When Did You Last Have a Cognitive Health Check-Up?
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When Did You Last Have a Cognitive Health Check-Up?
Regular health check-ups are an important part of a good health regime, especially as we get older. But after you’ve been prodded, probed, sampled and so forth… When did you last have a cognitive health check-up?
Keeping on top of things
In our recent Monday Research Review main feature about citicoline, we noted that it has beneficial effects for a lot of measures of cognitive health.
And that brought us to realize: just how on top of this are we?
Your writer here today could tell you what her sleep was like on any night in the past year, what her heart rate was like, her weight, and all that. Moods too! There’s an app for that. But cognitive health? My last IQ test was in 2001, and I forget when my last memory test was.
It’s important to know how we’re doing, or else how to we know if there has been some decline? We’ve talked previously about the benefits of brain-training of various kinds to improve cognition, so in some parts we’ll draw on the same resources today, but this time the focus is on getting quick measurements that we can retest regularly (mark the calendar!)
Some quick-fire tests
These tests are all free, quick, and accessible. Some of them will try to upsell you on other (i.e. paid) services; we leave that to your own discretion, but the things we’ll be using today are free.
Test your verbal memory
This one’s a random word list generator. It defaults to 12 words, but you can change that if you like. Memorize the words, and then test yourself by seeing how many you can write down from memory. If it gets too easy, crank up the numbers.
Test your visual memory
This one’s a series of images; the test is to click to say whether you’ve seen this exact image previously in the series or not.
Test your IQ
This one’s intended to be general purpose intelligence; in reality, IQ tests have their flaws too, but it’s not a bad metric to keep track of. Just don’t get too hung up on the outcome, and remember, your only competition is yourself!
Test your attention / focus
This writer opened this and this three other attention tests (to get you the best one) before getting distracted, noting the irony, and finally taking the test. Hopefully you can do better!
Test your creativity
This one’s a random object generator. Give yourself a set period of time (per your preference, but make a note of the time you allow yourself, so that you can use the same time period when you retest yourself at a later date) in which to list as many different possible uses for the item.
Test your musical sense
This one’s a pitch recognition test. So, with the caveat that it is partially testing your hearing as well as your cognition, it’s a good one to take and regularly retest in any case.
How often should you retest?
There’s not really any “should” here, but to offer some advice:
- If you take them too often, you might find you get bored of doing so and stop, essentially burning out.
- If you don’t take them regularly, you may forget, lose this list of tests, etc.
- Likely a good “sweet spot” is quarterly or six-monthly, but there’s nothing wrong with testing annually either.
It’s all about the big picture, after all.
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Can We Side-Step Age-Related Alienation?
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When The World Moves Without Us…
We’ve written before about how reduced social engagement can strike people of all ages, and what can be done about it:
How To Beat Loneliness & Isolation
…but today we’re going to talk more about a specific aspect of it, namely, the alienation that can come with old age—and other life transitions too, but getting older is something that (unless accident or incident befall us first) all of us will definitely do.
What’s the difference?
Loneliness is a status, alienation is more of a process. It can be the alienation in the sense of an implicit “you don’t belong here” message from the world that’s geared around the average person and thus alienates those who are not that (a lack of accessibility to people with disabilities can be an important and very active example of this), and it can also be an alienation from what we’ve previously considered our “niche” in the world—the loss of purpose many people feel upon retirement fits this bill. It can even be a more generalized alienation from our younger selves; it’s easy to have a self-image that doesn’t match one’s current reality, for instance.
Read more: Estranged by Time: Alienation in the Aging Process
So, how to “un-alienate”?
To “un-alienate”, that is to say, to integrate/reintegrate, can be hard. Some things may even be outright impossible, but most will not be!
Consider how, for example, former athletes become coaches—or for that matter, how former party-goers might become party-hosts (even if the kind of “party” might change with time, give or take the pace at which we like to live our lives).
What’s important is that we take what matters the most to us, and examine how we can realistically still engage with that thing.
This is different from trying to hold on grimly to something that’s no longer our speed.
Letting go of the only thing we’ve known will always be scary; sometimes it’s for the best, and sometimes what we really need is just more of a pivot, like the examples above. The crux lies in knowing which:
- Is our relationship with the thing (whatever it may be) still working for us, or is it just bringing strife now?
- If it’s not working for us, is it because of a specific aspect that could be side-stepped while keeping the rest?
- If we’re going to drop that thing entirely (or be dropped by it, which, while cruel, also happens in life), then where are we going to land?
This latter is one where foresight is a gift, because if we bury our heads in the sand we’re going to land wherever we’re dropped, whereas if we acknowledge the process, we can make a strategic move and land on our feet.
