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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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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IHT Rendezvous: At Davos, Crisis Is the New Normal

DAVOS, Switzerland — In certain ways, the very setting of the World Economic Forum reflects the restless, challenged state of human affairs. Our footing is uncertain, as on this ski resort’s slithery streets, and we have steep slopes to climb, as the Magic Mountain will remind the global elite this week.

Barely into 2013, Mali and Algeria are new sites of hot war and chilling fear. Where the tumult that began in the Arab Spring will end is still as unclear as when it erupted — far from Davos — two years ago.

The challenge posed by the free flow of information in China went to the New Year streets in Guangzhou. Washington’s feuding politicians walked up to the brink before resolving not to jump off the so-called fiscal cliff. Europe seems to have averted a collapse of the euro, but even in Germany, growth is anemic.

Crisis, in short, is the new normal.

And while the business community determinedly seeks opportunity in troubled times, even many an entrepreneur views the years since the financial crisis of 2008 as what Rich Lesser, the new chief executive of the Boston Consulting Group, called “a higher period of turbulence and uncertainty in the global economy than we have experienced in a very long time.”

The days in which “quants” and algorithms reigned supreme are gone, their increasingly untrackable results having helped the financial system spin out of control in 2008 and 2009. The heady triumph of capitalism after 1989 is also a distant memory, although its chief effect — that capital went global — remains a driving force of our age.

But global capital does not solve big world issues: debt and financial crisis, political paralysis or gridlock, the transformative effects of the digital revolution, climate change, resource shortages, shifting demographics.

For those tasks, we must rely either on the nation state — an aging collective unit that does not readily serve transnational action — or on international institutions whose effectiveness is regularly questioned by the Davos crowd.

“The global economy has integrated, but global society is as fragmented as ever,” said Dennis J. Snower, president of the Kiel Institute for the World Economy.

In that fragmentation, there is an increasing lack of consensus about the global way forward. A few years ago, the inexorable rise of China led to talk of a new Beijing consensus, replacing the Washington consensus that epitomized the confident domination of the United States.

But China, while still growing, is growing less fast. It remains a one-party state, and its advance has arguably resulted more from enormous investment than creative increases in productivity. The challenges to its new leadership are clear: the need for financial reform; the perils of shadow banking and corruption; thick urban pollution; and, above all, the free flow of information, as seen in the standoff this month between a state censor in Guangzhou and journalists at the Southern Weekend and their supporters.

Ian Bremmer, head of the Eurasia Group political consulting firm, who in general sees a big return of politics in business calculations as the world becomes permanently restless, likened China to a large car that is racing toward a brick wall, “and we don’t know if they have steering” to skirt the obstacle, or whether they will hit it.

“As China grows wealthier,” he said in an interview, “entrenched Chinese will see the benefit of the rule of law” — a key element of the Washington consensus. But “the new leadership is not anywhere near there.”

For Yasheng Huang, a professor at the Sloan School of Management at the Massachusetts Institute of Technology, the saving grace of the incoming president, Xi Jinping, and his colleagues is that they are pragmatists. Pragmatism, he argued in an interview by phone, “means that you weigh the costs and benefits of certain actions.” It “checks the ideology.”

Yet even as China helps to sustain international growth — where would Europe’s purveyors of luxury be without the eager Chinese consumer? — it remains, like other emerging countries, self-absorbed.

“Look at the big debates of the last five years,” said Minxin Pei, like Mr. Huang a Chinese-born academic, who teaches at Claremont McKenna College in California. “It’s very hard to find one that originated in Beijing. People talk about China outside China, but still the country is very inward-looking.” This also feeds rising nationalism seen most markedly in the escalating dispute between China and Japan in the East China Sea.

As with China, so with Russia, India and Brazil, or indeed South Africa, Nigeria, Indonesia and other favorites of those who seek bright spots on a gloomy globe. In Brazil, “everything is focused on being Brazilian, how great it is,” noted Misha Glenny, a British analyst who has written on global mafias, cybercrime and is now working on a book about Brazil.

