Alzheimer’s: The Bad News And The Good

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Dr. Devi’s Spectrum of Hope

This is Dr. Gayatri Devi. She’s a neurologist, board-certified in neurology, pain medicine, psychiatry, brain injury medicine, and behavioral neurology.

She’s also a Clinical Professor of Neurology, and Director of Long Island Alzheimer’s Disease Center, Fellow of the American Academy of Neurology, and we could continue all day with her qualifications, awards and achievements but then we’d run out of space. Suffice it to say, she knows her stuff.

Especially when it comes to the optimal treatment of stroke, cognitive loss, and pain.

In her own words:

❝Helping folks live their best lives—by diagnosing and managing complex neurologic disorders—that’s my job. Few things are more fulfilling! For nearly thirty years, my focus has been on brain health, concussions, Alzheimer’s and other dementias, menopause related memory loss, and pain.❞

~ Dr. Gayatri Devi

Alzheimer’s is more common than you might think

According to Dr. Devi,

❝97% of patients with mild Alzheimer’s disease don’t even get diagnosed in their internist offices, and half of patients with moderate Alzheimer’s don’t get diagnosed.

What that means is that the percentage of people that we think about when we think about Alzheimer’s—the people in the nursing home—that’s a very, very small fraction of the entirety of the people who have the condition❞

~ Dr. Gaytatri Devi

As for what she would consider the real figures, she puts it nearer 1 in 10 adults aged 65 and older.

Source: Neurologist dispels myths about Alzheimer’s disease

Her most critical advice? Reallocate your worry.

A lot of people understandably worry about a genetic predisposition to Alzheimer’s, especially if an older relative died that way.

See also: Alzheimer’s, Genes, & You

However, Dr. Devi points out that under 5% of Alzheimer’s cases are from genetics, and the majority of Alzheimer’s cases can be prevented be lifestyle interventions.

See also: Reduce Your Alzheimer’s Risk

Lastly, she wants us to skip the stigma

Outside of her clinical practice and academic work, this is one of the biggest things she works on, reducing the stigma attached to Alzheimer’s both publicly and professionally:

Alzheimer’s Disease in Physicians: Assessing Professional Competence and Tempering Stigma

Want more from Dr. Devi?

You might enjoy this interview:

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And here’s her book:

The Spectrum of Hope: An Optimistic and New Approach to Alzheimer’s Disease and Other Dementias – by Dr. Gayatri Devi

Enjoy!

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  • The Sleep Solution – by Dr. Chris Winter

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    This book’s blurb contains a bold claim:

    ❝If you want to fix your sleep problems, Internet tips and tricks aren’t going to do it for you. You need to really understand what’s going on with your sleep—both what your problems are and how to solve them.❞

    So, how well does it deliver, on the strength of being a whole book rather than an Internet article?

    Well, for sure we wouldn’t have the room to include all the information that Dr. Winter does, in one of our main feature articles here (we’d need to spread it out over several weeks, at least).

    He examines very thoroughly what is going on with sleep, sleep disturbance, and sleep deprivation. What’s going on with the different phases of sleep (far more than your phone’s sleep app will), and how imbalances in these can cause problems.

    While the usual sleep hygiene tips do get a mention, he broadly assumes we know that part already. Instead, he focuses on aligning as many components as possible of our rich and interesting circadian rhythm. Yes, even if that means clawing our way out of insomnia and/or a bad sleep schedule (or lack of coherent sleep schedule) first. He gives plenty of practical advice on how to do that.

    Bottom line: if you’d like to more deeply understand sleep, what is or isn’t wrong with yours, and how you can fix it, this book is a great resource.

    Click here to check out The Sleep Solution, and enjoy the benefits of better rest!

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  • How To Leverage Attachment Theory In Your Relationship

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    How To Leverage Attachment Theory In Your Relationship

    Attachment theory has come to be seen in “kids nowadays”’ TikTok circles as almost a sort of astrology, but that’s not what it was intended for, and there’s really nothing esoteric about it.

