14 Powerful Strategies To Prevent Dementia
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Dementia risk starts climbing very steeply after the age of 65, but it’s not entirely predetermined. Dr. Brad Stanfield, a primary care physician, has insights:
The strategies
We’ll not keep them a mystery; they are:
- Cognitive stimulation: which means genuinely challenging mental activities using a variety of mental faculties. This will usually mean that anything that is just “same old, same old” all the time will stop giving benefits after a short while once it becomes rote, and you’ll need something harder and/or different.
- Hearing health: being unable to participate in conversations increases dementia risk; hearing aids can help.
- Eyesight health: similar to the above; regular eye tests are good, and the use of glasses where appropriate.
- Depression management: midlife depression is linked to later life dementia, likely in large part due to social isolation and a lack of stimulation, but either way, treating depression earlier reduces later dementia risk.
- Exercising regularly: what’s good for the heart is good for the brain; the brain is a hungry organ and the blood is what feeds it (and removes things that shouldn’t be there)
- Head injury avoidance: even mild head injuries can cause problems down the road. Protecting one’s head in sports, and even while casually cycling, is important.
- Smoking cessation: just don’t smoke; if you smoke, make it a top priority to quit unless you are given direct strong medical advice to the contrary (there are cases, few and far between, whereby quitting smoking genuinely needs to be deferred until after something else is dealt with first, but they are a lot rarer than a lot of people who are simply afraid of quitting would like to believe)
- Cholesterol management: again, healthy blood means a healthy brain, and that goes for triglycerides too.
- Weight management: obesity, especially waist to hip ratio (indicating visceral abdominal fat specifically) is associated with many woes, including dementia.
- Diabetes management: once again, healthy blood means a healthy brain, and that goes for blood sugar management too.
- Blood pressure management: guess what, healthy blood still means a healthy brain, and that goes for blood pressure too.
- Alcohol reduction/cessation: alcohol is bad for pretty much everything, and for most people who drink, quitting is probably the top thing to do after quitting smoking.
- Social engagement: while we all may have our different preferences on a scale of introversion to extroversion, we are fundamentally a social species and thrive best with social contact, even if it’s just a few people.
- Air pollution reduction: avoiding pollutants, and filtering the air we breathe where pollutants are otherwise unavoidable, makes a measurable difference to brain health outcomes.
For more information on all of these (except the last two, which really he only mentions in passing), enjoy:
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Want to learn more?
You might also like to read:
How To Reduce Your Alzheimer’s Risk ← our own main feature on the topic
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America Worries About Health Costs — And Voters Want to Hear From Biden and Republicans
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President Joe Biden is counting on outrage over abortion restrictions to help drive turnout for his reelection. Former President Donald Trump is promising to take another swing at repealing Obamacare.
But around America’s kitchen tables, those are hardly the only health topics voters want to hear about in the 2024 campaigns. A new KFF tracking poll shows that health care tops the list of basic expenses Americans worry about — more than gas, food, and rent. Nearly 3 in 4 adults — and majorities of both parties — say they’re concerned about paying for unexpected medical bills and other health costs.
“Absolutely health care is something on my mind,” Rob Werner, 64, of Concord, New Hampshire, said in an interview at a local coffee shop in January. He’s a Biden supporter and said he wants to make sure the Affordable Care Act, also known as Obamacare, is retained and that there’s more of an effort to control health care costs.
The presidential election is likely to turn on the simple question of whether Americans want Trump back in the White House. (Nikki Haley, the former South Carolina governor and U.S. ambassador to the United Nations, remained in the race for the Republican nomination ahead of Super Tuesday, though she had lost the first four primary contests.) And neither major party is basing their campaigns on health care promises.
But in the KFF poll, 80% of adults said they think it’s “very important” to hear presidential candidates talk about what they’d do to address health care costs — a subject congressional and state-level candidates can also expect to address.
“People are most concerned about out-of-pocket expenses for health care, and rightly so,” said Andrea Ducas, vice president of health policy at the Center for American Progress, a Washington, D.C.-based progressive think tank.