In these countries, absorbed in their own material advances and increasingly wary of a Washington-made prescription for their future, the “fiscal cliff” and debate about the limit on the United States deficit serve as proof that they are on the right path, though critics might dispute it.

“On the whole, we made a recovery from the crisis even faster than other countries,” President Vladimir V. Putin of Russia told a news conference last month. “Just look at the recession in Europe, while Russia has posted growth, albeit a modest one, but we still have a much better situation than in the once-prosperous euro zone, or even in the United States.”

In the United States, recent books have argued that the country’s status as a debtor nation is curbing its global reach. After the last-minute fiscal deal this month, a commentary of the kind believed to reflect high government thinking on the state-run Chinese news agency Xinhua noted tartly: “The American people were once better known for their ability to make tough choices on difficult issues.” It went on, “The Americans may be proud of their mature democracy, but the political gridlock in Washington really looks ugly from an outsider’s view.”

One example of how nations in transition are going their own way is Egypt, where President Mohamed Morsi seems to seek a geopolitical mix: a dose of Turkey, an Islamist-leaning democracy, with much-needed financial aid from China, and relations with Washington warm enough to garner more aid and collaborate on diplomacy like mediating the Israeli-Palestinian fighting over the Gaza Strip last November.

The fluid nature of this world is enhanced by digital communication. With the collapse in newspaper readership and the spread of social media, “everyone gets little snippets of information, and never fully understands the implications,” Mr. Glenny noted. “Very few people do deeper reading and thinking.”

This, he argued, increases people’s sense that “everything has just become too big to grasp and understand.”

A crucial topic for the dozen or so analysts interviewed for this article, and central also to discussions of increasingly important trends like the global rise of women, is education. Instead of machines being in charge, a nimble human mind, connecting individuals with collective wisdom, is seen as the antidote to cacophony, poverty and chaos.

In this view, more and better schooling will help lift hundreds of millions out of poverty, make it easier for populations to cope with change and stimulate the kind of innovation that Mr. Lesser sees already in technology, medicine and health care.

What kind of education is a topic that will be much debated at Davos, to judge from several scheduled sessions on disruptive universities and the like.

“We need government to recognize the need to build the next-gen work force,” Mr. Lesser said. This is “fundamental to staying competitive in the future,” he said. “The challenge goes beyond education. It’s also about good immigration policies.” In this way, he argued, a country facing demographic challenges — Germans, according to a government survey released last week, are the most childless adults in Europe — may preserve wealth and adapt to the future.

Whether by increasing online courses, interacting with students or raising the relatively dismal level of numeracy and literacy among American high school graduates, improving education “is one of the few things I can be unguardedly optimistic about,” said Niall Ferguson, the Harvard University historian. “The solutions are relatively cheap, simple and to hand.”

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

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

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

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

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

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

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

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

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

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

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

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

Read More..

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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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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How M.I.T. Ensnared a Hacker, Bucking a Freewheeling Culture

Months earlier, the mysterious visitor had used the school’s computer network to begin copying millions of research articles belonging to Jstor, the nonprofit organization that sells subscription access to universities.

The visitor was clever — switching identifications to avoid being blocked by M.I.T.’s security system — but eventually the university believed it had shut down the intrusion, then spent weeks reassuring furious officials at Jstor that the downloading had been stopped.

However, on Jan. 3, 2011, according to internal M.I.T. documents obtained by The New York Times, the university was informed that the intruder was back — this time downloading documents very slowly, with a new method of access, so as not to alert the university’s security experts.

“The user was now not using any of the typical methods to access MITnet to avoid all usual methods of being disabled,” concluded Mike Halsall, a senior security analyst at M.I.T., referring to the university’s computer network.

What the university officials did not know at the time was that the intruder was Aaron Swartz, one of the shining lights of the technology world and a leading advocate for open access to information, with a fellowship down the road at Harvard.

Mr. Swartz’s actions presented M.I.T. with a crucial choice: the university could try to plug the weak spot in its network or it could try to catch the hacker, then unknown.