    What it can be, is a (fairly simple, but) powerful tool to understand about our relationships with each other.

    To demystify it, let’s start with a little history…

    Attachment theory was conceived by developmental psychologist Mary Ainsworth, and popularized as a theory bypsychiatrist John Bowlby. The two would later become research partners.

    • Dr. Ainsworth’s initial work focused on children having different attachment styles when it came to their caregivers: secure, avoidant, or anxious.
    • Later, she would add a fourth attachment style: disorganized, and then subdivisions, such as anxious-avoidant and dismissive-avoidant.
    • Much later, the theory would be extended to attachments in (and between) adults.

    What does it all mean?

    To understand this, we must first talk about “The Strange Situation”.

    “The Strange Situation” was an experiment conducted by Dr. Ainsworth, in which a child would be observed playing, while caregivers and strangers would periodically arrive and leave, recreating a natural environment of most children’s lives. Each child’s different reactions were recorded, especially noting:

    • The child’s reaction (if any) to their caregiver’s departure
    • The child’s reaction (if any) to the stranger’s presence
    • The child’s reaction (if any) to their caregiver’s return
    • The child’s behavior on play, specifically, how much or little the child explored and played with new toys

    She observed different attachment styles, including:

    1. Secure: a securely attached child would play freely, using the caregiver as a secure base from which to explore. Will engage with the stranger when the caregiver is also present. May become upset when the caregiver leaves, and happy when they return.
    2. Avoidant: an avoidantly attached child will not explore much regardless of who is there; will not care much when the caregiver departs or returns.
    3. Anxious: an anxiously attached child may be clingy before separation, helplessly passive when the caregiver is absent, and difficult to comfort upon the caregiver’s return.
    4. Disorganized: a disorganizedly attached child may flit between the above types

    These attachment styles were generally reflective of the parenting styles of the respective caregivers:

    1. If a caregiver was reliably present (physically and emotionally), the child would learn to expect that and feel secure about it.
    2. If a caregiver was absent a lot (physically and/or emotionally), the child would learn to give up on expecting a caregiver to give care.
    3. If a caregiver was unpredictable a lot in presence (physical and/or emotional), the child would become anxious and/or confused about whether the caregiver would give care.

    What does this mean for us as adults?

    As we learn when we are children, tends to go for us in life. We can change, but we usually don’t. And while we (usually) no longer rely on caregivers per se as adults, we do rely (or not!) on our partners, friends, and so forth. Let’s look at it in terms of partners:

    1. A securely attached adult will trust that their partner loves them and will be there for them if necessary. They may miss their partner when absent, but won’t be anxious about it and will look forward to their return.
    2. An avoidantly attached adult will not assume their partner’s love, and will feel their partner might let them down at any time. To protect themself, they may try to manage their own expectations, and strive always to keep their independence, to make sure that if the worst happens, they’ll still be ok by themself.
    3. An anxiously attached adult will tend towards clinginess, and try to keep their partner’s attention and commitment by any means necessary.

    Which means…

    • When both partners have secure attachment styles, most things go swimmingly, and indeed, securely attached partners most often end up with each other.
    • A very common pairing, however, is one anxious partner dating one avoidant partner. This happens because the avoidant partner looks like a tower of strength, which the anxious partner needs. The anxious partner’s clinginess can also help the avoidant partner feel better about themself (bearing in mind, the avoidant partner almost certainly grew up feeling deeply unwanted).
    • Anxious-anxious pairings happen less because anxiously attached people don’t tend to be attracted to people who are in the same boat.
    • Avoidant-avoidant pairings happen least of all, because avoidantly attached people having nothing to bind them together. Iff they even get together in the first place, then later when trouble hits, one will propose breaking up, and the other will say “ok, bye”.

    This is fascinating, but is there a practical use for this knowledge?

    Yes! Understanding our own attachment styles, and those around us, helps us understand why we/they act a certain way, and realize what relational need is or isn’t being met, and react accordingly.

