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Tag: Aging

  • Cannabis Use in Older Patients Associated With Lower Demand for Prescription Drugs

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    The use of medical cannabis products by qualified patients ages 50 and older is associated with a reduced need for prescription medications and significant health-related quality of life improvements, according to data published in the scientific journal Cannabis.

    Canadian investigators assessed medical cannabis use patterns and its effect on health outcomes in a cohort of 200+ older patients (average age: 67). Study participants primarily suffered from chronic pain-related conditions. Patients’ health data was collected at baseline and again at three months and at six months. Most patients in the study consumed orally administered cannabis products containing significant percentages of CBD.

    Researchers reported, “Most patients experienced clinically significant improvements in pain, sleep, and quality of life and reductions in co-medication,” including pain medications, antidepressants, and sleep aids. No serious adverse events were reported.

    “To the best of our knowledge, the present report describes one of the largest longitudinal study of authorized older medical cannabis patients to date,” the study’s authors concluded. “The results of this multi-site, prospective, longitudinal study of medical cannabis patients ages 50 years and older indicate that cannabis may be a relatively safe and effective treatment for chronic pain, sleep disturbances, and other conditions associated with aging, leading to subsequent reductions in prescription drug use and healthcare costs, as well as significant improvements in quality of life.”

    The findings are consistent with those of several other studies similarly reporting quality of life improvements and reduced prescription drug use among older cannabis consumers.

    Commenting on the latest study, NORML’s Deputy Director Paul Armentano said: “There is a growing body of evidence showing that cannabis can provide health-related quality of life improvements in older adults. Many older adults struggle with painanxietyrestless sleep, and other conditions for which cannabis products often mitigate. Many older adults are also well aware of the litany of serious adverse side-effects associated with available prescription drugs, like opioids or sleep aids, and they recognize the role medical cannabis can play as a potentially safer alternative.”

    The full text of the study, “Medical cannabis for patients over age 50: A multi-site, prospective study of patterns of use and health outcomes,” is available from The Research Society on Marijuana. Additional information is available from the NORML Fact Sheet, ‘Marijuana Use by Older Adult Populations.’

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    NORML

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  • Unbelievable facts

    Unbelievable facts

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    A 90-year-old woman signed a deal with a 47-year-old lawyer to give him her apartment upon her death…

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  • Can CBD Reduce Age Telling Wrinkles

    Can CBD Reduce Age Telling Wrinkles

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    Wrinkles are part of growing older – but what if you could delay them, especially with your hands?

    Botox, chemical peels, fillers and photo rejuvenation are all expensive and major ways to stop the signs of aging – wrinkles. For centuries, women, and men, have tried to turn back the clock by eliminating, or at least reducing the tell tale signs on the face.  Hands are notoriously known for gaining wrinkles early and leaking the secrets of a person’s age. But what if you can slow roll the wrinkles? Can CBD reduce age telling wrinkles. While many over promise what CBD can do, it might be able to help with this problem.

    RELATED: 5 Morning Activities To Help You Feel Happier

    CBD comes from the cannabis plant, but doesn’t get you high from THC. A study evaluating a novel retinol and CBD topical product found significant improvements in various skin quality domains, including visible pores, dehydration, surface roughness, and both static and dynamic wrinkles. Participants reported high satisfaction and willingness to recommend the product, with excellent tolerability

    One of the key ways CBD may combat wrinkles is through its potent anti-inflammatory properties. Inflammation is a major contributor to skin aging, leading to the breakdown of collagen and elastin. By inhibiting inflammatory cytokines, CBD can help calm irritated skin and prevent the acceleration of wrinkle formation. This anti-inflammatory action may also soothe skin conditions like eczema and psoriasis, which can exacerbate the signs of aging

    CBD is rich in antioxidants, which play a crucial role in protecting the skin from oxidative stress caused by free radicals. Free radicals, generated by factors like UV radiation and pollution, damage cellular structures and lead to premature aging. By neutralizing these harmful molecules, CBD helps preserve skin cell integrity and promotes a more youthful appearance.

    As we age, collagen production naturally declines, resulting in sagging skin and wrinkles. Research suggests that CBD may help stimulate collagen production, promoting firmer and more resilient skin. This effect is partly due to CBD’s ability to reduce inflammation and oxidative stress, both of which can impair collagen synthesis.

    Proper hydration is essential for maintaining youthful skin. CBD has hydrating and moisturizing properties that can help combat the effects of aging on skin moisture retention. By maintaining the skin’s natural barrier function, CBD prevents moisture loss and keeps the skin plump and hydrated, reducing the appearance of fine lines

    RELATED: This Epic Love Story Is Being Set To Music

    So, yes, done right, CBD can help with wrinkles, even the pesky hand ones. But while the research on CBD’s anti-aging effects is promising, experts emphasize the need for more extensive studies to fully understand its long-term benefits and potential side effects. As with any skincare product, it’s advisable to consult with a dermatologist before incorporating CBD into your anti-aging routine, especially if you have specific skin concerns or conditions.

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    Sarah Johns

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  • 9 Things You Should Do for Your Brain Health Every Day, According to Neurologists

    9 Things You Should Do for Your Brain Health Every Day, According to Neurologists

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    Taking care of your cognitive health ought to be—well, a no-brainer. According to a survey published in March, 87% of Americans are concerned about age-related memory loss and a decline in brain function as they grow older, yet only 32% believe they can take action to help control that trajectory.

    “All of us want to be cognitively intact for as long as possible,” says Dr. Seemant Chaturvedi, a neurologist and stroke specialist at the University of Maryland Medical Center. The good news, he adds, is that “there are definitely risk factors that can be modified.” Prioritizing healthy behaviors can increase the likelihood that, when we reach our 70s and 80s, we’re still able to summon important memories, drive a car, and engage in a wide variety of activities, Chaturvedi says. And there’s no such thing as “too young” to start taking these steps.

    With that in mind, we asked four neurologists what we should all do every day for better brain health.

    Manage your chronic illnesses

    If you have high blood pressure, high cholesterol, or diabetes, it’s essential to make sure it’s under control. Each condition can “damage the blood vessels in the brain and increase the risk of stroke and dementia,” while diminishing cognitive function, Chaturvedi says. In one study, for example, people who had hypertension in their 40s to early 60s had a 6.5% steeper decline in cognitive skills—including mental processing speed and executive function—in their 70s, 80s, and 90s, compared to those with normal blood pressure. Other research has found that people with higher levels of LDL cholesterol and lower levels of HDL cholesterol tend to have more amyloid plaque in their brain, which is linked with Alzheimer’s disease. 

    That’s why it’s important to get your numbers checked regularly, and to work with your doctor to establish a treatment regimen, Chaturvedi says. The sooner you do that, the better: “If you’re 35 or 40 and have high cholesterol, the current belief is that it’s better to start treatment early,” rather than waiting until you’re 65 or 70 and have a heart attack, he says. “If you get started early, maybe you could either postpone or never even have the heart attack,” which would be doing your brain a big favor.

    Read More: 7 Metrics Everyone Should Know About Their Own Health

    Exercise for 30 minutes

    Your entire body will benefit if you work out at least a few days a week—and that includes your brain. Research suggests that exercising improves cognitive processes and memory, while increasing the thickness of your cerebral cortex, which is responsible for tasks like language, thinking, and emotions. “We’re learning more and more about the benefits of regular exercise for brain health,” Chaturvedi says. “Even in patients who have mild dementia, it’s recommended they engage in exercise three to five times a week.”

    Whatever activity you choose—walking, biking, swimming—make sure you’re operating at a moderate intensity, or about 50% to 80% of your maximum heart rate. “A rule of thumb I give my patients is that if you and I were going for a walk, we’d want to be walking at a pace where we’d be pretty out of breath, but we’d still be able to have a conversation,” says Dr. Carolyn Fredericks, an assistant professor of neurology at Yale School of Medicine. One type of cardiovascular exercise doesn’t appear to be better than any other, she adds: “It’s just getting your heart into that range and keeping it there for a while.”

    Rest up

    Not getting enough sleep is a key risk factor for dementia, says Dr. Augusto Miravalle, a neurologist and multiple sclerosis specialist at Rush University Medical Center. Research suggests that people in their 50s and 60s who get six hours of sleep or less per night are 30% more likely to be diagnosed with dementia than those who log at least seven hours of Z’s. Another study found that sleep-initiation insomnia, or trouble falling asleep, is associated with a 51% increased dementia risk. 

    So what should you do if you lie awake at night counting sheep? Invest time in improving your sleep hygiene, which means taking steps like avoiding caffeine and alcohol in the evening, limiting naps, and putting away electronics before bed, Miravalle advises. If that doesn’t work, schedule an appointment with a sleep specialist to figure out if you need a more aggressive approach. Options like cognitive behavioral therapy for insomnia can help some people achieve more restful slumber.

    Read More: The Best Way to Treat Insomnia

    Eat like you’re vacationing on the Italian coast

    Fredericks always recommends her patients follow a Mediterranean diet, which emphasizes fruits, veggies, whole grains, fish, nuts, seeds, and healthy fats. “We’ve tried over the years to find the secret ingredient that makes the Mediterranean diet work,” she says. “Like, could it be the omega-3’s in the fish, or the vitamin E in the nuts? But every time we try to study an individual ingredient, we don’t actually see that big of a difference at a large group level.” What appears to be most impactful, she adds, is the style of eating and emphasis on whole foods.

    In addition to prioritizing certain ingredients, Miravaelle recommends avoiding those that negatively impact brain health, like trans fats and too much salt. In one study, young and middle-aged men who followed a diet heavy in trans fat remembered 11 fewer words out of 104 than those who didn’t consume as much. And excessive salt intake is linked with stroke, cognitive impairment, and cerebrovascular disease, which affects the brain’s blood vessels and circulation.

    Challenge your mind

    People often ask Dr. Roy Hamilton what kind of intellectual stimulation is best: Should they put together puzzles or play Sudoku every day? What about video games? He tries not to be overly prescriptive, but offers a few guidelines. Brain-boosting activities should be “mildly challenging,” says Hamilton, who’s a professor of neurology, psychiatry, and physical medicine and rehabilitation at the University of Pennsylvania Perelman School of Medicine. If they’re too easy, your return-on-investment will shrink; too hard, and you might give up before benefitting. “It’s got to be somewhere in the sweet zone, and it has to be something that you want to do,” he says. 

    Rather than focusing on one pursuit—playing games, learning a new language, reading classic literature—Hamilton recommends curating a “diet of intellectual activities.” “You’re probably not going to get optimal effects just by picking Wordle and being like, ‘I do Wordle every day, and that’s how I maintain my cognition,’” he says. “The brain’s a lot more complicated than that.” He compares it to asking a nutritionist what you should eat for a healthy diet: The answer wouldn’t be carrots, more carrots, and only carrots. Make it a point to exercise your brain in a variety of ways, he encourages, just like you feast on lots of different snacks and meals every day.

    Chat with a friend (or two)

    There’s no single metric for how much time we should spend around other people. Yet research is clear that social engagement strengthens the neural networks involved with attention and memory. In one study, adults ages 70 to 90 who said they had pleasant social interactions on a given day had better cognitive performance on that day and the following two, compared to when they didn’t have any such encounters. “Our brains aren’t meant to exist in isolation,” Fredericks says. “I think COVID drove home to all of us that we’re not meant to be alone in our apartments or houses—it just doesn’t feel good.” To boost your social life, consider reaching out to old friends, joining a birdwatching club or another group, volunteering, or video-chatting with a long-distance family member.

    Read More: How to Make Friends as an Adult—at Every Life Stage

    Skip the beer and cigarettes

    Drinking excessively isn’t good for brain health. Research suggests it can damage the parts of the brain involved in important functions like memory, decision-making, impulse control, and attention. “The more you drink, and the longer period of time over which you’re doing that volume of drinking, the worse it is for your brain,” says Hamilton, who’s on the board of trustees of the McKnight Brain Research Foundation. Think about it: When you overimbibe, you lose your inhibitions because the circuits that control your behavior go offline. “You’re literally causing temporary brain dysfunction,” Hamilton says, and over the long term, that damage takes a toll.

    Smoking is similarly perilous: It can lead to cognitive decline and dementia, while increasing the risk of stroke. If you’ve already tried to quit and failed, don’t let that dissuade future attempts. “Just keep going, because there’s no healthy amount of smoking,” Hamilton says. “It’s terrible for your cardiovascular health and, therefore, your brain vascular health, too.”