Here’s a good pop-science article about this—it’s aimed at people around retirement age, but honestly the advice is relevant for people of all ages, and facing all manner of life transitions, e.g. career transitions (of which retirement is of course the career transition to end all career transitions), relationship transitions (including B/B/B/B: births, betrothals/break-ups, and bereavements) health transitions (usually: life-changing illnesses and/or disabilities—which again, happens to most of us if something doesn’t get us first), etc. So with all that in mind, this becomes more of a “how to reassess your life at those times when it needs reassessing”:
How to Reassess Your Life in Retirement
But that doesn’t mean that letting go is always necessary
Sometimes, the opposite! Sometimes, the age-old advice to “lean in” really is all the situation calls for, which means:
- Be ready to say “yes” to things, and if nobody’s asking, be ready to “hey, do you wanna…?” and take a “build it and they will come” approach. This includes with people of different ages, too! Intergenerational friendships can be very rewarding for all concerned, if done right. Communities that span age-ranges can be great for this—they might be about special interests (this writer has friends ranging through four generations from playing chess, for instance), they could be religious communities if we be religious, LGBT groups if that fits for us, even mutual support groups such as for specific disabilities or chronic illness if we have such—notice how the very things that might isolate us can also bring us together!
- Be open-minded to new experiences; it’s easy to get stuck in a rut of “I’ve never done that” and mistake that self-assessment for an uncritical assumption of “I’m not the kind of person who does that”. Sometimes, you really won’t be! But at least think about it and entertain the possibility, before dismissing it out of hand. And, here’s a life tip: it can be really good to (within the realms of safety, and one’s personal moral principles, of course) take an approach of “try anything once”. Even if we’re almost certain we won’t like it, and even if we then turn out to indeed not like it, it can be a refreshing experience—and now we can say “Yep, tried that, not doing that again” from a position of informed knowledge. That’s the only way we get to look back on a richly lived life of broad experiences, after all, and it is never too late for such.
- Be comfortable prioritizing quality over quantity. This goes for friends, it goes for activities, it goes for experiences. The topic of “what’s the best number of friends to have?” has been a matter of discussion since at least ancient Greek times (Plato and Aristotle examined this extensively), but whatever number we might arrive at, it’s clear that quality is the critical factor, and quantity after that is just a matter of optimizing.
In short: make sure you’re investing—in your relationships, in your areas of interest, in your community (whatever that may mean for you personally), and most of all, and never forget this: in yourself.
Take care!
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Lies I Taught in Medical School – by Dr. Robert Lufkin
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There seems to be a pattern of doctors who practice medicine one way, get a serious disease personally, and then completely change their practice of medicine afterwards. This is one of those cases.
Dr. Lufkin here presents, on a chapter-by-chapter basis, the titularly promised “lies” or, in more legally compliant speak (as he acknowledges in his preface), flawed hypotheses that are generally taught as truths. In many cases, the “lie” is some manner of “xyz is normal and nothing to worry about”, and/or “there is nothing to be done about xyz; suck it up”.
The end result of the information is not complicated—enjoy a plants-forward whole foods low-carb diet to avoid metabolic diseases and all the other things to branch off from same (Dr. Lufkin makes a fair case for metabolic disease leading to a lot of secondary diseases that aren’t considered metabolic diseases per se). But, the journey there is actually important, as it answers a lot of questions that are much less commonly understood, and often not even especially talked-about, despite their great import and how they may affect health decisions beyond the dietary. Things like understanding the downsides of statins, or the statistical models that can be used to skew studies, per relative risk reduction and so forth.
Bottom line: this book gives the ins and outs of what can go right or wrong with metabolic health and why, and how to make sure you don’t sabotage your health through missing information.
Click here to check out Lies I Taught In Medical School, and arm yourself with knowledge!
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Osteoarthritis Of The Knee
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It’s Q&A Day at 10almonds!
Have a question or a request? We love to hear from you!
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
❝Very informative thank you. And made me think. I am a 72 yr old whitewoman, have never used ( or even been offered) HRT since menopause ~15 yrs ago. Now I’m wondering if it would have delayed the onset of osteoarthritis ( knee) and give me more energy in general. And is it wise to start taking hrt after being without those hormones for so long?❞
(this was in response to our article about menopausal HRT)
Thanks for writing! To answer your first question, obviously we can never know for sure now, but it certainly is possible, per for example a large-ish (n=1003) study of women aged 45–64, in which:
- Those with HRT were significantly less likely to have knee arthritis than those without
- However, to enjoy this benefit depended on continued use (those who used it for a bit and then stopped did not enjoy the same results)
- While it made a big difference to knee arthritis, it made only a small (but still beneficial) difference to wrist/hand arthritis.
We could hypothesize that this is because the mechanism of action is more about strengthening the bones (proofing against osteoporosis is one of the main reasons many people take HRT) and cartilage than it is against inflammation directly.
Since the knee is load-bearing and the hand/wrist joints usually are not, this would mean the HRT strengthening the bones makes a big difference to the “wear and tear” aspect of potential osteoarthritis of the knee, but not the same level of benefit for the hand/wrist, which is less about wear and tear and more about inflammatory factors. But that latter, about it being load-bearing, is just this writer’s hypothesis as to why the big difference.
