sandiegouniontribune.com TUESDAY • NOVEMBER 22, 2016

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AlexWest andKyleBuckett didn’tbecome friendsuntil two years ago,but their lives havelong followedparal-lel paths.EachoftheSanDiegomenhas servedmorethan15 years in theNavy, each com-

pletedmore thanadozendeploy-ments in IraqandAfghanistan, andeach is passionate about thehealingpower of surfing.

Together, they’re now the volun-teer forcebehindOneMoreWave, an18-month-oldSanDiegononprofitthat provides free custom-designedsurfboards towoundedmilitaryveterans.Over thepast year-and-a-

half,West,Buckett and surfboardshaperMicahShanahanhavedeliv-eredboards to 31 veteranswho’ve lostlimbs in combat, suffereddisablinginjuries or strugglewithpost-trauma-tic stress syndrome.Another 14

boards arenow in the finishing stagesatShanahan’sAddictSurfboards inSorrentoValley.

West, a 31-year-oldOceanBeachresident, saidhediscovered the thera-

MAKING A DIFFERENCE

Military veterans ride the wave to recovery

PAMKRAGEN

Micah Shanahan(left) of AddictSurfboards inSorrento Valleyshapes boardsfor Kyle Buckett(center) andAlex West, found-ers of the non-profit One MoreWave.PEGGY PEATTIE U-T

SEE DIFFERENCE • A7

Despite fears that de-mentia rates were going toexplode as the populationgrows older and fatter, andhas more diabetes and highblood pressure, a large na-tionally representative sur-vey has found the reverse.Dementia is actually on thewane. And when people doget dementia, they get it atolder andolder ages.

Previous studies foundthe same trend but involvedmuch smaller and less div-erse populations like themostly white population ofFramingham, Mass., andresidents of a few areas in

EnglandandWales.Thenewstudy foundthat

the dementia rate in Ameri-cans 65 and older fell by 24percent over 12 years, to 8.8percent in 2012 from11.6 per-cent in 2000. That trend is“statistically significant andimpressive,” said SamuelPreston, a demographer atthe University of Pennsylva-nia who was not associatedwith the study.

In 2000, people received adiagnosis of dementia at anaverage age of 80.7; in 2012,the averageagewas 82.4.

“Thedementia rate isnotimmutable,” said Dr. Rich-ard Hodes, director of the

STUDY: U.S. DEMENTIARATES SHOW DECLINEBY GINA KOLATA

SEE DEMENTIA • A10

YuccaMountain is back on thebargaining table on Capitol Hill.

And if the nuclear waste repos-itory inNevada gets back on track—and that’s a big “if,” consideringthe controversial site has been de-bated for going on 40 years and sixpresidential administrations — itcould provide a destination forthe 3.6 million pounds of nuclear

waste beached at the San OnofreNuclear Generating Station.

“There will almost certainly beefforts to reintroduce legislationthat would restart the Yuccaprocess,” said David Victor, chair-man of the Community Engage-ment Panel, which acts as a liai-son between the public and theoperators at San Onofre.

“What’s interesting is this isnot a normal left-right (political)

issue.”Located about 100miles north-

west of Las Vegas, Yucca Moun-tain at one time was determinedto be the best site to deposit thenation’s nuclear waste, which hasreached more than 70,000 metrictons at some 120 sites across thecountry.

The site was slated to open in2017.

But Sen. Harry Reid, D-Nev.,

who loathed the idea of storingwaste in his home state, becamethe senate majority leader afterthe 2006 elections. During the2008 presidential campaign, then-candidate Barack Obama saidYucca Mountain was “an expen-sive failure and should be aban-doned.”

The Obama administrationcut off funding for Yucca Moun-

The south portal of the proposed nuclear waste dump at Yucca Mountain, which is about 100 miles northwest of Las Vegas.JOHN LOCHER AP

BACK TO YUCCA MOUNTAINCongress expected to soon reconsider Nevada site for storing nuclear waste, including San Onofre plant’s

BY ROB NIKOLEWSKI

SEE YUCCA • A6

WASHINGTONPresident-elect Donald

Trump on Monday released a21⁄2-minute infomercial-stylevideo, turning to social mediato deliver a direct-to-cameramessage in which he vowed to

create jobs, renegotiate tradeagreements, end restrictionson energy production and im-posebanson lobbying.

Trump offered what hecalled an update on his transi-tion, which he said is working“very smoothly, efficiently andeffectively.”

Reading from a script andlooking into the camera,Trump steered clear of hismost inflammatory campaignpromises to deport immi-grants, track Muslims and re-

peal theAffordableCareAct.“Whether it’s producing

steel, building cars or curingdisease, I want the next gener-ation of production and inno-vation to happen right here, inour great homeland: America— creating wealth and jobs forAmerican workers,” Trumpsaid in the video.