    Wear a mask on bad air-quality days

    You already know air pollution can make your eyes sting and trigger a coughing attack. Perhaps more surprising: It’s linked to an increased likelihood of developing dementia. “Dementia in this country is pretty much following the map of air pollution,” Miravalle says. One way to protect yourself: Check daily air quality reports for your town, and if pollution is particularly high, wear a reusable face mask outside, like an N95 or KN95. As Miravalle puts it, “Anything you can do to decrease exposure to certain environmental toxins is a good, common-sense strategy.”

    Lower your stress 

    Minimizing stress can be an effective way to protect your brain health—but Hamilton acknowledges it’s no easy feat. “In my opinion, in the 21st century, maybe this is the hardest thing to do,” he says. “But there’s evidence that chronic stress is not great for cognition.” In one study, for example, people with elevated stress levels had a 37% higher risk of experiencing cognitive issues, including trouble with memory and thinking.

    Some people find that meditation or mindfulness help tame stress; others like doing yoga or booking a massage. Hamilton gets up at 5 a.m. every day to squeeze in a trip to the gym before his work day. “It’s not about my body so much as it is about my stress,” he says. Spend some time brainstorming what relaxes you, and after putting those strategies into action, you’ll likely benefit from head to toe.

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    Angela Haupt

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  • 6 Signs Your Dog or Cat May Benefit from Supplements | Animal Wellness Magazine

    6 Signs Your Dog or Cat May Benefit from Supplements | Animal Wellness Magazine

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    Every dog and cat parent will face unique challenges with their fur baby, and there are many issues you can help support with the right supplements. Here are six signs supplements might benefit your dog or cat!

    A good diet and regular exercise go a long way in supporting canine and feline health. However, diet, environment, genetics, and other factors also influence health. Seasonal allergies, skin & coat challenges, digestive issues, changing appetite or energy levels—all these issues may indicate that your fur baby might benefit from supplements. Let’s look at some of these issues and how you can help support whole-body health from the inside out!

    1. Skin and Coat Health

    Skin and coat health is important for dogs and cats for many reasons. Fur provides insulation, protects them from the elements, and even helps them communicate. Similarly, the skin provides protection from bacteria, helps regulate temperature and maintain moisture balance, and more. A supplement that provides nutritional benefits can help support skin and coat health if you notice changes in their skin and coat condition.

    2. Joint Health, Comfort, and Mobility

    Joint health challenges, especially associated with aging or active pets are common, and they can impact mobility, activity levels, and quality of life. Supplements that help to promote a healthy inflammatory response may help dogs and cats with their joints and mobility.

    3. Digestive and Gut Health

    Digestive health is linked to whole body health because it plays a role in nutrient absorption, energy production, immune health, hormone regulation, and more. As such, healthy digestion contributes to healthy stool consistency, a healthy appetite, good energy levels, and comfort after eating. Supplements that support overall health can also help to support a healthy gut if you notice changes in their digestive health.

    4. Changing Energy Levels

    Not all dogs and cats are built the same when it comes to energy levels. Some are dedicated couch potatoes, some don’t mind exercise, and others jump at every chance for play or activity. A sign that you may need to consult with your veterinarian, however, is if you notice a change in their energy levels. Ensuring your dog or cat gets all the right nutrients through diet and supplements can help them maintain their energy levels and keep them spry and playful.

    5. Dental Health

    Good dental health supports physical and mental well-being in dogs and cats. Strong teeth help dogs and cats chew, help keep their mouths pain-free, and encourage them to enjoy their food. In turn, the right food and supplements can help build and maintain strong teeth.

    6. Age-Related Needs

    Animals have different needs at different life stages, and diet alone may not always provide adequate support. For example, puppies and kittens need additional nutrients as they grow to ensure healthy development. On the other end of the spectrum, senior dogs and cats have their own needs and can often benefit from additional support for their joints, mobility, energy levels, vision, brain health, and weight management.

    Support Whole-Body Health with Whole-Food Supplements

    Spirited Paw whole food-based supplements are formulated with human-quality ingredients to support healthy dogs and cats. Whether your pup or kitty needs additional support for dental health, joints & mobility, or overall health and vitality, Spirited Paw has high-quality supplements that supply nutrients, minerals, and functional ingredients.

    Visit Spirited Paw to learn more!


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    Animal Wellness is North America’s top natural health and lifestyle magazine for dogs and cats, with a readership of over one million every year. AW features articles by some of the most renowned experts in the pet industry, with topics ranging from diet and health related issues, to articles on training, fitness and emotional well being.

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    Animal Wellness

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  • Don’t Expect to Live Significantly Longer, At Least Not in This Century

    Don’t Expect to Live Significantly Longer, At Least Not in This Century

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    Despite all the recent hype from anti-aging evangelists and companies touting ways to extend life, human life expectancy is actually slowing down after accelerating in the previous century.

    In a paper published in Nature Aging, researchers led by S. Jay Olshansky, professor of public health at the University of Illinois in Chicago, report that factors that have contributed to remarkable extensions of life expectancy in the 20th century are reaching the point of diminishing returns. Public-health interventions such as clean water and better sanitation and hygiene, as well as medical innovations like vaccines and advances in drug and surgical treatments, are approaching their optimal impact. For human life expectancy to extend much further beyond where it exists today, says Olshansky, entirely new strategies that focus on manipulating the biological processes of aging need to occur. And we aren’t there yet.

    A brief history of human life extension

    At the beginning of the 20th century, humans began living longer primarily thanks to factors that reduced deaths among children and those who were middle-aged—what Olshansky refers to as phase 1 of human life extension. These included basic sanitation practices and better understanding of disease and ways to prevent spread of infectious agents like bacteria and viruses. Governments also shouldered greater responsibility for protecting public health. Following the 1918 influenza pandemic, for example, the federal government took a more hands-on approach at slowing contagious diseases by advocating hygiene practices as well as isolation and containment.

    Phase 2 continued in the middle of the century with medical advances against specific diseases such as heart problems and cancer. Vaccines against childhood diseases like measles and pertussis helped more children survive into adulthood. And advances in treating most illnesses have further extended life expectancy. In 1900, babies in the U.S. lived to about age 32—but by 2021, the average person lived to 71.

    Read More: What to Know Before Buying a Hearing Aid

    “We need to be grateful for what public health and medicine gave us and is still giving us, which is added survival time in the middle and now older ages,” says Olshansky. “The vast majority of people living beyond 60 are living on manufactured time—time created in phases 1 and 2 that enable us to live longer lives and enjoy life extension that our ancestors rarely had the opportunity to experience.”

    Anti-aging headwinds

    But those interventions can only add so many years. That’s because they’re occurring alongside opposing forces that are driving down life expectancy and increasing mortality, which include the rise of chronic diseases like obesity and lifestyle practices such as smoking. Then there’s the immutable fact of biological aging itself. Despite all the gains in improving health, the body—our brains, bones, and muscles—and all of our systems continue to age; with chronic disease, they might even age more quickly. Back in 1990, “we predicted that this phenomenon of the limited lifespan hypothesis would play itself out at the beginning of the 21st century, and that the rise of life expectancy would start to slow down as the ability to manufacture time begins to wane,” Olshansky says.

    Read More: The Man Who Thinks He Can Live Forever

    And that’s where we find ourselves in 2024. Researchers continue to study the benefits of a healthy diet and exercise in not just extending life, but adding healthy years, as well as new ways to preserve or even reverse aging processes. But, says Olshansky, “We need to accept the new reality that there is a limit to how long we can live. We are getting medical Band-Aids in phase 2 that are yielding smaller and smaller gains in longevity.”

    The new research

    Olshansky and his team analyzed data spanning 1990 to 2019 from the eight countries with the highest life expectancy, as well as Hong Kong and the U.S. (The U.S. is not among the longest-lived populations.) They documented a slowing in the increase in life expectancy during that period—and the U.S. was among several countries whose life expectancy was actually lower at the end of any given decade than it was at the beginning of that decade. Olshansky attributes that decline to higher deaths among middle-aged groups, perhaps due to substance abuse, suicide, and, more recently, COVID-19. Disparities in access to health care also mean that “some are doing so poorly that they are pulling down the average [life expectancy] for the population,” he says.

    In order to achieve the dramatic longevity that anti-aging proselytizers currently promise without evidence—like living to 100 and beyond by fasting or taking certain supplements—life expectancy would need to increase by about three years per decade. But even in most of the longest-lived populations, the rate of improvement has slowed to under 2.5 years annually, making the claims unrealistic and unattainable under current disease models. And in order for life expectancy for newborns to reach 110 years, about 70% of females would need to survive long enough to become centenarians; currently, only about 5% of women in the longest-lived countries are expected to reach that milestone.

    That doesn’t mean humans won’t at some point be routinely living into their 100s, says Olshansky. But given current trends, and without substantially improved methods for manipulating the biological processes of aging, that won’t happen in this century. Despite the hype, no methods have proven to address and reverse aging. And those will be key to not only extending survival but ensuring that the added years are healthy ones and not plagued by frailty and disease.

    “We got what we wanted—we got much longer lives,” Olshansky says. “But we are starting to see a rise in dementia, sensory impairment, and things that we are not able to manipulate quite as effective as we would like.”

    The nest step is to “deal with the consequences of our success,” he says. “Phase 3 should be focused on extending health span by going after aging itself and not just the diseases associated with it.”

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    Alice Park

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  • 8 Signs You’re in Perimenopause

    8 Signs You’re in Perimenopause

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    Carin Luna-Ostaseski still recalls the shock of discovering her periods had become monsoons. Short monsoons, she clarifies—her cycle went from lasting a week to two to three days—but still monsoons. She realized she was going through at least one tampon every hour.

    Then, more confusion: Earlier this year, partway through a flight, she became convinced she was having a heart attack—her heart was racing wildly, and she felt scared. It turned out she was actually experiencing a panic attack, triggered by—surprise!—perimenopause, which can lead to symptoms like weird periods, mood swings, and anxiety. “You Google the symptoms, like ‘I’m bleeding too much,’” says Luna-Ostaseski, 47, who lives in San Francisco. “You don’t think, ‘This is perimenopause.’ Our parents’ generation knew about menopause, but I think perimenopause is a new concept for our generation.”

    So what exactly is it? In a nutshell: the conclusion of a woman’s reproductive life, starting anywhere from age 40 to 44, though there can be variances on either side. While it’s still possible to get pregnant during perimenopause, it becomes more difficult; experts caution that you shouldn’t suddenly stop practicing safe sex. The transition lasts until someone officially enters menopause—which is exactly one year after their last period, usually around age 51. During perimenopause, hormones like estrogen and progesterone fluctuate wildly: “What used to be a predictable, EKG-like ebb and flow becomes chaotic,” says Dr. Mary Claire Haver, an ob-gyn who specializes in menopause care (and has developed a large social-media following around it).

    Read More: Menopause Is Finally Going Mainstream

    The vast majority of women are “so confused” when they start experiencing symptoms, Haver adds. “They go to their provider, and depending who they see, are told there’s nothing they can do—this is a normal part of life. Or they’re offered a hysterectomy, which is a surgical treatment of a medical issue, not a hormone issue, so they’re being castrated to cure their menopause.” That tracks with Luna-Ostaseski’s experience: She and her friends talk about their symptoms “constantly,” and share helpful services and products with each other. (She even created a website and newsletter called “Hot or Just Me?” to dispense those resources to a wider audience.) They call it “girlfriend medicine” to reflect the way they’ve stepped up to support each other, since doctors often don’t grasp what they’re going through.

    Complicating matters: There’s no single, accurate test for perimenopause. To arrive at a diagnosis, Haver does blood work to rule out conditions like hypothyroidism or autoimmune disease, and then narrows things down to perimenopause based on symptoms and through process of elimination. After that, she starts talking about treatment: Many patients benefit from medications like hormone therapy and low-dose birth control pills, in addition to lifestyle changes. “Menopause is inevitable,” Haver says. “But suffering is not. It might mean you need to make some changes in your life, or that pharmacology is going to be helpful—but if you just ignore it, it’s going to get worse.”

    With that in mind, we asked experts to describe the symptoms that can indicate you might be experiencing perimenopause.