The decision — to treat the downloading as a continuing crime to be investigated rather than a security threat that had been stopped — led to a two-day cat-and-mouse game with Mr. Swartz and, ultimately, to charges of computer and wire fraud. Mr. Swartz, 26, who faced a potentially lengthy prison term and whose trial was to begin in April, was found dead of an apparent suicide in his Brooklyn apartment on Jan. 11.

Mr. Swartz’s supporters called M.I.T.’s decision a striking step for an institution that prides itself on operating an open computer network and open campus — the home of a freewheeling programming culture. M.I.T.’s defenders viewed the intrusion as a computer crime that needed to be taken seriously.

M.I.T. declined to confirm any of these details or comment on its actions during the investigation. The university’s president, L. Rafael Reif, said last week, “It pains me to think that M.I.T. played any role in a series of events that have ended in tragedy.” He appointed a professor, Hal Abelson, to analyze M.I.T.’s conduct in the investigation. To comment now, a spokeswoman for the university said, would be “to get ahead of that analysis.”

Early on Jan. 4, at 8:08 a.m., according to Mr. Halsall’s detailed internal timeline of the events, a security expert was able to locate that new method of access precisely — the wiring in a network closet in the basement of Building 16, a nondescript rectangular structure full of classrooms and labs that, like many buildings on campus, is kept unlocked.

In the closet, Mr. Halsall wrote, there was a netbook, or small portable computer, “hidden under a box,” connected to an external hard drive that was receiving the downloaded documents.

At 9:44 a.m. the M.I.T. police were called in; by 10:30 a.m., the Cambridge police were en route, and by 11 a.m., Michael Pickett, a Secret Service agent and expert on computer crime, was on the scene. On his recommendation, a surveillance camera was installed in the closet and a second laptop was connected to the network switch to track the traffic.

There may have been a reason for the university’s response. According to the timeline, the tech team detected brief activity from China on the netbook — something that occurs all the time but still represents potential trouble.

E-mails among M.I.T. officials that Tuesday in January 2011 highlight the pressures university officials felt over a problem they thought they had solved. Ann J. Wolpert, the director of libraries, wrote to Ellen Finnie Duranceau, the official who was receiving Jstor’s complaints: “Has there ever been a situation similar to this when we brought in campus police? The magnitude, systematic and careful nature of the abuses could be construed as approaching criminal action. Certainly, that’s how Jstor views it.”

Some of Mr. Swartz’s defenders argue that collecting and providing evidence to the government without a warrant may have violated federal and state wiretapping statutes.

John Schwartz contributed reporting.

This article has been revised to reflect the following correction:

Correction: January 21, 2013

An earlier version of this article misquoted part of statement by a spokeswoman for the Massachusetts Institute of Technology. Referring to a review of M.I.T.’s conduct that was commissioned by the university’s president, she said to comment now on the events surrounding Aaron Swartz’s arrest would be “to get ahead of that analysis,” not “to get ahead of that investigation.” 

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Well: A Check on Physicals

“Go Beyond Your Father’s Annual Physical. Live Longer, Feel Better”

This sales pitch for the Princeton Longevity Center’s “comprehensive exam” promises, for $5,300, to take “your health beyond the annual physical.” But it is far from certain whether this all-day checkup, and others less inclusive, make a meaningful difference to health or merely provide reassurance to the worried well.

Among physicians, researchers and insurers, there is an ongoing debate as to whether regular checkups really reduce the chances of becoming seriously ill or dying of an illness that would have been treatable had it been detected sooner.

No one questions the importance of regular exams for well babies, children and pregnant women, and the protective value of specific exams, like a Pap smear for sexually active women and a colonoscopy for people over 50. But arguments against the annual physical for all adults have been fueled by a growing number of studies that failed to find a medical benefit.

Some experts note that when something seemingly abnormal is picked up during a routine exam, the result is psychological distress for the patient, further testing that may do more harm than good, and increased medical expenses.

“Part of the problem of looking for abnormalities in perfectly well people is that rather a lot of us have them,” Dr. Margaret McCartney, a Scottish physician, wrote in The Daily Mail, a British newspaper. “Most of them won’t do us any harm.”