Here’s a look at the major health care issues that could help determine who wins in November.
Abortion
Less than two years after the Supreme Court overturned the constitutional right to an abortion, it is shaping up to be the biggest health issue in this election.
That was also the case in the 2022 midterm elections, when many voters rallied behind candidates who supported abortion rights and bolstered Democrats to an unexpectedly strong showing. Since the Supreme Court’s decision, voters in six states — including Kansas, Kentucky, and Ohio, where Republicans control the legislatures — have approved state constitutional amendments protecting abortion access.
Polls show that abortion is a key issue to some voters, said Robert Blendon, a public opinion researcher and professor emeritus at the Harvard T.H. Chan School of Public Health. He said up to 30% across the board see it as a “personal” issue, rather than policy — and most of those support abortion rights.
“That’s a lot of voters, if they show up and vote,” Blendon said.
Proposals to further protect — or restrict — abortion access could drive voter turnout. Advocates are working to put abortion-related measures on the ballot in such states as Arizona, Florida, Missouri, and South Dakota this November. A push in Washington toward a nationwide abortion policy could also draw more voters to the polls, Blendon said.
A surprise ruling by the Alabama Supreme Court in February that frozen embryos are children could also shake up the election. It’s an issue that divides even the anti-abortion community, with some who believe that a fertilized egg is a unique new person deserving of full legal rights and protections, and others believing that discarding unused embryos as part of the in vitro fertilization process is a morally acceptable way for couples to have children.
Pricey Prescriptions
Drug costs regularly rank high among voters’ concerns.
In the latest tracking poll, more than half — 55% — said they were very worried about being able to afford prescription drugs.
Biden has tried to address the price of drugs, though his efforts haven’t registered with many voters. While its name doesn’t suggest landmark health policy, the Inflation Reduction Act, or IRA, which the president signed in August 2022, included a provision allowing Medicare to negotiate prices for some of the most expensive drugs. It also capped total out-of-pocket spending for prescription drugs for all Medicare patients, while capping the price of insulin for those with diabetes at $35 a month — a limit some drugmakers have extended to patients with other kinds of insurance.
Drugmakers are fighting the Medicare price negotiation provision in court. Republicans have promised to repeal the IRA, arguing that forcing drugmakers to negotiate lower prices on drugs for Medicare beneficiaries would amount to price controls and stifle innovation. The party has offered no specific alternative, with the GOP-led House focused primarily on targeting pharmacy benefit managers, the arbitrators who control most Americans’ insurance coverage for medicines.
Costs of Coverage
Health care costs continue to rise for many Americans. The cost of employer-sponsored health plans have hit new highs in the past few months, raising costs for employers and workers alike. Experts have attributed the increase to high demand and expensive prices for certain drugs and treatments, notably weight loss drugs, as well as to medical inflation.
Meanwhile, the ACA is popular. The KFF poll found that more adults want to see the program expanded than scaled back. And a record 21.3 million people signed up for coverage in 2024, about 5 million of them new customers.
Enrollment in Republican-dominated states has grown fastest, with year-over-year increases of 80% in West Virginia, nearly 76% in Louisiana, and 62% in Ohio, according to the Centers for Medicare & Medicaid Services.
Public support for Obamacare and record enrollment in its coverage have made it politically perilous for Republicans to pursue the law’s repeal, especially without a robust alternative. That hasn’t stopped Trump from raising that prospect on the campaign trail, though it’s hard to find any other Republican candidate willing to step out on the same limb.
“The more he talks about it, the more other candidates have to start answering for it,” said Jarrett Lewis, a partner at Public Opinion Strategies, a GOP polling firm.
“Will a conversation about repeal-and-replace resonate with suburban women in Maricopa County?” he said, referring to the populous county in Arizona known for being a political bellwether. “I would steer clear of that if I was a candidate.”