    Irregular periods

    Perimenopause is a transitional stage characterized by having an irregular period, says Dr. Christine Greves, an ob-gyn at Orlando Health Women’s Institute. Someone who has always had a 28-day cycle, for example, might find that her periods start to vary by about seven days. “They can be shorter or longer,” she says, or not arrive at all. “Sometimes, you might not release an egg and will skip a period.” Women often report changes in flow, too, noting that their periods become heavier or lighter.

    The reason for the change? Unlike men, who make new sperm every day, women are born with all the eggs they’ll ever have. Over time, those eggs “start becoming less sensitive to our hormonal stimulation, and we don’t ovulate as regularly,” says Dr. Mary Farhi, an ob-gyn at Rush University Medical Center. As a result—given that the ovaries are producing fewer hormones—your periods naturally become irregular, she explains.

    Hot flashes

    About 75% of women experience hot flashes and night sweats during perimenopause, says Dr. Mindy Goldman, chief clinical officer of Midi Health, a virtual care clinic focused on perimenopause and menopause. You might experience intense heat and start sweating or turn bright red, mostly around your head, neck, chest, and upper back. Though scientists don’t understand exactly what causes hot flashes, hormones likely play an important role. Vasomotor symptoms tend to be especially bothersome at night, leading to frequent wake-ups, which is one reason why many perimenopausal women report fatigue.

    Read More: How to Deal With Menopause When It’s Hot Outside

    They’ve hit Luna-Ostaseski hard: At least once a week, she asks her husband if it’s hot or just her. “He’s wearing a sweater, and I’m stripping off layers of clothes for relief,” she says. She’s found that wearing natural fabrics helps, as does setting her bedroom temperature to 65°F. She avoids alcohol, spicy foods, caffeine, and hot drinks—all of which can trigger flashes—and prioritizes deep breathing, meditation, and stress management. She’s also learned that taking magnesium glycinate before bed is helpful, and she sleeps on cooling sheets and blankets. “I’ve gotten the hot flashes a little more under control,” she says, “but they still come and go.”

    Vaginal dryness

    Vaginal dryness triggered by hormonal changes is another hallmark symptom of perimenopause. “You can experience dryness in general, or dryness with intercourse,” Greves says. Depending on severity, over-the-counter lubricants can be effective. But she also recommends a more surprising antidote: cooking oil. Coconut oil works particularly well and doesn’t contain any irritants. “It’s in your cabinet, and it’s cheap,” she says. “That is an option to conquer the dryness.” In some cases, Greves adds, vaginal estrogen works best, especially among those experiencing painful intercourse. “Estrogen is like putting lotion in the vagina—it makes it nice and supple,” she says. There are a variety of ways to take it, including creams, gels, and rings; ask your doctor what might work best for you.

    Joint pain

    More than 70% of women experience musculoskeletal pain during perimenopause—and for 25% of them, it’s debilitating, according to recent research. Changing levels of estrogen, paired with a loss of muscle mass and bone density, can lead to rapid progression of arthritis, frozen shoulder, and other types of joint pain. As the study authors noted, these symptoms can be “silent, devastating, and permanent unless addressed.”

    While physical therapy is helpful in some cases, hormone therapy “is actually really, really powerful,” Haver says. Research suggests it can reduce inflammation and pain, while also helping prevent osteoporosis, which weakens bones. Prioritizing good nutrition and resistance training also plays an important role in improving symptoms and preventing falls and frailty.

    Weight gain

    When Haver entered perimenopause, her biggest complaint was the unexplained belly fat she gained. She had been privileged to not have to worry about her weight for most of her life, she says, and suddenly, without changing her habits, she no longer recognized her own body.

    Read More: 15 Things to Say When Someone Comments on Your Weight

    That’s a familiar experience, experts say. “We know that metabolism slows, and we know that after menopause, there’s an average of about five pounds of weight gain,” Goldman says. “Perimenopause is when people may gradually start noticing an increase in weight.” She coaches them to focus on eating well—protein and whole foods are important—and employing healthy exercise habits. That can help stave off additional weight gain as you progress through menopause, experts agree.

    Brain fog

    Do you ever feel like there’s a cloud over your head, or that you can’t multitask the way you used to? It could be a lot of things, including perimenopause. Luna-Ostaseski says she occasionally walks into a room and forgets why she’s there—and while driving, she once blanked on why she was headed in a particular direction. “To someone who prides herself on a sharp mind, it’s concerning,” she says. She hasn’t found an effective solution yet, but makes it a point to journal on her foggy days to see if she can identify triggers.

    Women frequently tell Goldman they can’t remember a person’s name or summon words as quickly as they’d like. “We know that estrogen withdrawal can clearly have a cognitive impact,” she says. Researchers are currently exploring exactly how estrogen affects the brain, and Goldman notes that many women see cognitive improvements after starting hormone therapy. That’s not, however, always the only factor: If someone isn’t sleeping well because of hot flashes, their fatigue can dampen mental clarity. Plus, “there’s data that says when you’re tired, you don’t exercise as much, and you don’t make healthy food choices,” she adds, which can affect cognitive health. “It’s all tied together.” That’s why treating perimenopause requires thinking holistically.

    Mood changes

    Perimenopause clues often arrive in the form of mood changes: PMS symptoms sometimes worsen, and you might notice you feel super irritable or angry, or that you’re crying more often. Plus, women who have had postpartum depression could be at increased risk for recurrent depression during perimenopause and menopause. “That’s part of the history I always ask people,” Farhi says. “We can only take so much stress, and once it gets too heavy, it can tip us over. I always tell people that your 40s are the time to fill your tank, because you don’t want to hit menopause with an empty tank.”

    Read More: Does Text Therapy Really Work?

    Therapist Jessika Fruchter was “blindsided” when she began experiencing perimenopause symptoms about a year and a half ago. She recalls traveling to a favorite spot by the ocean where she lives in Southern California and bursting into tears. “Because I know myself really well, and also because of my clinical training, I was like, ‘Something’s off here,’” she says. In addition to working to find specialized providers to support her own health, she shifted her practice to focus on serving women in perimenopause. It’s much easier to find a therapist who specializes in perinatal health than it is to find one with menopause expertise, she points out, and she wants to change that. She’s starting to offer menopause training courses for other therapists, as well as support groups for her clients.

    To find resources near you, tap into online tools like Psychology Today’s therapist and support group directories, Fruchter suggests. Make it a point to practice self-compassion, too, she urges. “It’s about cultivating that nurturing, calming, caregiver voice inside of us,” she says. “It’s telling yourself that you got this—this is natural, and it’s going to pass—and lowering the bar.”

    Shattered sense of identity

    Many women feel a sense of grief as they navigate perimenopause. “For some, it’s really about the end of the reproductive years,” Fruchter says. “Others are very attached to their menstrual cycle. And there’s this constant bump up against toxic youth culture and middle-aged invisibility.”

    Fruchter suggests reframing perimenopause as stepping into a new—and potentially liberating—chapter of life. She often hears from people who find they don’t have as much of a filter once they hit the years surrounding menopause, finally squashing their people-pleasing tendencies and setting firm boundaries. Some treat it as a literal “pause,” seizing the opportunity to take inventory of their life.

    Fruchter—who describes perimenopause as “a second puberty”—stresses that there’s no reason to feel ashamed or to suffer mentally or physically. “There’s so much beauty in this transition if we have the right support,” she says. “Most of the women I know are incredibly resilient and used to white-knuckling through challenges on their own. But just because we can doesn’t mean we should have to.”

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    Angela Haupt

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  • Coffee may help with muscle mass as you age, new study says

    Coffee may help with muscle mass as you age, new study says

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    Coffee may help with muscle mass as you age, new study says

    “The research shows a clear association.”

    Your go-to cup of coffee may do more than pep you up in the morning—it could help you to age more comfortably. That’s the main takeaway from a new study, which found a link between drinking coffee every day and having higher muscle mass. Video above: Six ways drinking coffee is linked to better healthIn case you’re not familiar with it, muscle mass is the amount of muscle in your body, and it helps with your strength, balance, and metabolism. Plus, as you age, having a higher muscle mass has been linked with more mobility and a lower risk of falls.But what does coffee have to do with muscle mass? Here’s the deal.What did the study find?For the study, which was published in Frontiers in Nutrition in August, researchers analyzed health data from more than 8,300 adults in the United States. The scientists looked at participants’ muscle mass through bone density scans and then compared that with their coffee intake from questionnaires.The study authors found that people who drank coffee every day had an 11 to 13 percent higher muscle mass than non-coffee drinkers. This, they concluded, may help lower the risk of developing sarcopenia, a musculoskeletal disease. (Worth noting: There did not seem to be an association between drinking decaf coffee and muscle mass.)“An appropriate increase in coffee and caffeine intake may be advocated in populations at high risk for low skeletal muscle mass,” the researchers added.Does coffee improve muscle mass?It’s important to point out that the study didn’t prove that drinking coffee gives you higher muscle mass. Instead, it found a link between a daily coffee and having higher muscle mass. “It’s not definitive proof that coffee alone will preserve muscle mass as you age,” says Scott Keatley, RD, co-owner of Keatley Medical Nutrition Therapy.Still, Keatley says that findings are “fascinating,” adding, “The research shows a clear association between coffee and caffeine intake and improvements in skeletal muscle mass.” As for why, Keatley says it could be due to the anti-inflammatory and antioxidant properties of caffeine. Inflammation is linked to decreased muscle mass, so tamping down on it could potentially have the opposite effect, he explains. Coffee may also help clear out damaged cells and maintain muscle integrity, Keatley says. “That could help prevent the muscle degradation typically seen with aging,” he says. Should I start drinking coffee for muscle mass? Nope, we’re not there yet. “While the research suggests coffee can have benefits for muscle mass, I wouldn’t recommend starting a coffee habit solely for that purpose,” Keatley says. “While coffee may have some benefits, it’s not a one-size-fits-all solution,” he says. “People need to take into account their own health, lifestyle, and whether caffeine affects them negatively.”If you want to build up your muscle mass, Keatley suggests focusing on having a balanced, protein-rich diet with lean sources like fish, chicken, and plant-based proteins. “Engaging in resistance training is a proven method to build and maintain muscle mass, and combining that with activities like walking or cycling helps improve overall function,” he says. And, if you happen to drink coffee, that may help you out, too.

    Your go-to cup of coffee may do more than pep you up in the morning—it could help you to age more comfortably. That’s the main takeaway from a new study, which found a link between drinking coffee every day and having higher muscle mass.

    Video above: Six ways drinking coffee is linked to better health

    In case you’re not familiar with it, muscle mass is the amount of muscle in your body, and it helps with your strength, balance, and metabolism. Plus, as you age, having a higher muscle mass has been linked with more mobility and a lower risk of falls.

    But what does coffee have to do with muscle mass? Here’s the deal.

    What did the study find?

    For the study, which was published in Frontiers in Nutrition in August, researchers analyzed health data from more than 8,300 adults in the United States. The scientists looked at participants’ muscle mass through bone density scans and then compared that with their coffee intake from questionnaires.

    The study authors found that people who drank coffee every day had an 11 to 13 percent higher muscle mass than non-coffee drinkers. This, they concluded, may help lower the risk of developing sarcopenia, a musculoskeletal disease. (Worth noting: There did not seem to be an association between drinking decaf coffee and muscle mass.)

    “An appropriate increase in coffee and caffeine intake may be advocated in populations at high risk for low skeletal muscle mass,” the researchers added.

    Does coffee improve muscle mass?

    It’s important to point out that the study didn’t prove that drinking coffee gives you higher muscle mass. Instead, it found a link between a daily coffee and having higher muscle mass. “It’s not definitive proof that coffee alone will preserve muscle mass as you age,” says Scott Keatley, RD, co-owner of Keatley Medical Nutrition Therapy.

    Still, Keatley says that findings are “fascinating,” adding, “The research shows a clear association between coffee and caffeine intake and improvements in skeletal muscle mass.”

    As for why, Keatley says it could be due to the anti-inflammatory and antioxidant properties of caffeine. Inflammation is linked to decreased muscle mass, so tamping down on it could potentially have the opposite effect, he explains.

    Coffee may also help clear out damaged cells and maintain muscle integrity, Keatley says. “That could help prevent the muscle degradation typically seen with aging,” he says.

    Should I start drinking coffee for muscle mass?

    Nope, we’re not there yet. “While the research suggests coffee can have benefits for muscle mass, I wouldn’t recommend starting a coffee habit solely for that purpose,” Keatley says.