    That sometimes, an anxiously attached person just needs some reassurance:

    • “I love you”
    • “I miss you”
    • “I look forward to seeing you later”

    That sometimes, an avoidantly attached person needs exactly the right amount of space:

    • Give them too little space, and they will feel their independence slipping, and yearn to break free
    • Give them too much space, and oops, they’re gone now

    Maybe you’re reading that and thinking “won’t that make their anxious partner anxious?” and yes, yes it will. That’s why the avoidant partner needs to skip back up and remember to do the reassurance.

    It helps also when either partner is going to be away (physically or emotionally! This counts the same for if a partner will just be preoccupied for a while), that they parameter that, for example:

    • Not: “Don’t worry, I just need some space for now, that’s all” (à la “I am just going outside and may be some time“)
    • But: “I need to be undisturbed for a bit, but let’s schedule some me-and-you-time for [specific scheduled time]”.

    Want to learn more about addressing attachment issues?

    Psychology Today: Ten Ways to Heal Your Attachment Issues

    You also might enjoy such articles such as:

    Lastly, to end on a light note…

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  • The Wandering Mind – by Dr. Michael Corballis

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Our mind’s tendency to wander can be a disability, but could it also be a superpower? Dr. Corballis makes the case for such.

    While many authors focus on, well, how to focus, Dr. Corballis argues in this book that our wandering imagination can be more effective at problem-solving and creative tasks, than a focused, blinkered mind.

    The book’s a quick read (184 pages of quite light reading), and yet still quite dense with content. He takes us on a tour of the brain, theory of mind, the Default Mode Network (where a lot of the brain’s general ongoing organization occurs), learning, memory, forgetting, and creativity.

    Furthermore, he cites (and explains) studies showing what kinds of “breaks” from mental work allow the wandering mind to do its thing at peak efficiency, and what kinds of breaks are counterproductive. Certainly this has practical applications for all of us!

    Bottom line: if you’d like to be less frustrated by your mind’s tendency to wander, this is a fine book to show how to leverage that trait to your benefit.

    Click here to check out The Wandering Mind, and set yours onto more useful tracks!

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Related Posts

  • The Snooze-Button Controversy
  • The Bitter Truth About Coffee (or is it?)

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    The Bitter Truth About Coffee (or is it?)

    Yesterday, we asked you for your (health-related) views on coffee. The results were clear: if we assume the responses to be representative, we’re a large group of coffee-enthusiasts!

    One subscriber who voted for “Coffee is a healthy stimulant, hydrating, and full of antioxidants” wrote:

    ❝Not so sure about how hydrating it is! Like most food and drink, moderation is key. More than 2 or 3 cups make me buzz! Just too much.❞

    And that fine point brings us to our first potential myth:

    Coffee is dehydrating: True or False?

    False. With caveats…

    Coffee, in whatever form we drink it, is wet. This may not come as a startling revelation, but it’s an important starting point. It’s mostly water. Water itself is not dehydrating.

    Caffeine, however, is a diuretic—meaning you will tend to pee more. It achieves its diuretic effect by increasing blood flow to your kidneys, which prompts them to release more water through urination.

    See: Effect of caffeine on bladder function in patients with overactive bladder symptoms

    How much caffeine is required to have a diuretic effect? About 4.5 mg/kg.

    What this means in practical terms: if you weigh 70kg (a little over 150lbs), 4.5×70 gives us 315.

    315mg is about how much caffeine might be in six shots of espresso. We say “might” because while dosage calculations are an exact science, the actual amount in your shot of espresso can vary depending on many factors, including:

    • The kind of coffee bean
    • How and when it was roasted
    • How and when it was ground
    • The water used to make the espresso
    • The pressure and temperature of the water

    …and that’s all without looking at the most obvious factor: “is the coffee decaffeinated?”

    If it doesn’t contain caffeine, it’s not diuretic. Decaffeinated coffee does usually contain tiny amounts of caffeine still, but with nearer 3mg than 300mg, it’s orders of magnitude away from having a diuretic effect.

    If it does contain caffeine, then the next question becomes: “and how much water?”