Biden and his campaign have pounced on Trump’s talk of repeal. The president has said he wants to make permanent the enhanced premium subsidies he signed into law during the pandemic that are credited with helping to increase enrollment.
Republican advisers generally recommend that their candidates promote “a market-based system that has the consumer much more engaged,” said Lewis, citing short-term insurance plans as an example. “In the minds of Republicans, there is a pool of people that this would benefit. It may not be beneficial for everyone, but attractive to some.”
Biden and his allies have criticized short-term insurance plans — which Trump made more widely available — as “junk insurance” that doesn’t cover care for serious conditions or illnesses.
Entitlements Are Off-Limits
Both Medicaid and Medicare, the government health insurance programs that cover tens of millions of low-income, disabled, and older people, remain broadly popular with voters, said the Democratic pollster Celinda Lake. That makes it unlikely either party would pursue a platform that includes outright cuts to entitlements. But accusing an opponent of wanting to slash Medicare is a common, and often effective, campaign move.
Although Trump has said he wouldn’t cut Medicare spending, Democrats will likely seek to associate him with other Republicans who support constraining the program’s costs. Polls show that most voters oppose reducing any Medicare benefits, including by raising Medicare’s eligibility age from 65. However, raising taxes on people making more than $400,000 a year to shore up Medicare’s finances is one idea that won strong backing in a recent poll by The Associated Press and NORC Center for Public Affairs Research.
Brian Blase, a former Trump health adviser and the president of Paragon Health Institute, said Republicans, if they win more control of the federal government, should seek to lower spending on Medicare Advantage — through which commercial insurers provide benefits — to build on the program’s efficiencies and ensure it costs taxpayers less than the traditional program.
So far, though, Republicans, including Trump, have expressed little interest in such a plan. Some of them are clear-eyed about the perils of running on changing Medicare, which cost $829 billion in 2021 and is projected to consume nearly 18% of the federal budget by 2032.
“It’s difficult to have a frank conversation with voters about the future of the Medicare program,” said Lewis, the GOP pollster. “More often than not, it backfires. That conversation will have to happen right after a major election.”
Addiction Crisis
Many Americans have been touched by the growing opioid epidemic, which killed more than 112,000 people in the United States in 2023 — more than gun deaths and road fatalities combined. Rural residents and white adults are among the hardest hit.
Federal health officials have cited drug overdose deaths as a primary cause of the recent drop in U.S. life expectancy.
Republicans cast addiction as largely a criminal matter, associating it closely with the migration crisis at the U.S. southern border that they blame on Biden. Democrats have sought more funding for treatment and prevention of substance use disorders.
“This affects the family, the neighborhood,” said Blendon, the public opinion researcher.
Billions of dollars have begun to flow to states and local governments from legal settlements with opioid manufacturers and retailers, raising questions about how to best spend that money. But it isn’t clear that the crisis, outside the context of immigration, will emerge as a campaign issue.
KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.
Subscribe to KFF Health News’ free Morning Briefing.
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It’s On Me – by Dr. Sara Kuburic
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This isn’t about bootstrapping and nor is it a motivational pep talk. What it is, however, is a wake-up call for the wayward, and that doesn’t mean “disaffected youth” or such. Rather, therapist Dr. Sara Kuburic tackles the problem of self-loss.
It’s about when we get so caught up in what we need to do, should do, are expected to do, are in a rut of doing… That we forget to also live. After all, we only get one shot at life so far as we know, so we might as well live it in whatever way is right for us.
That probably doesn’t mean a life of going through the motions.
The writing style here is personal and direct, and it makes for quite compelling reading from start to finish.
Bottom line: if ever you find yourself errantly sleepwalking through life and would like to change that, this is a book for you.
Click here to check out It’s On Me, and take control of what’s yours!
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Bath vs Shower – Which is Healthier?
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Our Verdict
When comparing bathing to showering, we picked the shower.
Why?
For the basic task of getting your body clean, the shower is better as it is an entirely one-way process. Clean water hits your body, dirty water leaves it, and no dirt is making its way back.