    “While coffee may have some benefits, it’s not a one-size-fits-all solution,” he says. “People need to take into account their own health, lifestyle, and whether caffeine affects them negatively.”

    If you want to build up your muscle mass, Keatley suggests focusing on having a balanced, protein-rich diet with lean sources like fish, chicken, and plant-based proteins.

    “Engaging in resistance training is a proven method to build and maintain muscle mass, and combining that with activities like walking or cycling helps improve overall function,” he says. And, if you happen to drink coffee, that may help you out, too.

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  • I’m from Japan, home to some of the world’s longest living people: The No. 1 beverage I drink every day

    I’m from Japan, home to some of the world’s longest living people: The No. 1 beverage I drink every day

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    Growing up in Nara, Japan, surrounded by tea fields, matcha has always been a part of my life. The full aroma and the deep bitter and sweet umami taste of this vivid green tea evokes so much nostalgia for me. 

    When I was in high school, I started taking formal tea ceremony lessons. It was a highlight of my week. Our tea master would always give my classmates and me delicious, seasonal Japanese wagashi (sweets) and flowers, and she invited us to watch and help during her tea ceremony at a prestigious temple in Kyoto. 

    I still regularly perform Chado, the traditional Japanese tea ceremony for preparing green tea. I stopped for a time when I moved to the United States, but resuming the practice here in New York has provided a valuable sense of community for me. 

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    More than anything, I associate matcha with the wisdom of my elders. My 99-year-old aunt and my 98-year-old mentor, who I call Papa-san, have been making their own matcha for most of their lives. I’ve even inherited some of their matcha bowls and utensils.

    Matcha is my No. 1 beverage for boosting longevity, and I drink it every day.

    Here I am offering a tea ceremony and lecture for the community in Beacon, New York.

    Photo: Michiko Tomioka

    The health benefits of matcha 

    A delicious batch of vegan matcha cupcakes.

    Photo: Michiko Tomioka

    Studies have also shown that matcha can reduce the risk of cardiovascular diseases and can improve your gut health as well. 

    There are so many ways to consume matcha, including sweet treats like cake, cookies, chia pudding and mochi

    How to receive a bowl of matcha in the traditional way 

    If you ever have the opportunity to attend a Chakai (tea gathering) or be served in a formal setting, there are several rules to follow — these are some key ones.

    When you are served, say “Okemae chodai Itashimasu,” which meansThank you for serving tea to me.” Then pick up the bowl, hold it with both hands, take a moment to look at the color and enjoy. 

    My daily matcha with my 99-year-old aunt’s tea bowl.

    Photo: Michiko Tomioka

    After you finish, once again, look at the bowl and carefully hold it in both hands. Then return it back to the place where you were served.

    The most important thing is to express your appreciation, relax and embrace the moment. 

    How I prepare my bowl of matcha every day 

    My day starts with offering a prayer and a bowl of matcha to my ancestors. Then I make a bowl for myself and one for my son before he goes to work as a physical therapist. This daily ritual for performing Chado fills me with such a sense of peace. 

    Here are the steps I take:

    1. I boil approximately two ounces of water.
    2. I place half a cup of hot water into my bowl and with my chasen (bamboo tea whisk), I swirl the water several times to purify my tools. Takayama, a village in my home of Nara, is famous for making chasen.
    3. I drain the water and then wipe everything with a clean cloth or paper towel.
    4. With my chashaku (traditional bamboo tea scoop), I measure out two grams of green matcha powder and place it on the bottom of the bowl.
    5. I slowly pour approximately 60 ml of hot water over the powder and enjoy the emerging aroma.
    6. I hold the bowl carefully with my left hand and whisk, making sure to hold the chasen vertically, for about 20 seconds. I call this my “gift of Zen moment.”

    In Japan, making my own tea scoop at Master Tango Tanimura’s place in Takayama, Nara. The Tanimura family has been producing tea whisks for nearly 500 years.

    Photo: Michiko Tomioka

    During the summer, I will sometimes transfer the prepared tea into a portable thermos and add about half a cup of crushed ice for a refreshing and cool to-go treat. 

    One of my favorite makers of matcha is the Ippodo Tea Company. It is based in Kyoto, and has been operational since the 1700s. I also recommend using bamboo tea whisks, which you can often find in Asian grocery stores or online.

    If you’re just getting started, you can always use a small kitchen hand whisk or even a mason jar with a lid — but no blender, please, the matcha powder is so delicate. 

    After I complete this meditative routine, I always feel a little lighter. Simply put, it is healing. 

    Michiko Tomioka, MBA, RDN, is a certified nutritionist and longevity expert. Born and raised in Nara, Japan, her approach focuses on a plant-based diet. She has worked in nutritional roles at substance recovery centers, charter schools and food banks. Follow her on Instagram @michian_rd

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  • Hungary birth rate falls to record monthly low despite €30,000 offer to 3 child families

    Hungary birth rate falls to record monthly low despite €30,000 offer to 3 child families

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    Viktor Orbán, Hungary’s right-wing prime minister, has several populist policies, one of which has been to grow Hungary’s native population.

    But early successes appear to be running out of steam in Hungary, as its birth rate is still falling despite huge incentives being offered to new parents.

    Populations across Western Europe are struggling with falling birth rates, which threaten long-term economic growth and could create a healthcare crisis as fewer young people are forced to care for and subsidize an increasingly older population. 

    However, financial barriers, such as rising accommodation prices, are a major obstacle to childbearing, which has been compounded by the cost of living crisis. Changing workplace dynamics, with more women enjoying meaningful careers, also push back the average age for couples to have their first child. 

    Immigration is regarded as the most realistic way of maintaining an optimal average population age, but that has become highly politically contentious since the global financial crash. 

    Hungary’s fight to increase childbirth

    Hungary is particularly sensitive to immigration, which Orbán has repeatedly argued would harm the country’s cultural fabric. From 2025, immigrants from non-EU countries will have to pass a Hungarian history and culture test to become residents of the country. 

    Instead, it is championing the classic populist policy of increased childbirth among natives.

    “We do not need numbers, but Hungarian children,” Orbán said in his State of the Nation address in 2019 as he rolled out childbirth incentives.

    To do so, Hungary is offering weighty financial incentives to up appearances in its hospital’s midwifery units. 

    In 2019, Hungary offered parents a €30,000 interest-free loan to spend on anything they wanted. The loan would be forgiven if they had three children. 

    Mothers of four children or more are exempt from paying income taxes under Orbán’s policy, which could be extended to those with fewer children.

    Hungary’s birth rate rose through the 2010s, rising from a record low of 1.25 in 2011 to 1.61 in 2021. But in recent years, growth has halted. In June, Hungary registered a record-low number of 6,000 births. 

    Wolfgang Lutz, founding director of the Wittgenstein Centre for Demography and Global Human Capital in Vienna, told the Financial Times that the policies had merely pushed forward births among women who had intended to have children at some stage in their lives anyway. 

    Those on lower incomes complained to the publication that the subsidies weren’t adequate to incentivize having more children, which became increasingly expensive to manage more children. The removal of income tax does little for self-employed workers, for example.

    Permeating the debate has been an encouragement for the growth of “traditional,” heterosexual family units. 

    Hungary’s policies are focused on incentives for new mothers, while in 2021 the country introduced laws that banned LGBT content from being shown in schools, something the U.S. and EU labeled as “discriminatory.” 

    Populist swing

    Increasing childbirth has long been a critical policy anchor of right-leaning populist governments, allowing them to solidify their stance as self-proclaimed protectors of traditional family values while offering them an anti-immigration platform. 

    While Orbán’s birthing policy looks to be on the ropes, the playbook does have one high profile proponent: U.S. Republican vice presidential candidate J.D. Vance.

    Vance suggested in 2021 that Americans with children should get more votes than their childless peers. While on the campaign trail at the same time, Vance also hailed Orbán’s push for more births.

    “Viktor Orbán, who is, of course, the bugaboo of nearly every liberal in the mainstream American media, has implemented a couple of policies that I think are really interesting.

    “They offer loans to new married couples that are forgiven at some point later if those couples eventually stay together and have children. Why can’t we do that here? Why can’t we actually promote family formation here in our country?”

    Vance recently walked back his comments on giving more votes to parents, describing them as a “thought experiment” amid heavy backlash.

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    Ryan Hogg

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  • How to Be More Spontaneous As a Busy Adult

    How to Be More Spontaneous As a Busy Adult

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    My nine-year-old skips, jumps, flails his arms, jumps some more, kicks, skip-jumps, stops by to punch me in the leg, and continues. He drifts through the house to the energetic pop rock of his favorite band, Imagine Dragons.

    He’s mouthing the words, but his “dancing” takes no cues from the music’s rhythm. He prefers to romp spontaneously.

    Many people enjoy life with some dashes of spontaneity, and this freedom is often associated with being young. Meanwhile, rigid thinking is linked to worse mental health (and humans tend to get more mentally inflexible after childhood). You’re not doomed to a grown-up life of no surprises, though. Researchers have recently identified ways to increase spontaneity for well-being—and perhaps even longevity.

    Here’s what they’ve learned about spontaneity and how to cultivate it.

    What is spontaneity?

    Spontaneity is about loosening your mind and actions. It’s voluntary and off-task, serving no particular purpose—like an out-of-the-blue road trip this summer.

    We’re spontaneous when thoughts are free to move about, flexibly shifting across ideas and topics, often wandering to external matters that go beyond self-directed, personal concerns. This type of unconstrained thought is linked to specific neural action at the front of the brain, found Julia Kam, a psychology professor at the University of Calgary in Canada. “It’s a marker of letting your mind go,” Kam says.

    Read More: How to Start—And Stick to—A Breathwork Practice

    Thoughts that are automatic and stuck, like repetitive worries, compete with spontaneity, says Jessica Andrews-Hanna, a neuroscientist at the University of Arizona. “Habitual thoughts are ingrained in our psyches,” she explains, when brain regions related to emotion and self-focus interact repeatedly. If these constraints can be relaxed, “spontaneity is free to emerge” for a wide range of thoughts and behaviors. 

    Creativity is related but different. It’s the ability to choose among many spontaneously generated options for some useful purpose, whereas spontaneity “doesn’t need an end-game,” says Tali Marron, a clinical psychologist at Israel’s Shalvata Mental Health Center. It can be its own reward, like an amateur artist throwing paint at a canvas for fun, regardless of what’s produced.

    Why are kids little spontaneity machines?

    Young people enjoy these intrinsic pursuits naturally. As Picasso said, we are all born artists. The problem is, we grow up. 

    “Kids are little spontaneity machines,” says Edward Slingerland, a philosophy professor at the University of British Columbia in Canada and author of Trying Not to Try: The Art and Science of Spontaneity. He recalls his daughter at an age when she couldn’t walk a line from points A to B without zig-zagging jumps and somersaults. Kids are also known for experimenting with new personality traits, outfits, and passions that arise seemingly out of nowhere.

    Few adults seek a return to this behavior. Walking in a straight line is mostly very useful. So is a stable identity that doesn’t change with the weather. But adults can benefit from understanding why and how the young are so spontaneous.

    Read More: What’s the Best Skincare Routine?

    One factor is dopamine, a chemical in the brain related to motivation and reward. Sandeep Robert Datta, a neurobiologist at Harvard, monitors the brains of mice while they explore unfamiliar territory. He’s found that dopamine inspires their spontaneous movement just like more predictable movement rewarded by food, and this random behavior is far more common in younger mice. “They generate lots of spontaneous exploratory movements that peak just before adulthood, when mice begin to settle down and act their age,” Datta says.

    Dopamine drives human movement, too. “Your behavior any moment is the sum of actions that make you feel good” and more unusual ones that help you “better understand and interact with the world around you,” Datta says. The more we explore an environment, like a city, the better we grasp what’s possible, increasing resourcefulness. In humans as in mice, though, dopamine levels drop as we age—10% each decade

    Another explanation for youthful spontaneity is neuroplasticity. The period of “juvenile exuberance” coincides with the brain being “massively flexible and engaged in ongoing learning,” Datta says. Like dopamine, neuroplasticity declines after a certain point in life. “With the juvenile-to-adult transition, neural circuits get locked to some extent into adult configurations,” says Datta. “Spontaneity can be viewed as a measure of biological aging.”