    For example, an Americano (espresso, with hot water added to make it a long drink) will be more hydrating than a ristretto (espresso, stopped halfway through pushing, meaning it is shorter and stronger than a normal espresso).

    A subscriber who voted for “Coffee messes with sleep, creates dependency, is bad for the heart and gut, and is dehydrating too” wrote:

    ❝Coffee causes tachycardia for me so staying away is best. People with colon cancer are urged to stay away from coffee completely.❞

    These are great points! It brings us to our next potential myth:

    Coffee is bad for the heart: True or False?

    False… For most people.

    Some people, like our subscriber above, have an adverse reaction to caffeine, such as tachycardia. An important reason (beyond basic decency) for anyone providing coffee to honor requests for decaff.

    For most people, caffeine is “heart neutral”. It doesn’t provide direct benefits or cause direct harm, provided it is enjoyed in moderation.

    See also: Can you overdose on caffeine?

    Some quick extra notes…

    That’s all we have time for in myth-busting, but it’s worth noting before we close that coffee has a lot of health benefits; we didn’t cover them today because they’re not contentious, but they are interesting nevertheless:

    Enjoy!

    Don’t Forget…

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    Learn to Age Gracefully

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  • Taurine: An Anti-Aging Powerhouse? Exploring Its Unexpected Benefits

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Dr. Mark Rosenberg explains:

    Not a stimulant, but…

    • Its presence in energy drinks often causes people to assume it’s a stimulant, but it’s not. In fact, it’s a GABA-agonist, thus having a calming effect.
    • The real reason it’s in energy drinks is because it helps increase mitochondrial ATP production (ATP = adenosine triphosphate = how cells store energy that’s ready to use; mitochondria take glucose and make ATP)
    • Taurine is also anti-inflammatory, antioxidant, and anticancer.
    • In the category of aging, human studies are slow to give results for obvious reasons, but mouse studies show that supplementing taurine in middle-aged mice increased their lifespan by 10–12%, as well as improving various physiological markers of aging.
    • Taking a closer look at aging—literally; looking at cellular aging—taurine reduces cellular senescence and protects telomeres, thus decreasing DNA mutations.

    For more on the science of these, plus Dr. Rosenberg’s personal experience, enjoy:

    Click Here If The Embedded Video Doesn’t Load Automatically!

    Want to learn more?

    You might also like to read:

    Take care!

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  • Pistachios vs Pine Nuts – Which is Healthier?

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Our Verdict

    When comparing pistachios to pine nuts, we picked the pistachios.

    Why?

    First looking at the macros, pistachios have nearly 2x the protein while pine nuts have nearly 2x the fat. The fats are healthy in moderation (mostly polyunsaturated, a fair portion of monounsaturated, and a little saturated), but we’re going to value the protein content higher. Also, pistachios have approximately 2x the carbs, and/but nearly 3x the fiber. All in all, we’ll call this section a moderate win for pistachios.

    When it comes to vitamins, pistachios have more of vitamins A, B1, B5, B6, B9, and C, while pine nuts have more of vitamins B2, B3, E, K, and choline. All in all, pistachios are scraping a 6:5 win here, or we could call it a tie if we want to value pine nuts’ vitamins more (due to the difference in how many foods each vitamin is found in, and thus the likelihood of having a deficiency or not).

    In the category of minerals, pistachios have more calcium, copper, potassium, and selenium, while pine nuts have more iron, magnesium, manganese, and zinc. This would be a tie if we just call it 4:4, but what’s worth noting is that while both of these nuts are a good source of most of the minerals mentioned, pine nuts aren’t a very good source of calcium or selenium, so we’re going to declare this section a very marginal win for pistachios.

    Adding up the moderate win, the scraped win, and the barely scraped win, all adds up to a win for pistachios. However, as you might have noticed, both are great so do enjoy both if you can!

    Want to learn more?

    You might like to read:

    Why You Should Diversify Your Nuts

    Take care!

    Don’t Forget…

    Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!

    Learn to Age Gracefully

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