She cited the medical saga of Brian Mulroney, former prime minister of Canada. A CT scan performed as part of a checkup in 2005 revealed two small lumps in Mr. Mulroney’s lungs. Following surgery, he developed an inflamed pancreas, which landed him in intensive care. He spent six weeks in the hospital, then was readmitted a month later for removal of a cyst on his pancreas caused by the inflammation.

The lumps on his lungs, by the way, were benign. But what if, you may ask, Mr. Mulroney’s lumps had been cancer? Might not the discovery during a routine exam have saved his life?

Logic notwithstanding, the question of benefits versus risks from routine exams can be answered only by well-designed scientific research.

Defining the value of a routine checkup — determining who should get one and how often — is especially important now, because next year the Affordable Care Act will add some 30 million people to the roster of the medically insured, many of whom will be eligible for government-mandated preventive care through an annual exam.

Dr. Ateev Mehrotra of the University of Pittsburgh School of Medicine, who directed a study of annual physicals in 2007, reported that an estimated 44.4 million adults in the United States undergo preventive exams each year. He concluded that if every adult were to receive such an exam, the health care system would be saddled with 145 million more visits every year, consuming 41 percent of all the time primary care doctors spend with patients.

There is already a shortage of such doctors and not nearly enough other health professionals — physician assistants and nurse practitioners — to meet future needs. If you think the wait to see your doctor is too long now, you may want to stock up on some epic novels to keep you occupied in the waiting room in the future.

Few would challenge the axiom that an ounce of prevention is worth a pound of cure. Lacking incontrovertible evidence for the annual physical, this logic has long been used to justify it:

¶ If a thorough exam and conversation about your well-being alerts your doctor to a health problem that is best addressed sooner rather than later, isn’t that better than waiting until the problem becomes too troublesome to ignore?

¶ What if you have a potentially fatal ailment, like heart disease or cancer, that may otherwise be undetected until it is well advanced or incurable?

¶ And wouldn’t it help to uncover risk factors like elevated blood sugar or high cholesterol that could prevent an incipient ailment if they are reversed before causing irreparable damage?

Even if there is no direct medical benefit, many doctors say that having their patients visit once a year helps to maintain a meaningful relationship and alert doctors to changes in patients’ lives that could affect health. It is also an opportunity to give patients needed immunizations and to remind them to get their eyes, teeth and skin checked.

But the long-sacrosanct recommendation that everyone should have an annual physical was challenged yet again recently by researchers at the Nordic Cochrane Center in Copenhagen.

The research team, led by Dr. Lasse T. Krogsboll, analyzed the findings of 14 scientifically designed clinical trials of routine checkups that followed participants for up to 22 years. The team found no benefit to the risk of death or serious illness among seemingly healthy people who had general checkups, compared with people who did not. Their findings were published in November in BMJ (formerly The British Medical Journal).

In introducing their analysis, the Danish team noted that routine exams consist of “combinations of screening tests, few of which have been adequately studied in randomized trials.” Among possible harms from health checks, they listed “overdiagnosis, overtreatment, distress or injury from invasive follow-up tests, distress due to false positive test results, false reassurance due to false negative test results, adverse psychosocial effects due to labeling, and difficulties with getting insurance.”

Furthermore, they wrote, “general health checks are likely to be expensive and may result in lost opportunities to improve other areas of health care.”

In summarizing their results, the team said, “We did not find an effect on total or cause-specific mortality from general health checks in adult populations unselected for risk factors or disease. For the causes of death most likely to be influenced by health checks, cardiovascular mortality and cancer mortality, there were no reductions either.”

What, then, should people do to monitor their health?

Whenever you see your doctor, for any reason, make sure your blood pressure is checked. If a year or more has elapsed since your last blood test, get a new one.

Keep immunizations up to date, and get the screening tests specifically recommended based on your age, gender and known risk factors, including your family and personal medical history.

And if you develop a symptom, like unexplained pain, shortness of breath, digestive problems, a lump, a skin lesion that doesn’t heal, or unusual fatigue or depression, consult your doctor without delay. Seek further help if the initial diagnosis and treatment fails to bring relief.

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