    These changes affect more than movement. Spontaneous thoughts also seem to peak when we’re younger. Studies show that college students and young adults engage in mind wandering up to 50% of the day, Kam says. In older age, it typically declines to about 30%.

    That is, unless adults actively strengthen their spontaneity muscles. “Things that keep your brain plastic are probably very important to maintaining spontaneous behavior,” Datta says. The connection between spontaneity and longevity still needs to be tested. But Kam and Andrews-Hanna have found links between freely-moving spontaneous thoughts and having more life satisfaction. And a positive mindset is associated with slower aging.

    Follow these steps to enhance spontaneity regardless of age.

    Take free-moving, free-thinking breaks

    Make time to roam freely. Fantasize and daydream while strolling, losing track of where you’re going. Use GPS to find your way back.

    Andrews-Hanna takes such walks, letting her thoughts flow. Kam exercises while avoiding mental to-do lists, television, or anything else productive or distracting. “You can’t focus your mind 24/7,” she says. “I carve out time to let my thoughts wander wherever they want.” 

    Peter Felsman, assistant professor of social work at Oakland University in Rochester, Mich., introduces people to “sense and savor” walks, guiding them to spontaneously engage in whatever provides pleasure, like watching a bee go from flower to flower. For these walks, psychologists recommend giving “yourself over to the experience as if it were the only thing that existed in the world. When you lose interest…discover something else that is attractive.”

    Put yourself in a surprising situation

    “You can force neuroplasticity and spontaneity to remain part of your life by getting yourself to do new things,” Slingerland says. “Embrace surprise,” Felsman adds. “Pleasant breaking of routine wakes people up to life.”

    Recently, Felsman joined a friend for a sailing outing. He thought it’d be relaxing but, once on the water, they were invited to compete in several hours of competitive racing. The idea made Felsman nervous because this was his first time sailing. But he embraced the novelty of getting to learn how to participate in a sailing crew. “It just sort of happened,” he says. “It was extraordinary.”

    Read More: 8 Eating Habits That Actually Improve Your Sleep

    Datta, too, values spontaneous, new experiences. His father has Parkinson’s disease, which is associated with low dopamine levels. “The one thing that makes him better is novelty,” he says. “If I surprise him with a trip to the mall, the beach, or anywhere else, he perks up in a way that I’m not used to.”

    Free associate

    If you feel stuck with an unsatisfying routine, it may help to try a certain form of free association, in which you describe your inner train of thought out loud, one word at a time, each word associating with the previous one. You might go from cloud to mother to kitchen, depending on your associations. This aids creativity and, just as importantly, it practices silencing our internal critics while boosting spontaneity, says Marron, the Israeli psychologist. 

    When people’s thoughts move freely, the executive parts of their brain—controlling functions like planning and decision-making, also known as convergent thinking—aren’t as activated, Marron has found. “Their associations are more flexible with less inhibition.” They improve at watching their thoughts diverge, like zigzagging children, without “feeling like half their ideas are spam,” she says. 

    Asking people to read positive, creative stories could make these associations more original and lively. Free-writing is another activity that encourages “free, flowing forms of thinking,” Andrews-Hanna says. 

    Some people enjoy being alone with their divergent thoughts more than others. Andrews-Hanna has developed an app called MindWindow that lets users gain insight into their own thinking patterns, including spontaneity. 

    Take an improv class 

    Studies in adults show that taking improv classes, another free-association activity, reduces symptoms of depression and anxiety. It also boosts creativity, which is linked to well-being. Felsman’s research in Detroit schools found that kids who participated in an improv class became better at tolerating uncertainty—key to mental health—and less socially anxious.

    Read More: 8 Ways to Find Humor in Your Everyday Life

    The executive parts of the brain are important. Without their control functions, associations would loosen too much, Marron says. But free association can help ensure that top-down, executive forces don’t dominate one’s mental landscape. “The ideal is to find a balance between divergent and convergent thinking, so you can flexibly act in line with your values,” Felsman adds.

    Reduce stress

    Anxiety is linked to narrower, more ritualized thoughts and behavior. Practicing mindfulness can “break your attachment” to repetitive, negative thinking, Andrews-Hanna says, freeing up mental bandwidth for spontaneity. New research shows that psilocybin can weaken psychological constraints, perhaps by reducing stress and shifting the brain temporarily to a childlike state of neuroplasticity. Ignoring the stressful, digital constraints of smartphones can help, too.

    Try not to try

    Spontaneity as a virtue has ancient roots. It was seen as essential to enjoying life in 5th century BCE China through the concept of wu-wei, which translates as “no trying,” Slingerman writes in his book. People with wu-wei are successful without striving; they know when to trust their unconscious mind and do what comes naturally. Cultivate it by engaging in something awe-inspiring that syncs you up with the larger, natural order, Slingerman says—in his case, it’s ocean kayaking.

    Play without structure

    Part of Andrews-Hanna’s regimen for spontaneity involves playing with her kids. “I try to get into their mode of thinking, rather than directing their play,” she says. “It’s very difficult, more natural for a four-year-old. But it helps me connect with them and become more flexible in my thinking.”

    Read More: How Much Do You Actually Need to Shower?

    Recently, I started joining my son’s dancing. I imitate him with my own jumping and flailing. When he’s really feeling the music, he shakes his head vigorously, appearing to have, as Wordsworth said of poetry, “a spontaneous overflow of powerful feelings.” I shake my head, too, thinking about him sharing his gift of spontaneity. 

    At first, we collided a few times, but now we expertly dodge each other. Maybe it’s reopening my neural connections—or maybe not. But it’s certainly a welcome divergence from my sedentary routine. The rinse-repeat of daily life is like “hitting the same gumball machine all day,” Datta says. “If that’s all you do, when the machine runs out, you’re screwed.” There’s a fundamental need to continuously try random things. “These movements might seem meaningless, but who knows in the future whether a move you made while dancing will be useful to you.” Even if there’s no point, though, the true benefit may be simply enjoying the spontaneity for its own sake.

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    Matt Fuchs

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  • How to Prevent or Delay Dementia

    How to Prevent or Delay Dementia

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    More than 10 million people around the world develop dementia each year. And many people assume there’s nothing they can do to avoid that fate—that dementia is “one of these things that just happens,” says Gill Livingston, a professor in the department of brain sciences at University College London.

    But a new report published in The Lancet says otherwise. Nearly half of dementia cases could, in fact, be prevented or delayed if people adopted certain habits, according to the report, which was written by a group of almost 30 experts convened by the Lancet and based on an analysis of hundreds of studies.

    Some risk factors for dementia can be best addressed through policy solutions—for example, by passing climate policies that reduce the public’s exposure to air pollution, a risk factor for cognitive decline. But there’s also plenty that individuals can do. Even people with genetic risk factors for dementia may be able to extend their cognitively healthy lifespans if they take certain actions, says Livingston, lead author of the report.

    Here’s where to start, according to the latest research.

    Keep your brain busy

    Research suggests people who get a strong early-life education, as well as those who work mentally stimulating jobs during midlife, are at decreased risk of developing dementia later on. But even if neither of those are the case for you, there’s still plenty you can do to keep your mind sharp.

    Aim to have plenty of new and varied experiences that get the brain working in different ways, Livingston suggests—things like learning a new skill, reading a book (especially one outside your usual genre), or traveling somewhere you’ve never been. Variety is key, Livingston emphasizes. “If you just do Sudoku, you become good at Sudoku, but that doesn’t generalize to the rest of your brain,” she says. “Your brain has lots of different functions, so the idea is to keep them all engaged.”

    Socialize

    One of the best ways to keep your brain busy, Livingston says, is by “talk[ing] to a variety of different people, because you don’t know what they’re going to say.” Doing so is a win-win: you’re keeping your brain sharp by coming up with responses and conversation topics, and getting plenty of social interaction at the same time.

    Read More: What’s the Best Skincare Routine?

    Social contact is good for nearly all aspects of health, studies show—and that goes for cognitive health, too. People with active social calendars from midlife onward may be up to 50% less likely to experience cognitive decline as they age, relative to people who are more isolated, according to one research review from 2023. And there seems to be something special about friendship. Research suggests that people who socialize not just with family, but also with non-relatives, tend to have better cognitive performance as they get older.

    Stay physically active

    Being sedentary isn’t good for your physical, mental, or cognitive health. A 2023 study found a strong link between having 10 or more hours of sedentary time per day and being diagnosed with dementia. Conversely, studies suggest that regular exercise may slash the risk of developing Alzheimer’s by nearly half, and any kind of dementia by almost 30%.

    The U.S. government recommends getting at least 150 minutes of moderate-intensity activity or 75 minutes of vigorous exercise each week to maintain good health and ward off chronic disease. But even if you can’t reach those benchmarks, doing anything is better than nothing. Virtually any amount of physical activity “really begins to shift the dial,” Livingston says. “You don’t have to be an ultramarathon runner”—just spend a little time each day moving in whatever way is enjoyable and sustainable for you.

    And if you can, get moving outside. A 2022 study suggests spending time in green space may keep the mind healthy.

    Wear a helmet

    If your preferred form of exercise is a contact sport or an activity that comes with the risk of falling—like riding a bicycle—it’s crucial to wear a helmet when you do it. Suffering even one head injury over the course of your life may put you in danger of developing dementia, according to 2021 research.

    Take care of your mental health

    Another argument in favor of regular exercise: it may help prevent or treat depression, which is another well-established risk factor for dementia.

    Read More: How to Start—And Stick to—A Breathwork Practice

    But, of course, exercise alone may not be enough to protect mental health. Psychotherapy and medication are considered the gold-standard treatments for depression, and a 2022 study found that people with depression who were treated using such methods had a significantly lower dementia risk than people with untreated depression.

    Follow doctor’s orders

    Many of the health metrics that come up doing a routine physical—including your levels of “bad” cholesterol, blood pressure, diabetes risk, and weight—also have ties to dementia risk, studies suggest. Controlling these factors by exercising regularly; eating a diet rich in fruits, vegetables, whole grains, nuts, and other nutritious foods; and taking medication, if recommended by your physician, may help preserve your cognitive health, too.

    Don’t drink too much or smoke

    If you needed yet another reason to quit smoking, here’s one: current smokers may be up to 40% more likely to develop Alzheimer’s than people who have never used cigarettes, according to a 2015 research review—but that increased risk seems to mostly disappear among former smokers. Quitting, in other words, seems to be beneficial for your health in numerous ways.

    Read More: Can Food Really Change Your Hormones?

    Excessive alcohol consumption can also harm the brain, studies suggest. Current U.S. dietary guidelines recommend that men have no more than two alcoholic beverages per day and women no more than one. And having even fewer than that is likely a good idea, according to a flurry of recent research. Increasingly, science suggests that the less you drink, the better for your brain and body.

    Protect your senses

    Hearing and vision loss are both associated with dementia, perhaps in part because these conditions decrease the brain’s exposure to external stimuli and in part because they make it harder to stay cognitively, physically, and socially active. While there are some things you can do proactively—such as keeping volume low when listening to music—both conditions can be somewhat unavoidable parts of aging.

    If they happen to you, don’t delay getting treatment. Studies show that using hearing aids or correcting vision problems, such as by having cataracts removed, can slow one’s rate of cognitive decline.

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    Jamie Ducharme

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  • What happens when you can’t manage your investments anymore? – MoneySense

    What happens when you can’t manage your investments anymore? – MoneySense

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    I try to picture 84-year-old me being told by my kids that it is time to hire a financial planner. I may not be so keen myself when the time comes. Maybe I should bookmark this column.

    I took over the management of my mother’s finances toward the end of her life. She seemed reluctant, but she knew it was time. I think she still saw me as her little boy even though thousands of clients and readers looked to me for advice that she was hesitant to take.

    Managing your own investments to save on fees

    If you expect to pay $35,000 a year on fees to invest in mutual funds, Laasya, I am speculating here, but you probably have somewhere between $1.5 million and $2 million of investments. Mutual fund management expense ratios (MERs) are embedded fees that are paid from the fund’s returns each year. They are about 2% on average but can range from under 0.5% for low-cost, passive index funds to 3% or more for segregated funds from insurance companies.

    If you have $1 million or more to invest, there are discretionary portfolio managers who use stocks and bonds or proprietary pooled funds who may charge 1% or less of your portfolio value. (Discretionary means the portfolio manager makes buy and sell decisions on your behalf.)