Baths do not have this advantage, and if you enter a bath dirty, you will then be sitting in dirty water. You will leave it a lot cleaner than you entered it (because a lot of the dirt stayed in the bathwater to be drained away after the bath), but not as clean as if you had showered.
One could argue soap or equivalent will prevent the dirt re-sticking, and that’s true, but it’s true for soap in the shower too, so it doesn’t offset anything.
Additionally, being immersed in water for more than 15 minutes can start to have a (paradoxically) dehydrating effect on the skin; this happens not only because of losing skin oils to the water, but also because of osmosis, the resultant mild edema, the body’s homeostatic response to the mild edema, then getting out the bath and drying, leaving one with the response having now just caused dehydrated skin.
Baths do have some health advantages! And these come primarily from the mental health benefits of relaxation in warm water and/or generally pampering oneself. Additionally, some bath oils or bath salts can be beneficial in a way that couldn’t be administered the same way in the shower.
Best of both worlds?
In some parts of the world (Thailand and Turkey come to mind; doubtlessly there are many others) there are traditions of first taking a shower to get clean, and then taking a bath for the rest of the bathing experience. As a bonus, the bathing experience is then all the more pleasant for the water remaining just as clean as it was to start with.
However, if you do have to pick one (and for the purpose of our “This or That” exercise, we do), then it’s the shower, hands-down.
Want to read more?
You might want to also take into account how it’s still possible to have too much of a good thing:
Enjoy!
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Ruminating vs Processing
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When it comes to traumatic experiences, there are two common pieces of advice for being able to move forwards functionally:
- Process whatever thoughts and feelings you need to process
- Do not ruminate
The latter can seem, at first glance, a lot like the former. So, how to tell them apart, and how to do one without the other?
Getting tense
One major difference between the two is the tense in which our mental activity takes place:
- processing starts with the traumatic event (or perhaps even the events leading up to the traumatic event), analyses what happened and if possible why, and then asks the question “ok, what now?” and begins work on laying out a path for the future.
- rumination starts with the traumatic event (or perhaps even the events leading up to the traumatic event), analyses what happened and if why, oh why oh why, “I was such an idiot, if only I had…” and gets trapped in a fairly tight (and destructive*) cycle of blame and shame/anger, never straying far from the events in question.
*this may be directly self-destructive, but it can also sometimes be only indirectly self-destructive, for example if the blame and anger is consciously placed with someone else.
This idea fits in, by the way, with Dr. Elisabeth Kübler-Ross’s “five stages of grief” model; rumination here represents the stages “bargaining”, “despair”, and “anger”, while emotional processing here represents the stage “acceptance”. Thus, it may be that rumination does have a place in the overall process—just don’t get stuck there!
For more on healthily processing grief specifically:
What Grief Does To The Body (And How To Manage It)
Grief, by the way, can be about more than the loss of a loved one; a very similar process can play out with many other kinds of unwanted life changes too.
What are the results?
Another way to tell them apart is to look at the results of each. If you come out of a long rumination session feeling worse than when you started, it’s highly unlikely that you just stopped too soon and were on the verge of some great breakthrough. It’s possible! But not likely.
- Processing may be uncomfortable at first, and if it’s something you’ve ignored for a long time, that could be very uncomfortable at first, but there should quite soon be some “light at the end of the tunnel”. Perhaps not even because a solution seems near, but because your mind and body recognize “aha, we are doing something about it now, and thus may find a better way forward”.
- Rumination tends to intensify and prolong uncomfortable emotions, increases stress and anxiety, and likely disrupts sleep. At best, it may serve as a tipping point to seek therapy or even just recognize “I should figure out a way to deal with this, because this isn’t doing me any good”. At worst, it may serve as a tipping point to depression, and/or substance abuse, and/or suicidality.
See also: How To Stay Alive (When You Really Don’t Want To) ← which also has a link back to our article on managing depression, by the way!
Did you choose it, really?
A third way to tell them apart is the level of conscious decision that went into doing it.