ThebriefYouTubevideoof-fered one of the few opportuni-ties for the public to hear fromTrump directly since he was

TRUMP OUTLINES GOALSIN VIDEOTAPED ADDRESSPresident-elect offersupdate on transition

BYMICHAEL D. SHEAR& JULIE HIRSCHFELD DAVIS

President-elect Donald Trump promisedMonday to create wealth for Americans.

EVAN VUCCI AP

SEE TRUMP • A8

Amanhunt for a suspect inthe fatal shooting of a veteranTexas police detective endedMonday with an arrest in thekilling that was one of severalweekend attacks against lawenforcement inmultiplestates,authorities said.

The San Antonio detectiveand officers shot in Missouriand Florida were conducting

routine tasksSunday whenthey became thetargets of vi-olence. The de-tective was writ-ing a trafficticket when hewas shot todeath in hissquad car Sun-daymorningout-

sidepoliceheadquarters.“I think theuniformwas the

target and the first person thathappened along was the firstperson that (the suspect) tar-geted,” San Antonio PoliceChief William McManus saidMonday.

In Missouri, a St. Louis po-lice sergeant was shot twice inthe face Sunday evening whilehe sat in traffic in amarkedpo-lice vehicle. He was releasedfromahospitalMonday.

Law enforcement officialssay there’s been an alarmingspike in ambush-style attacks.Sixty officers, including theSan Antonio detective, wereshot to death on the job thisyear, compared with 41 in all of2015, according to the NationalLawEnforcement OfficersMe-morialFund.Ofthe60killed,20were purposely targeted bytheir assailant compared witheight last year, the group said.

Police officers also wereshot and injured during trafficstops in Sanibel, Fla., andGladstone, Mo., on Sundaynight, but authorities have notsuggested these were targetedattacks.All theshootingscomeless than five months after ablack military veteran killedfive white officers at a protestin Dallas — the deadliest dayfor American law enforcementsinceSept. 11, 2001.

Racewasa factor in theDal-las attack, but police have notsaid if race played a part in any

SUSPECTARRESTEDIN SHOOTINGOF OFFICERFatality among severalrecent attacks on police

BY JIM SALTER& DAVIDWARREN

SEE POLICE • A9

DetectiveBenjaminMarconi

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National Institute on Aging.“It canchange.”

And that “is very goodnews,” said John Haaga, di-rector of the institute’s divi-sion of behavioral and socialresearch. It means, he said,that “roughly amillion and ahalf peopleaged65andolderwho do not have dementianow would have had it if therate in 2000 had been inplace.”

Keith Fargo, director ofscientific programs and out-reach at theAlzheimer’s As-sociation, said thegrouphadbeen encouraged by some ofthe previous research show-ing a decline but had alsobeen “a little bit nervous”about drawing conclusionsbecause the populations inthe earlier studies were sohomogeneous.

Now, he said of the newdata, “here is a nationallyrepresentative study. It’swonderfulnews.”

An estimated 4million to5millionAmericans developdementia each year. It re-mains the most expensivedisease inAmerica—astudyfundedby theNational Insti-tuteonAgingestimatedthatin 2010 it cost up to $215 bil-lion a year to care for demen-tia patients, surpassingheart disease ($102 billion)

andcancer ($77billion).The study, published on-

line Monday by the journalJAMA InternalMedicine, in-cluded 21,000 Americans 65andolderacrossall races,ed-ucation and income levels,who participate in theHealth and RetirementStudy, which regularly sur-veyspeopleandfollowsthemas they age. TheNational In-stitute on Aging funded thework but was not involvedwith the data collection,analysisor interpretation.

To assess dementia, par-ticipantswere asked, amongother things, to recall 10nouns immediatelyandaftera delay, to serially subtractseven from 100, and to countbackward from 20. The testwas based on extensive re-search indicating it was agood measure of memoryandthinkingskills.

Participants also wereasked about their educationlevels, incomeandhealth.

Inaway, thedementiade-cline might seem unexpect-ed. It occurreddespite an in-crease in diabetes— the dia-betes prevalence amongold-er Americans surged to 21percent in 2012 from 9 per-cent in 1990. It began to fallonly very recently. And, thestudy found, diabetes in-creased the risk of dementiaby39percent.

More older people todayalsohave cardiovascular risk

factors—high levels of bloodpressure, blood sugar andcholesterol—which increasethe risk of dementia. Butmoreare takingmedicationsfor those conditions, so per-haps better control of thoserisk factors played a role inthedecline.

The findings about obesi-ty were especially puzzling.Compared with people ofnormal weight, overweightpeople andobesepeoplehada 30 percent lower risk of de-mentia, the study found.Underweight people had arisk 2.5 times as great. Yetthe obesity picture is mud-dled because other studieshave found that obesity inmiddleage increasesdemen-tia risk inoldage.

Then there is the educa-tion question. On average,older Americans in 2012 hadone more year of schoolingthan older Americans in2000. And years of educationwere associated with de-creaseddementia risk in thisstudy,as inmanyothers.

It is still not clear exactlywhy educationwould reducetheriskofdementia.There isthe cognitive reserve hy-pothesis: that educationchangesdevelopingbrains ina good way, making themmore resistant to dementia,and that people with moreeducation have brains thatare better able to compen-sate fordementiadamage.

But education also islinked to more wealth. Peo-ple with more educationoften live in different envi-ronments than those whohave less schooling, and theytend to have better healthoverall. They also are lesslikely tosmoke.

As for black Americans,the dementia risk washigher, but some possiblereasons — less education,lesswealth,more cardiovas-cular risk factors — did notfully explain the difference.One possibility is that theyreceived a poorer quality ofeducation, so each year of itoffered less protection fromdementia, said the study’slead author, Dr. KennethLanga.

In the end, much of whatis happening with dementiarates defies explanation,said Langa, a professor ofmedicine at theUniversity of

Michigan in AnnArbor, whoalso works in the VeteransAffairs health care systemthere.

Dr.DenisEvans, aprofes-sor ofmedicine atRushUni-versity Medical Center inChicago,urgedcaution inac-cepting the conclusion thatdementia rates were declin-ingand, if theyare, inaccept-ing the possible explana-tions.Althoughhehadnoth-ingbutpraise fortheabilitiesof the researchers, he notedthat such studies are ex-tremelydifficulttodo.Decid-ing if a respondent has de-mentia can easily be inad-vertentlyskewed,hesaid.

“It’sverycomplex,”Evanssaid.

But the decline is consis-tentwithwhat seems to be along-term trend, despite re-searchers’ failure to find anyeffective way for individualsto protect themselves fromAlzheimer’s, the most com-mon form of dementia.Langa estimates that com-pared with the rate in theearly 1990s, there has beenabout a 25 to 30 percent de-crease in dementia ratesamongolderAmericans.

As for the future, that ishardtopredict,Langasaid.

Evenwith the lower prev-alenceofdementia, therewillbemanymoreolderpeopleinthe United States over thenext few decades, especiallypeople age 85 and older whoare at the highest risk. Forthat reason, the total num-ber of people with dementiashould rise, although not asmuchashadbeenestimated.

And there are forces act-ing against the continuationof the decline in dementiarates. More people reachingage 65 and older in the nextfew decades will have beenobese inmiddle age, possiblyincreasing their risk of de-mentia. In addition, thetrend toward more years ofschooling seems to have lev-eled off, so the education ef-fectmightnotbeasmuchofafactor.

But researchers remainoptimistic.

The study found associa-tions,Hodesnoted. “Nowthereal challenge,” he said, “is tosee if we can generate evi-denceofwhatcauseswhat.”

Kolata writes for The New York Times.

DEMENTIAFROM A1

WICHITA, Kan.When Shane Cox began

selling his homemade fire-arms and silencers out of hismilitary surplus store, hestamped “Made in Kansas”on them to assure buyersthataKansas lawwouldpre-vent federal prosecution ofanyone owning firearmsmade, sold and kept in thestate.

The 45-year-old Chanuteresident also handed outcopies to customers of theSecondAmendmentProtec-tionActpassedin2013bytheKansas Legislature andsigned by Gov. Sam Brown-back, and even collectedsales taxes. His biggest sell-ing item was unregisteredgun silencers that were fly-ing out of the shop as fast asCox couldmake them, pros-ecutors said later. One ofthose customers — 28-year-old Jeremy Kettler ofChanute — was so enthusi-astic about the silencer thathe posted a video on Face-book.

But lastweekajuryfoundCox guilty of violating fed-eral lawfor themanufacture,sale and possession of un-registered firearms and si-

lencers. Kettler was foundguilty on one count of pos-sessing the unregistered si-lencer.

The case could reverber-ate across the country be-cause it cites the SecondAmendmenttotheU.S.Con-stitution, pitting the federalgovernment’s right to regu-late firearms against therights of states. The judgeoverseeing the case expectsitultimately toendupbeforetheU.S.SupremeCourt.

At trial, defense attor-neys contended their clientsbelieved the Kansas lawmade their activities legal,arguing they are “caught inthe crossfire” of the strugglebetween the state and thefederalgovernmentoverguncontrol.

CoxandKettlerwerecon-victed under the NationalFirearmsAct,which isapartof theInternalRevenuecodeenacted under Congress’power to levy taxes.Thecaseraises the question ofwhether that taxing author-ity can be used to regulatefirearms that stay withinstate borders. Advocates forstates’ rights also contendsuch guns do not fall underCongress’ power to regulateinterstatecommerce.

MAN’S HOMEMADE SILENCERSBECOME GUN RIGHTS ISSUEASSOCIATED PRESS

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