    You could certainly invest in exchange-traded funds (ETFs), and now there are plenty of simple asset-allocation ETFs (also known as all-in-one ETFs) that can be a one-stop shop for investors. Fees are in the 0.25% range.

    Why self-directed investing may not be the answer

    The problem with buying an ETF, Laasya, is that your kids are concerned about you investing on your own. And if they wanted to be self-directed investors, they probably would have offered to help you manage your investments. They did not. So, if you pull your investments to manage them yourself again, you may be putting your kids in an uncomfortable position, as they may potentially have to become DIY investors at some point if you’re unable to manage your own investments.

    Self-directed investing may seem easy to people who are comfortable doing it. But I remain convinced that some people will never be able to manage their own investments, no matter how simple it becomes.

    Have you considered a robo-advisor?

    I often joke with my wife that I am very good at a short list of things in the financial planning realm, but not much else. There are plenty of things that I could probably learn to do around my house or in other aspects of life that I have no interest in learning. I would rather pay an expert.

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    Jason Heath, CFP

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  • Blood Tests for Alzheimer’s May Be Coming to Your Doctor’s Office

    Blood Tests for Alzheimer’s May Be Coming to Your Doctor’s Office

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    WASHINGTON — New blood tests could help doctors diagnose Alzheimer’s disease faster and more accurately, researchers reported Sunday—but some appear to work far better than others.

    It’s tricky to tell if memory problems are caused by Alzheimer’s. That requires confirming one of the disease’s hallmark signs—buildup of a sticky protein called beta-amyloid—with a hard-to-get brain scan or uncomfortable spinal tap. Many patients instead are diagnosed based on symptoms and cognitive exams.

    Labs have begun offering a variety of tests that can detect certain signs of Alzheimer’s in blood. Scientists are excited by their potential but the tests aren’t widely used yet because there’s little data to guide doctors about which kind to order and when. The U.S. Food and Drug Administration hasn’t formally approved any of them and there’s little insurance coverage.

    “What tests can we trust?” asked Dr. Suzanne Schindler, a neurologist at Washington University in St. Louis who’s part of a research project examining that. While some are very accurate, “other tests are not much better than a flip of a coin.”

    Demand for earlier Alzheimer’s diagnosis is increasing

    More than 6 million people in the United States and millions more around the world have Alzheimer’s, the most common form of dementia. Its telltale “biomarkers” are brain-clogging amyloid plaques and abnormal tau protein that leads to neuron-killing tangles.

    New drugs, Leqembi and Kisunla, can modestly slow worsening symptoms by removing gunky amyloid from the brain. But they only work in the earliest stages of Alzheimer’s and proving patients qualify in time can be difficult. Measuring amyloid in spinal fluid is invasive. A special PET scan to spot plaques is costly and getting an appointment can take months.

    Read More: A New Alzheimer’s Drug May Be the Most Effective One Yet

    Even specialists can struggle to tell if Alzheimer’s or something else is to blame for a patient’s symptoms.

    “I have patients not infrequently who I am convinced have Alzheimer’s disease and I do testing and it’s negative,” Schindler said.

    New study suggests blood tests for Alzheimer’s can be simpler and faster

    Blood tests so far have been used mostly in carefully controlled research settings. But a new study of about 1,200 patients in Sweden shows they also can work in the real-world bustle of doctors’ offices—especially primary care doctors who see far more people with memory problems than specialists but have fewer tools to evaluate them.

    In the study, patients who visited either a primary care doctor or a specialist for memory complaints got an initial diagnosis using traditional exams, gave blood for testing and were sent for a confirmatory spinal tap or brain scan.

    Blood testing was far more accurate, Lund University researchers reported Sunday at the Alzheimer’s Association International Conference in Philadelphia. The primary care doctors’ initial diagnosis was 61% accurate and the specialists’ 73%—but the blood test was 91% accurate, according to the findings, which also were published in the Journal of the American Medical Association.

    Which blood tests for Alzheimer’s work best?

    There’s almost “a wild West” in the variety being offered, said Dr. John Hsiao of the National Institute on Aging. They measure different biomarkers, in different ways.

    Doctors and researchers should only use blood tests proven to have a greater than 90% accuracy rate, said Alzheimer’s Association chief science officer Maria Carrillo.

    Read More: Changing Your Diet and Lifestyle May Slow Down Alzheimer’s

    Today’s tests most likely to meet that benchmark measure what’s called p-tau217, Carrillo and Hsiao agreed. Schindler helped lead an unusual direct comparison of several kinds of blood tests, funded by the Foundation for the National Institutes of Health, that came to the same conclusion.

    That type of test measures a form of tau that correlates with how much plaque buildup someone has, Schindler explained. A high level signals a strong likelihood the person has Alzheimer’s while a low level indicates that’s probably not the cause of memory loss.

    Several companies are developing p-tau217 tests including ALZpath Inc., Roche, Eli Lilly and C2N Diagnostics, which supplied the version used in the Swedish study.

    Who should use blood tests for Alzheimer’s?

    Only doctors can order them from labs. The Alzheimer’s Association is working on guidelines and several companies plan to seek FDA approval, which would clarify proper use.

    For now, Carrillo said doctors should use blood testing only in people with memory problems, after checking the accuracy of the type they order.

    Especially for primary care physicians, “it really has great potential to help them in sorting out who to give a reassuring message and who to send on to memory specialists,” said Dr. Sebastian Palmqvist of Lund University, who led the Swedish study with Lund’s Dr. Oskar Hansson.

    The tests aren’t yet for people who don’t have symptoms but worry about Alzheimer’s in the family—unless it’s part of enrollment in research studies, Schindler stressed.

    That’s partly because amyloid buildup can begin two decades before the first sign of memory problems, and so far there are no preventive steps other than basic advice to eat healthy, exercise and get enough sleep. But there are studies underway testing possible therapies for people at high risk of Alzheimer’s, and some include blood testing.

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    LAURAN NEERGAARD/AP

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  • A New Alzheimer’s Drug May Be the Most Effective One Yet

    A New Alzheimer’s Drug May Be the Most Effective One Yet

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    On July 2, the U.S. Food and Drug Administration (FDA) approved a new drug for treating Alzheimer’s disease. Donanemab, or Kisunla, is the third drug approved to target one of the causes of Alzheimer’s: the buildup of amyloid protein in the brain. Based on the data provided by the drug’s manufacturer, Eli Lilly, for the FDA to review, it’s the most effective drug yet in slowing cognitive decline associated with the disease.

    Studies reviewed by the FDA showed that the drug slowed progression to the next more-advanced stage of the disease by 39%, which translates to anywhere from four to seven months longer during which people can be more independent and function without extensive support from caregivers. Over that period, those receiving donanemab showed about 40% less decline in their ability to perform daily tasks such as keeping appointments, making meals, and using household appliances.

    By comparison, lecanemab (Leqembi), made by Eisai and approved in Jan. 2023, can slow cognitive decline by 27% compared to a placebo over 18 months. The makers of the other amyloid-targeting drug, aducanumab (Aduhelm), which in 2021 became the first such medication approved, decided to remove it from the market by the end of 2024.

    Donanemab’s effectiveness likely comes from its ability to specifically target the toxic plaques of amyloid that accumulate in the brain and strangle nerve cells until they eventually shrivel away. The drug is a monoclonal antibody that seeks out a portion of the amyloid protein that develops over time in the brain. “After it sits in the brain, like cholesterol, it builds up over time and changes,” says John Sims, senior medical director at Lilly. “Donanemab is very purposefully built with the postal codes for amyloid specific to brain plaques. That’s why, as far as we know today, donanemab is probably the most effective plaque-clearing antibody out there.”

    Read More: What to Do If You Can’t Afford Your Medications

    Another feature that sets the drug apart is that it was designed as a finite treatment, similar to the way cancer therapies are used, to aggressively remove amyloid plaques over a certain period of time after which patients can stop taking it. Doctors can then monitor patients for any signs of re-accumulation of amyloid. If those deposits build up again and hit a certain threshold, patients would start getting the drug again.

    In studies the company presented to the FDA, after 18 months on the drug, nearly 70% of people no longer showed visible signs of amyloid in their brain scans.

    That’s not to say it won’t come back; it likely will. “I think to get from a negative amyloid state to the lowest level of amyloid might take on average four years, but we have ongoing studies to study that,” says Sims. “Right now, we don’t know how best to take care of people whose amyloid comes back—it’s an unanswered question.”

    The panel of experts the FDA convened earlier in June agreed that there was not enough data yet to provide specific advice to doctors about if and when to stop donanemab treatment, but the label on the drug does allow doctors to consider stopping donanemab if the drug successfully clears amyloid and the plaques are no longer detectable on patients’ brain scans.

    That reflects a potentially new direction for Alzheimer’s treatments that wasn’t possible before drugs like donanemab were able to remove most of the damaging plaques from patients’ brains. Dr. David Hyman, chief medical officer at Lilly, says the company plans to continue studying people who have stopped donanemab after clearing it from their brains to get a better understanding of how quickly the protein starts to re-accumulate, and to determine when patients might need to start getting the drug again. Lilly will also study patients who were not able to clear their amyloid during the 18-month study period and learn more about whether different patients might need different treatment cycles.

    Potentially shorter cycles of treatment could also save patients and insurers money. Lilly says a six-month course will cost about $12,500, a year’s treatment $32,000 and 18 months of infusions $48,696. About 17% of the patients in the company’s studies no longer showed visible amyloid in their brain scans after six months, about 47% at 12 months and 69% at 18 months.

    Donanemab has another advantage over the existing approved treatment. While patients get infusions of lecanemab twice a month, they only need one infusion a month of donanemab. “For elderly patients who are most likely eligible for this drug, and their caregivers, it’s a significant reduction in burden having an infusion once a month vs. twice a month,” says Dr. Howard Fillit, founding executive director and chief science officer at the Alzheimer’s Drug Discovery Foundation.

    Eventually, treatments like donanemab could and should be used even earlier in the disease, as amyloid starts building up but before patients experience cognitive problems. Among people in Lilly’s study at the earliest stages of Alzheimer’s, the drug was linked to an up to 60% slowing of cognitive decline, and Sims says that models from his scientists estimate that donanemab could lead to as much as 90% slowing of cognitive decline, if it’s started in patients early enough. “The overwhelming lesson from our dataset is that the earlier you identify a patient and give them treatment, the bigger impact you can have,” says Dr. David Hyman, chief medical officer for Eli Lilly. “Where the field is going, and where we are going with donanemab, is evaluating it as a preventive therapy. We are moving to care for healthy people rather than treatment for sick people.”

    Read More: The Vaccines You’ll Need This Fall and Winter

    Identifying patients who don’t yet have symptoms remains a challenge, however, especially since current methods such as PET scans and spinal fluid tests are expensive and invasive, and not accessible to many older patients. “We have a lot of work to do as a field to close the last-mile care gaps in this patient population,” says Hyman. “My biggest concerns are—can we identify patients early enough in the course of their disease, can we have a physician workforce that is trained in administering these medicines, do we have the infusion capacity to treat patients who can benefit, and can we monitor these patients [with brain scans]?”

    More from TIME

    Finding better ways to track markers of Alzheimer’s proteins, such as in the blood, could be critical to expanding use of the new treatments. In its studies submitted to the FDA, Lilly relied on a blood test for identifying people as early as possible—sometimes even before they are even aware they might have Alzheimer’s—using another Alzheimer’s related protein called tau. Lilly is collaborating with Roche to make the test more available to doctors who can order it as a way to find patients most likely to benefit from donanemab. Amyloid blood tests could similarly help doctors to monitor patients and inform their decisions about when to stop donanemab and when patients might need to start infusions again when amyloid starts to re-accumulate. These tests are not fully approved by the FDA are currently available on a limited basis to doctors who order them to help make treatment decisions for their patients. While the FDA’s expert committee discussed the utility of tau testing, they decided not to recommend it as a requirement for prescribing the drug, since the test’s limited availability might further restrict patients’ access to donanemab.

    In coming years, Alzheimer’s experts also anticipate that simply targeting amyloid won’t be enough. Amyloid-based treatments do come with serious side effects, including bleeding and inflammation in the brain. That’s why anyone taking these drugs, including donanemab, need to get regular MRIs to monitor for signs of trouble. The risk is manageable, however, and doctors can taper down the dose or stop infusions for short periods.