- Processing is almost always something that one decides “ok, let’s figure this out”, and sits down to figure it out.
- Rumination tends to be about as voluntary as social media doomscrolling. Technically we may have decided to begin it (we also might not have made any conscious decision, and just acted on impulse), but let’s face it, our hands weren’t at the wheel for long, at all.
A good way to make sure that it is a conscious process, is to schedule time for it in advance, and then do it only during that time. If thoughts about it come up at other times, tell yourself “no, leave that for later”, and then deal with it when (and only when) the planned timeslot arrives.
It’s up to you and your schedule what time you pick, but if you’re unsure, consider an hour in the early evening. That means that the business of the day is behind you, but it’s also not right before bed, so you should have some decompression time as a buffer. So for example, perhaps after dinner you might set a timer* for an hour, and sit down to journal, brainstorm, or just plain think, about the matter that needs processing.
*electronic timers can be quite jarring, and may distract you while waiting for the beeps. So, consider investing in a relaxing sand timer like this one instead.
Is there any way to make rumination less bad?
As we mentioned up top, there’s a case to be made for “rumination is an early part of the process that gets us where we need to go, and may not be skippable, or may not be advisable to skip”.
So, if you are going to ruminate, then firstly, we recommend again bordering it timewise (with a timer as above) and having a plan to pull yourself out when you’re done rather than getting stuck there (such as: The Off-Button For Your Brain: How To Stop Negative Thought Spirals).
And secondly, you might want to consider the following technique, which allows one to let one’s brain know that the thing we’re thinking about / imagining is now to be filed away safely; not lost or erased, but sent to the same place that nightmares go after we wake up:
A Surprisingly Powerful Tool: Eye Movement Desensitization & Reprocessing (EMDR)
What if I actually do want to forget?
That’s not usually recommendable; consider talking it through with a therapist first. However, for your interest, there is a way:
The Dark Side Of Memory (And How To Forget)
Take care!
Don’t Forget…
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Quick Healthy Recipe Ideas
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It’s Q&A Day at 10almonds!
Have a question or a request? You can always hit “reply” to any of our emails, or use the feedback widget at the bottom!
In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!
As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!
So, no question/request too big or small
“It was superb !! Just loved that healthy recipe !!! I would love to see one of those every day, if possible !! Keep up the fabulous work !!! ”
We’re glad you enjoyed! We can’t promise a recipe every day, but here’s one just for you:
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5 ways to naturally boost the “Ozempic Effect”
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Dr. Jason Fung is perhaps most well-known for his work in functional medicine for reversing diabetes, and he’s once again giving us sound advice about metabolic hormone-hacking with dietary tweaks:
All about incretin
As you may gather from the thumbnail, this video is about incretin, a hormone group (the most well-known of which is GLP-1, as in GLP-1 agonists like semaglutide drugs such as Ozempic, Wegovy, etc) that slows down stomach emptying, which means a gentler blood sugar curve and feeling fuller for longer. It also acts on the hypothalmus, controlling appetite via the brain too (signalling fullness and reducing hunger).
Dr. Fung recommends 5 ways to increase incretin levels:
- Enjoy dietary fat: this increases incretin levels more than carbs
- Enjoy protein: again, prompts higher incretin levels of promotes satiety
- Enjoy fiber: this is more about slowing digestion, but when it’s fermented in the gut into short-chain fatty acids, those too increase incretin secretion
- Enjoy bitter foods: these don’t actually affect incretin levels, but they can bind to incretin receptors, making the body “believe” that you got more incretin (think of it like a skeleton key that fits the lock that was designed to be opened by a different key)
- Enjoy turmeric: for its curcumin content, which increases GLP-1 levels specifically
For more information on each of these, here’s Dr. Fung himself:
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Want to learn more?
You might also like to read:
- Semaglutide for Weight Loss?
- Ozempic vs Five Natural Supplements
- How To Prevent And Reverse Type 2 Diabetes ← this was our “Expert Insights” feature on Dr. Fung’s work
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
Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails: