiwan’s history.”

As Mark Harrison, a Taiwan specialist at the University of Tasmania, said in a telephone interview, it’s all part of Taiwanese people’s attempts to build an inclusive society.

“Taiwan’s history is very complex, and it’s a very strange history,’’ said Mr. Harrison. “In that history, there have been whole periods erased by various regimes,” as they asserted power over the island, including the Qing dynasty from China, the Japanese colonialists and, finally, the Nationalists.

“What’s been really interesting about Taiwan,’’ he said, “is how it has gone about recovering its history and understanding itself, and many nations could learn from that.’’

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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.

A version of this article appeared in print on 01/23/2013, on page B1 of the NewYork edition with the headline: Microsoft May Back Dell Buyout.
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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.

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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.

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McDonald's December Sales Help Fourth-Quarter Profit







(Reuters) - McDonald's Corp reported an unexpected rise in sales in December at established U.S. restaurants, helping to lift its fourth-quarter profit above analysts estimates.




The world's largest restaurant chain on Wednesday said sales at U.S. eateries open at least 13 months rose 0.9 percent in December, compared with an average estimate compiled by Consensus Metrix calling for a 1.78 percent drop in the month.


A push by the company to have more of its restaurants open on Christmas and a shift of the limited-time offering of its popular McRib sandwich to December, both helped boost U.S. sales during the month.


But analysts said the early part of 2013 will be tough for the chain as it runs short of quick fixes for boosting U.S. sales that have been hurt by stiffer competition for customers who are pinching pennies in a weak economic recovery.


Net income at the world's biggest restaurant chain rose to $1.40 billion, or $1.38 per share, from $1.38 billion, or $1.33 per share, a year earlier.


Analysts on average forecast $1.33 a share, according to Thomson Reuters I/B/E/S.


Total sales rose 1.5 percent to $4.59 billion.


McDonald's fourth-quarter global sales at restaurants open at least 13 months rose 0.1 percent. Analysts on average had forecast a 0.3 percent decline, according to Consensus Metrix.


(Reporting By Lisa Baertlein in Los Angeles and Brad Dorfman in Chicago; Editing by Maureen Bavdek)


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IHT Rendezvous: Oscar Anticipation in the Subtitle Category

PARIS—With the multiple nominations for “Lincoln,” “Django Unchained” and “Zero Dark Thirty,” Europeans may see this year’s Academy Award field as something of a celebration of American history, in the age of Obama.

Still, “Amour,” Michael Haneke’s Austrian film shot in France and in French, made it into the best picture category, confirmation that the Academy thinks subtitled films can hold their own against American blockbusters. “Amour,” about life, death, age and love, is nominated in five categories (best picture, best foreign film, best actress, director and screenplay).

As Vanessa Thorpe wrote recently in The Guardian, “Academy voters appear to be hinting at a new openness to other cultures and the growing acceptability of subtitled entertainment.”

She theorized that a larger cultural shift is happening:

The new appetite for foreign fare might have started with the mass popularity of translated Scandinavian thrillers, from Stieg Larsson to Jo Nesbo, or it may have been the accidental result of cash-strapped public television schedulers searching for new quality drama with a reasonable price tag.

France took great national pride in last year’s best picture winner, “The Artist,” but, as Elaine Sciolino wrote at the time, it was shot in Los Angeles with an American crew, the rights were bought by an American, and it is all about Hollywood.

The fierce competition this year, and perhaps its grim subject matter, makes “Amour” something of a long shot as best picture. Among the best foreign-language film nominees, however, it stands as the overwhelming favorite to take the prize at the awards ceremony on Feb. 24.

The film has already swept all the European awards, including the 2012 Cannes Film Festival Palme d’Or; it was given the Golden Globe last week for best foreign language film, and more than 20 other awards and nominations. Oscar observers tend to agree it should leave with a golden statue, if not for best picture then surely for best foreign film.

But award ceremonies sometimes welcome surprises, and the foreign film category this year has some other strong contenders. The selection was made from a record-breaking 71 submissions in the category this year.

With two Scandinavian films in the running, three of the five nominees are from Europe. Denmark’s entry, “A Royal Affair,” a sumptuous romantic drama set in the 18th century, lost to “Amour” at the Golden Globes but took two awards at the Berlin International Film Festival: for best script and best actor for Mads Mikkelsen, whom you might recognize as the villain from “Casino Royale.”

“Kon-Tiki,” a box-office hit from Norway, got a double Golden Globe-Oscar nomination. It tells the story of Thor Heyerdahl’s 1947 trip across the Pacific on a small raft with five other men. Larry Rohter, who has been following the foreign film race closely for The New York Times, writes on the Carpetbagger blog that the Weinstein brothers are reportedly planning to release it in English this year.

Last year’s contenders included Iranian and Israeli films, this year the remaining two nominees are from the Americas.

The Chilean director Pablo Larrain was third-time lucky with “No,” his third film about the Pinochet years. Starring Gael Garcia Bernal, the film is about the 1988 referendum that ended the Pinochet dictatorship in Chile. This is Mr. Larrain’s second attempt at the award after being shortlisted in 2008 for his film “Tony Manero,” With “No,” which opens in February in the United States, Mr. Larrain won the top prize in the Directors’ Fortnight section at Cannes.

In a recent Q&A with Larry Rohter, the 36-year-old director talked about the difficulty that film committees face in choosing their entries for the Oscars. “What happens when the committee in each country meets to decide, sometimes they make the mistake that they think the movie that should be submitted is the one that they like more themselves,” he said.

Canada got a nod with “War Witch,” a film shot primarily in Congo about an adolescent girl-soldier trapped in civil war. The film, in French and the African language Lingala, wowed the critics and was awarded a top prize at this year’s Tribeca Film Festival. The nomination was yet another win for the government-supported National Film Board of Canada, which has garnered Oscar nominations for three years in a row.

Neither “No” nor “War Witch” made it into the Golden Globes selection.

The nomination will probably help “No” when it begins its release in Europe and the United States next month, as being in the Oscar race often gives movies a “nomination bump” in box-office figures, though Edmund Helmer wrote in an analysis recently for Reuters that a Golden Globe may be a better win financially.

One film that didn’t need to wait for its Golden Globe nomination to rock the box-office was “The Intouchables,” perhaps the most surprising absentee of the Oscars’ foreign film selection. The French movie, about the friendship between a rich Parisian quadriplegic and his caretaker, has become the highest-grossing film ever made in a language other than English, with a worldwide box-office take of roughly $410 million, about three times that of “The Artist.” Take that, Oscar.

Are you more likely to see a movie if it has won awards? Does the prospect of subtitles keep you from seeing a movie? And are there films you’ve seen that you think should have been nominated in the foreign film category that weren’t?

Fill out your own ballot in The New York Times Oscar poll.

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Storm and Pension Costs Leave Verizon With Bigger Loss





Verizon Communications is still adding plenty of customers and selling a lot of phones, but the impact from Hurricane Sandy and pension costs sank the company’s quarterly earnings.


The company on Tuesday reported a fourth-quarter loss of $4.22 billion, or $1.48 a share, more than double the loss a year ago. Damages from Hurricane Sandy cost 7 cents a share, and pension charges reduced earnings by $1.55 a share, Verizon said. Revenue climbed to $30.05 billion, a 5.7 percent increase compared with a year ago.


Analysts had expected adjusted earnings of 50 cents a share, compared to actual adjusted earnings of 45 cents a share, and revenue of $29.75 billion, according to Thomson Reuters.


“Verizon seized growth opportunities in the fourth quarter to cap a year of solid progress across the entire business,” said Lowell McAdam, chief executive of Verizon, in a statement. “We delivered a total return of 13.2 percent to shareholders in 2012, and we enter 2013 ready to accelerate the momentum we’ve achieved and create significant shareholder value in the years to come.”


The company, based in New York, said that its wireless business was growing. Over the quarter, it sold 9.8 million smartphones, compared with 7.7 million in the same quarter a year ago, and added 2.1 million contract subscribers, the most valuable type of customer, versus 1.2 million a year ago. The company said its new shared data plans helped increase the money it made from subscribers; average monthly revenue from each account grew 6.6 percent to $146.80.


Verizon Wireless, the largest American wireless carrier, is leading the race to build out its fourth-generation network, called LTE, which is faster and more efficient than its predecessor. The company has deployed LTE in 476 cities; AT&T, the second-biggest American carrier, is in a distant second with 135 cities.


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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.”

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