    More effective treatments will also become necessary, since not everyone improves on amyloid-targeting drugs. Amyloid, tau, and another protein, alpha synuclein, are all involved in the disease somehow, and targeting each in different ways in different patients will be key to a more comprehensive treatment for the disease. “Anti-amyloid treatments might help some people, but some people might break through and continue to progress,” says Sims. “Hopefully in the future doctors will be able to say, ‘You need an amyloid treatment, or maybe some tau therapy, or even alpha synuclein therapy.’ Ideally, they would tailor treatments to people’s disease.”

    These are issues Alzheimer’s doctors have never wrestled with until now, because there haven’t been effective treatments that could remove toxic proteins in significant ways. But with better therapies like donanemab, monitoring patients for changes in the levels of those proteins will become more of a priority.

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    Alice Park

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  • Lilly wins FDA approval for new drug to slow Alzheimer’s

    Lilly wins FDA approval for new drug to slow Alzheimer’s

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    Eli Lilly & Co.’s Alzheimer’s treatment was cleared in the US as the second drug to slow progression of the mind-robbing disease that afflicts 6 million Americans.

    It’s a big win for Lilly and its investors, who have been eagerly anticipating the drug since it showed promise in clinical trials more than three years ago. Called Kisunla, the medicine endured a number of regulatory delays on the road to approval. It will compete with Eisai Co.’s Leqembi, which has been available for sale in the US since early 2023.

    Shares of Indianapolis-based Lilly closed down 0.8% Tuesday in New York. The stock had surged more than 50% so far this year before today amid rapid growth of weight-loss and diabetes sales. Shares of Eisai partner Biogen Inc. fell 1.3%

    The Alzheimer’s drug will cost $32,000 in the first year of treatment, Lilly said. That’s slightly more than the $26,500 annual price for Leqembi for a person of average size. But doctors can stop the treatment if brain plaques — the toxic material that the drug removes — fall to minimal levels, which they did in many people in trials after about a year.

    Lower costs

    That means that the total out-of-pocket treatment cost of the drug could sometimes be less than other amyloid drugs, Lilly said. In Leqembi’s main approval trial, patients were treated for a full 18 months.
    The Eisai and Lilly products are both infusions that remove toxic amyloid from the brains of Alzheimer’s patients. They only modestly slow the disease and are approved only for people with early-stage Alzheimer’s, a minority of the total patient population with the disease. Side effects of both include brain swelling and brain bleeding.

    Brain swelling or bleeding occurred in 36% of patients on Lilly’s drug in the company’s main study, and produced symptoms in 6% of them, according to the drug’s label. Regular scans are required to monitor for these effects. Lilly’s drug has a potential convenience advantage since it’s infused every four weeks, compared with every two for Leqembi.

    Less frequent dosing and the potential to stop treatment are “a really big deal,” Howard Fillit, co-founder of the Alzheimer’s Drug Discovery Foundation, said in an interview before the approval.

    Series of delays

    Lilly faced a series of delays bringing Kisunla to the market. In early 2023, the FDA refused to give the drug accelerated approval based on early trial results, telling the company it wanted to wait for a late-stage trial. When Lilly submitted that data, the FDA needed more time to review it. Then earlier this year, the agency decided late in the review process to convene a day-long hearing to review the drug’s safety and efficacy.

    A panel of outside advisers to the FDA voted unanimously in favor of the drug on June 10.
    “There’s a lot of emotion in the hallways today,” Anne White, president of Lilly Neuroscience, said in an interview before the approval. “We have portraits up on our walls of family members to remind us why we’re doing what we’re doing.”

    Once considered integral to Lilly’s future, Alzheimer’s has been overshadowed by the company’s GLP-1 medicines that aid in weight loss, a market expected to reach $130 billion a year by the end of the decade, according to analysts at Goldman Sachs.

    Sales of Alzheimer’s drugs are also expected to grow significantly. Bloomberg Intelligence analysts see sales surging to $13 billion by 2030 from about $250 million this year.

    “Having multiple treatment options is the kind of advancement we’ve all been waiting for — all of us who have been touched, even blindsided, by this difficult and devastating disease,” said Joanne Pike, CEO of the Alzheimer’s Association, in a statement. The nonprofit has pushed hard for approval and broad insurance coverage for amyloid-lowering drugs.

    Leqembi’s rollout by Eisai and partner Biogen Inc. has been slowed by logistical issues, reimbursement uncertainties and complicated safety testing requirements. Medicare, the US health program for the elderly, didn’t routinely cover the treatments until recently, and hospital neurology programs weren’t set up to perform the monitoring required to use the drugs.

    Subscribe to the Fortune Next to Lead newsletter to get weekly strategies on how to make it to the corner office. Sign up for free.

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    Madison Muller, Robert Langreth, Bloomberg

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  • Column: How’d the grandpa debaters do? Three experts on aging size up Biden, Trump

    Column: How’d the grandpa debaters do? Three experts on aging size up Biden, Trump

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    Not a good night for Biden.

    Not a proud night for Trump.

    A sad night for the United States.

    That’s my take after watching the presidential debate, but I didn’t watch alone. I enlisted three experts on aging to share their observations. I was focused on a single question while watching President Biden debate former President Trump. At their advanced ages — Biden at 81, Trump at 78 — is either up to the task of running the country?

    This has been a hot topic for months, with many people convinced that Biden has lost his mental sharpness. (Not that Trump’s mental state hasn’t come into question.) I asked my three experts not to do a political analysis, or to make a medical diagnosis, because as I’ve written more than once, that’s a complicated process that can’t be performed from a distance.

    California is about to be hit by an aging population wave, and Steve Lopez is riding it. His column focuses on the blessings and burdens of advancing age — and how some folks are challenging the stigma associated with older adults.

    What I wanted was their take on command, coherence, competence, composure, reason and skills of communication and articulation. Aging takes a toll, physical and mental, but you can be an old 60-year-old and a young 85-year-old because everyone ages differently.

    Biden froze up early on. He failed to come up with a word he was fumbling for while speaking about the national debt, and he looked lost.

    One of my experts, Dr. Zaldy Tan, director of the Memory and Aging Program at Cedars-Sinai, emailed to say a televised debate can be like a “cognitive stress test” and is “bound to bring about subtle, albeit normal, age-related changes in one’s mental agility.”

    It seemed to me, however, that with a scratchy, weak voice and a sometimes-vacant look in his eyes, Biden might be in trouble.

    He and Trump both seemed pretty agile though during one exchange in which they took off the gloves and went bare-knuckle.

    “You have the morals of an alley cat,” Biden said, staring down his foe while listing a few of Trump’s many transgressions.

    “I didn’t have sex with a porn star,” Trump insisted, and if there’s a political campaign button with that claim on it, I’d like to buy a bushel of them.

    The candidates took turns accusing each other of being criminals, which made me think back on another low point in American politics, when Richard Nixon insisted, as his presidency was in flames, “I am not a crook.”

    Former President Trump speaks during a debate with President Biden in Atlanta.

    Former President Trump and President Biden took turns accusing each other of being criminals during the debate.

    (Gerald Herbert / Associated Press)

    Another of my debate watchers was Dr. Myron Shapero, an urgent care physician in Beverly Hills. I wanted his perspective because he’s older than either Biden or Trump by a good stretch. Shapero is 90, and he thought Biden did not have a good night.

    “I think it’s obvious that Biden is not Biden anymore,” said Shapero. “What Trump needed was someone sharp, sure, strong, who could counterpunch … and Joe always had that capacity.” On Thursday, “he didn’t have it.”

    Shapero said the word that came to mind, as the night wore on and he studied Biden’s performance, was “flustered.”

    “It’s the aging process, and everyone handles it differently,” said Shapero. “He was vacant. He was not fully present, and it was painful to see.”

    Dr. Tan was more forgiving in his assessment.

    “Besides the speech impediment,” he said, referencing a longtime Biden affliction, “it is possible that he experienced mind wandering, more commonly referred to as losing one’s train of thought. The tendency to mind wander increases with higher stress levels, sleep deprivation and taking certain medications.”

    Caroline Cicero, an associate professor in the Leonard Davis School of Gerontology at USC, said she saw a sitting president who was not at his best.

    “Viewers surely noticed that President Biden did not command confidence in his performance,” Cicero said. “His blank stares left me wondering if his strategy was not to react and to stay stone-faced, so that he didn’t appear to be a grumpy old man.”

    Cicero said she wondered why Biden at times did not respond “more directly” to Trump attacks. “Reaction times do slow with age,” she said.

    Three people watch the presidential debate in a lounge in a Chicago neighborhood.

    Tanzella Young, left, Crystal Blakley and Jason Sanford watch the presidential debate at the M Lounge in the South Loop neighborhood of Chicago.

    (Charles Rex Arbogast / Associated Press)

    Early in the debate, when Biden trailed off, Trump said: “I really don’t know what he said at the end of that sentence. I don’t think he knows what he said, either.”

    Trump went in for the kill, as Dr. Shapero saw it.

    “Smelling blood made him nastier and more pathological,” Shapero said. “I feel that substance-wise, [Trump] was filled with lies, but stylistically, I think he came off stronger because he was less maniacal” than he usually is.

    One can ask whether Trump, a man aggressively removed from truth and civility, is fit for office. And Biden scored some points in exposing his opponent’s many barnacles, including the fact that he’s a convicted felon.

    But what I saw in Biden was a decent man and career public servant who is past his prime.

    What I saw in Trump was the usual boast and bluster, with no apparent ability or desire to control his own worst instincts.

    They ended the debate arguing about who had the better golf handicap.

    Lord help us.

    Steve.lopez@latimes.com

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    Steve Lopez

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  • Aging Might Not Be Inevitable

    Aging Might Not Be Inevitable

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    In 1997, a French woman named Jeanne Calment died at the age of 122. She was the world’s oldest verified person, according to the Gerontology Research Group. Her daily habits included drinking a glass of port wine and smoking a cigarette after meals (she also ate 2.5 pounds of chocolate every week). “Nobody else has lived past 120 since she died,” says Venki Ramakrishnan, the Nobel Prize–winning biologist and author of Why We Die. Indeed, while the number of centenarians is increasing every year, the number of people living past 110 is not. “This suggests that maybe there’s a natural limit to human lifespan.”

    If such a limit exists, it’s one imposed by biological evolution. “Evolution wants to make sure that your genes have the maximum likelihood of being passed on,” Ramakrishnan says. “It doesn’t care about how long you live.” This explains, for instance, why there seems to be a correlation between the size of animals and their life expectancy—in general, the larger the species, the longer it will live. Most mayflies live between one and two days. Monarch butterflies can live for months. Bowhead whales live more than 200 years. Greenland sharks may live more than 500 years. “If you’re a smaller species, there’s no point spending a lot of resources maintaining and repairing the body because the likelihood of being eaten or starved to death are high,” says Ramakrishnan. “Larger species, on the other hand, will have the advantage of more time finding mates and producing offspring.”

    A few species, however, seem to be exempt from this rule. The hydra, a small freshwater animal with 12 tentacles, doesn’t seem to age at all. The immortal jellyfish can even age backward. “It suggests that aging is not inevitable and that we might be able to circumvent our natural limits if we alter our biology,” Ramakrishnan says.

    That is why understanding the biological underpinnings of why we age and die is such a hot topic of research today. Scientists are trying to find out how to manipulate cellular aging processes—for instance, how to destroy senescent cells (aged cells that cause inflammation), or how to reprogram cells to revert them to an earlier state of development. Over the past decade, more than 300,000 scientific papers about aging have been published, while billions of dollars have been funneled into more than 700 longevity startups, including Altos Labs, Human Longevity, Elysium Health, and Calico.

    One of the most promising avenues of research involves the discovery of chemical compounds that can mimic the effects of a low-calorie diet, which is recognized as one of most well-established ways to slow down aging. One such compound is rapamycin, first discovered on the soil of Easter Island, due to its antifungal properties. “Later they found out that it was also a potent antitumor and anti-inflammatory,” Ramakrishnan says. “It’s also immunosuppressant, so it can also make people prone to infection and slow down wound healing. We need to find that sweet spot between not having the side effects and having just the [anti-aging] benefits.”

    Longevity researchers are also familiar with a body of research that shows that young blood can rejuvenate old bodies—in mice, at least. This discovery came about when researchers first surgically connected the circulatory system of a young and old mouse—a technique called parabiosis—and observed that this procedure slowed down the symptoms of aging, lengthening the lifespan of the older animal by 10 percent. Ramakrishnan notes that while scientists are still trying to identify the factors in young blood that cause this effect, “there are companies that jumped the gun and started offering young plasma to billionaires.”

    “While we’re waiting for all these things to happen there are things we can do.” Ramakrishnan notes. “This is likely similar to the advice your grandparents gave you. Eat moderately, eat healthy diets, get enough sleep and exercise. It turns out that each of those affects the other two so it’s really a virtuous cycle. If you do all of them at once, it works better than any medicine on the market, it has no side effects, and it’s free.”

    This article appears in the July/August 2024 issue of WIRED UK magazine.

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    João Medeiros

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  • Meet the 102-year-old healthy-living pioneer who was espousing ‘wellness’ long before it was a trend

    Meet the 102-year-old healthy-living pioneer who was espousing ‘wellness’ long before it was a trend

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    Oprah Winfrey, Madonna, Kate Winslet, Jane Fonda, and Bill Moyers have all stayed at the famous Rancho la Puerta wellness resort and spa, an exquisite collection of mountain-edged casitas, pavilions, pools, and gardens on 4,000 acres in Baja California, Mexico. 

    But the property’s biggest star is Deborah Szkeley, who co-founded the ranch with her husband in 1940, and now—at 102 years old—is the embodiment of all the property aspires to deliver: health, longevity, and peace of mind.  

    “The morning I turned 100, I lay in bed and thought, ‘Huh, I’m 100. What’s different?’ I couldn’t think of anything,” Szekely tells Fortune, sitting down recently for an interview in her hotel suite in New York City, where she had flown in from her home in San Diego to speak at two different wellness conferences. “I’ve had a lovely life and when it ends, it ends. But I enjoy it,” she says. “I really, truly don’t take on worries that I cannot do anything about. Otherwise I’d be an old lady! But where I can do something, I do something.”

    The Brooklyn native has accomplished a dizzying amount in her life, including starting and running Rancho la Puerta and also the Golden Door, a luxe Japanese spa and resort in San Diego (which she sold in 1998). At 60 she ran for Congress and served as president of the Inter-American Foundation; at 80, she realized a long-held dream and founded the New Americans Museum and Immigration Learning Center in San Diego.

    All are extensions of her formative years, rooted in values such as healthy living, vegetarianism, and sustainability as put forth by her mother, a Jewish Austrian immigrant and “health nut” who was an RN and the vice president of the New York Vegetarian Society who put her family on an all-fruit diet. In 1934, she made a bold decision that changed their lives forever.

    “It was the Depression. And my dad was very depressed,” recalls Szkeley, née Shainman, who was 12 when her mother caught him examining his life insurance policy, and feared his suicide.

    “One day my mom came to dinner and she said, ‘We’re leaving in 16 days.’ And my brother and I and my dad looked at her, and my dad said, ‘Where to?’ ‘Tahiti.’ And we said, ‘Where is that?’ and she said, ‘I don’t know. But here are the tickets.’” She had chosen the destination because of its fresh air and fresh fruits—both in short supply in New York during the Depression—and soon they all boarded a steamship, spending several weeks traveling by sea to their new home.

    “And from then on, we had a different kind of a life,” the centenarian says, adding that she remembers “a lot” from the few years they spent in Tahiti, living a rustic lifestyle in a grass hut, and that she still “thinks in French much of the time” because of her schooling from that time.

    While there, the family met another health-minded transplant: Edmond Szkeley, aka “the professor,” a Romanian immigrant and burgeoning health guru known for his writings and lectures on philosophy and ancient religions, exercise, and the value of fresh organic vegetables. They all eventually returned to the U.S., and Deborah’s family attended his summer “health camps.” That’s when Deborah decided to work for him and when she and Edmond fell in love. They married when he was 34 and she was just 17.

    “I did it as a way of getting out,” she explains. “He was head of the British International Health and Education Society, and he was going to England. And I thought, ‘I will go to England, and if it works out, fine. If not, I’m free. I can go to France.’ And it worked out. So I stayed.”

    Founding Rancho la Puerta

    The new couple, in search of a place to create a health camp together, found their way to Baja, in part as a way for Edmond to sidestep the fact that he had no immigration papers allowing him to stay in the U.S. There, they settled on a vast piece of land at the foothills of Mount Kuchumaa, writing to friends with invitations to come and stay on the land.

    “For $17.50 a week,” she says, “it was bring-your-own-tent.” It took off, she adds, as “my husband was well-known.” 

    They created their own permanent tents, soon replaced with cabanas built from surplus army packing crates, and then added vegetable gardens, exercise classes, a dining hall with mostly raw vegan food (today the menu is pescatarian), and a printing press for Edmond’s books. Advertising in Los Angeles brought in the Hollywood crowd—as it did to the Golden Door, which Deborah created in 1958 after traveling to Japan a dozen times in one year for inspiration.

    The couple had two children, and today her daughter, Sarah Livia Brightwood, who has had thousands of trees planted on the property, runs the resort.

    “She’s the boss,” says Deborah. “She makes the decisions … I don’t interfere.” (One of her grandsons—a professional surfer—is on the board; the other is a recent high-honors graduate of University of Southern California.) 

    Today Rancho la Puerta, which she calls “the ranch,” is “a small town” with 400 employees. It charges guests $5,100 and up per person for weeklong packages and is replete with 20 full-time fitness instructors, 11 gyms, a cooking school, an organic farm, three spa treatment centers, programs including group hikes and workshops, and peaceful nature trails for walking—with not a single golf cart in sight. Of its 10,000 acres, only about 300 are actively used by guests, which is part of a conscious effort towards keeping the footprint as small as possible.

    “We do not grow,” says Deborah. “We’re smaller than we were, by design.”

    Deborah is at the property three days a week and still holds weekly Q&A sessions with her guests to an always-packed house, often fielding questions about how she’s managed to live such a long and healthy life. People want to know what kind of water she drinks—a question that makes her laugh—and what her skincare routine is, to which she replies, “Soap and water.” As she tells Fortune, “Those are not my occupations. The fact that I don’t worry is more important than the water. I really have accepted what I can do and can’t do.”

    But really: What’s her secret?

    Her healthy lifestyle—including having never eaten red meat and still walking a mile a day even after twice breaking a hip (she now uses a wheeled walker)—has certainly been a contributing factor to her longevity. But Deborah knows it’s not everything: Her father lived to 81, but her mother died of cancer in her 60s. Edmond died in his ’70s (after they had separated), albeit due to his refusal to have surgery on an umbilical hernia. “He died from a strangulated hernia, as soon as he went to the hospital,” she says. She’s outlived her brother. And then there was the greatest loss of her life: the death of her son (which she declines to go into detail about). 

    But when it comes to having outlasted so many people, Deborah says, “I don’t think about it. You just accept.” 

    She tends to have much younger friends, which helps. “I’ve always had friends that are younger—because of the conversation, the theater, the plays we go to see, the activities we do, you know? They’re in their 40s,” she says. “It’s fun.”

    Her advice to others seeking longevity is to keep both body and mind active—and to read a lot, as she does, favoring ninth-century Japanese mysteries. “I like Buddhism,” she says. “I call myself a Jewish Zen Buddhist.”

    But an active mind, for Deborah, does not include rumination.  

    “The thing is I do not allow negative thoughts. We are in control. And we can say, ‘I don’t want to go there.’ You just don’t go. I don’t,” she says. “I mean, the world is a terrible place and there’s terrible things happening all the time … But I’m trying to help as many people as I can to live healthier lives.”

    More on aging well:

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    Beth Greenfield

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  • What women should know about Medicare coverage for health screenings and exams

    What women should know about Medicare coverage for health screenings and exams

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    As women get older, our risk for certain chronic diseases increase. We can thank the aging process itself, and the loss of estrogen’s protective effects after menopause. Older women are more prone to conditions like osteoporosis, which can cause brittle bones. The chance of heart disease rises, as do the odds of developing dementia, in part because women tend to live longer than men, and risk increases with age.

    Diagnosing some conditions is more challenging, since the frequency, appearance and long term effects of many diseases often appear differently in women than in men. It’s a key reason not to neglect regular health screenings and wellness visits, since staying healthier through preventive care and screenings can make the health challenges of aging easier.

    Wellness exams are critical for older women

    Medicare pays for annual preventive care with no co-pay. That’s especially relevant for women, who made up more than half (55%) of all Medicare beneficiaries in 2021. Nearly 1 in 8 (12%) were 85 or older; many had functional difficulties, an analysis from KFF found. That included difficulty walking, bathing, vision loss, or other issues that significantly impacted their quality of life. People age 85 and older tend to have five or more chronic conditions, which can become more complicated to manage with age.

    Women know they should focus on their health, says Alina Salganicoff, director of women’s health policy at KFF. But, “sometimes the system is not set up for women to take care of themselves, because they have competing demands, like work, or family caregiving responsibilities.” This often creates limited windows of time for women to prioritize themselves.

    And, if women don’t have access to a primary care provider or don’t receive regular care, they could skip important preventive measures like mammograms, she says.

    “Having coverage is the first step, but many other factors affect whether women get the services they need,” Salganicoff says. That includes their relationships with their clinicians, their own prior experiences, access to care, fears about conditions like dementia or cancer, or social supports like transportation, mobility or cognitive issues, or having someone to accompany them.

    That first wellness visit is probably key to everything else in managing an older patient, according to Segen Chase, an internal medicine physician in private practice in Manhattan, Kansas. About 35% of her clinic’s patients are Medicare beneficiaries, including many who live at a nearby retirement community.

    “It’s so important that we will do anything we can to have them visit and work with the practice’s wellness coordinator to go through all of the needed assessments,” said Chase, who is part of the American Medical Women’s WEL leadership training program.

    Wellness exams include annual tracking of numerous behavioral and physical markers like vision, hearing, fall risk, sexual health, nutrition, alcohol and tobacco use, as well as psychosocial risks like depression, stress, loneliness or social isolation, pain, and fatigue. Patients also undergo cognitive screening, which can reveal subtle changes in brain health.

    Wellness screenings may also include questions about someone’s living situation, because it helps us to determine whether they might need additional help at home, Chase says. “That also gives us an opportunity to discuss advance care planning, when they’re not in a crisis situation.” Medicare pays for this as part of the Part B annual wellness visit.

    Women with Medicare overall experience higher rates of certain health conditions compared to men, according to the KFF analysis. Urinary incontinence (37% vs. 18%), depression (31% vs. 21%), osteoporosis (29% vs. 7%), and pulmonary disease (20% vs. 16%) were more common among women than men. Women are also more likely than men to live alone. More than one-third of all women with Medicare (36%) live by themselves and more than half of those 85 and older live solo. This can increase the odds of  loneliness and social isolation, which are connected to increased risk of depression, dementia and stroke, according to the American Medical Association.

    The wellness visit can help uncover some of the hidden issues, and together, the physician and patient can create a care plan to manage these and other chronic conditions, Chase says.

    Which preventive women’s health services does Medicare cover?

    Medicare Part B covers a range of preventive services that benefit women’s health, including:

    There are no copays, deductibles or coinsurance charges for these and other covered screenings, although certain other criteria may apply, according to the Medicare Rights Center. Medicare Part A (hospital insurance) and Medicare Part B (medical insurance) will even help pay for an osteoporosis injectable drug and visits by a home health nurse to inject the drug if you are eligible.

    This partial list of Medicare-covered screenings may seem daunting, which is why it’s so important for women to speak with their clinicians and discuss their health history, risk factors, and priorities, according to Salganicoff. “It’s a complicated program and can be difficult for people to navigate,” she says.

    These shouldn’t be one-off conversations, either, Chase says. As we age, priorities and what is realistic for a person to achieve may shift. So ongoing dialogue is a key to maintaining health.

    We know certain conditions show up differently in women, so “a lot of medicine comes back to communication, keeping the sanctity of the relationship while honoring their independence and finding out what’s most important to that person,” she says. Chase finds these discussions help women open up more about both their physical and emotional challenges, especially those who are caregivers. “They’re often exhausted but don’t want to admit it.”

    Providing women with clear, simple information so they can learn about all of their Medicare benefits and receive the necessary support to get the preventive care and other needed services, can go a long way towards keeping women healthy well into older age.

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    Liz Seegert

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