The researchers do mention:
❝In OA the mechanisms by which HRT might act are highly speculative, but could entail changes in cartilage repair or bone turnover, perhaps with cytokines such as interleukin 6, for example.❞
What is clear though, is that it does indeed appear to have a protective effect against osteoarthritis of the knee.
With regard to the timing, the researchers do note:
❝Why as little as three years of HRT should have a demonstrable effect is unclear. Given the difficulty in ascertaining when the disease starts, it is hard to be sure of the importance of the timing of HRT, and whether early or subclinical disease was present.
These results taken together suggest that HRT has a metabolic action that is only effective if given continuously, perhaps by preventing disease initiation; once HRT is stopped there might be a ‘rebound’ effect, explaining the rapid return to normal risk❞
~ Ibid.
You can read the study here:
On whether it is worth it now…
Again, do speak with an endocrinologist because your situation may vary, but:
- hormones are simply messengers, and your body categorically will respond to those messages regardless of age, or time elapsed without having received such a message. Whether it will repair all damage done is another matter entirely, but it would take a biological miracle for it to have no effect at all.
- anecdotally, many women do enjoy life-changing benefits upon starting HRT at your age and older!
(We don’t like to rely on “anecdotally”, but we couldn’t find studies isolating according to “length of time since menopause”—we’ll keep an eye out and if we find something in the future, we’ll mention it!)
Meanwhile, take care!
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Think you’re good at multi-tasking? Here’s how your brain compensates – and how this changes with age
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We’re all time-poor, so multi-tasking is seen as a necessity of modern living. We answer work emails while watching TV, make shopping lists in meetings and listen to podcasts when doing the dishes. We attempt to split our attention countless times a day when juggling both mundane and important tasks.
But doing two things at the same time isn’t always as productive or safe as focusing on one thing at a time.
The dilemma with multi-tasking is that when tasks become complex or energy-demanding, like driving a car while talking on the phone, our performance often drops on one or both.
Here’s why – and how our ability to multi-task changes as we age.
Doing more things, but less effectively
The issue with multi-tasking at a brain level, is that two tasks performed at the same time often compete for common neural pathways – like two intersecting streams of traffic on a road.
In particular, the brain’s planning centres in the frontal cortex (and connections to parieto-cerebellar system, among others) are needed for both motor and cognitive tasks. The more tasks rely on the same sensory system, like vision, the greater the interference.
This is why multi-tasking, such as talking on the phone, while driving can be risky. It takes longer to react to critical events, such as a car braking suddenly, and you have a higher risk of missing critical signals, such as a red light.
The more involved the phone conversation, the higher the accident risk, even when talking “hands-free”.
Generally, the more skilled you are on a primary motor task, the better able you are to juggle another task at the same time. Skilled surgeons, for example, can multitask more effectively than residents, which is reassuring in a busy operating suite.
Highly automated skills and efficient brain processes mean greater flexibility when multi-tasking.
Adults are better at multi-tasking than kids
Both brain capacity and experience endow adults with a greater capacity for multi-tasking compared with children.
You may have noticed that when you start thinking about a problem, you walk more slowly, and sometimes to a standstill if deep in thought. The ability to walk and think at the same time gets better over childhood and adolescence, as do other types of multi-tasking.
When children do these two things at once, their walking speed and smoothness both wane, particularly when also doing a memory task (like recalling a sequence of numbers), verbal fluency task (like naming animals) or a fine-motor task (like buttoning up a shirt). Alternately, outside the lab, the cognitive task might fall by wayside as the motor goal takes precedence.
Brain maturation has a lot to do with these age differences. A larger prefrontal cortex helps share cognitive resources between tasks, thereby reducing the costs. This means better capacity to maintain performance at or near single-task levels.
The white matter tract that connects our two hemispheres (the corpus callosum) also takes a long time to fully mature, placing limits on how well children can walk around and do manual tasks (like texting on a phone) together.
For a child or adult with motor skill difficulties, or developmental coordination disorder, multi-tastking errors are more common. Simply standing still while solving a visual task (like judging which of two lines is longer) is hard. When walking, it takes much longer to complete a path if it also involves cognitive effort along the way. So you can imagine how difficult walking to school could be.
What about as we approach older age?
Older adults are more prone to multi-tasking errors. When walking, for example, adding another task generally means older adults walk much slower and with less fluid movement than younger adults.
These age differences are even more pronounced when obstacles must be avoided or the path is winding or uneven.
Older adults tend to enlist more of their prefrontal cortex when walking and, especially, when multi-tasking. This creates more interference when the same brain networks are also enlisted to perform a cognitive task.
These age differences in performance of multi-tasking might be more “compensatory” than anything else, allowing older adults more time and safety when negotiating events around them.
Older people can practise and improve
Testing multi-tasking capabilities can tell clinicians about an older patient’s risk of future falls better than an assessment of walking alone, even for healthy people living in the community.
Testing can be as simple as asking someone to walk a path while either mentally subtracting by sevens, carrying a cup and saucer, or balancing a ball on a tray.
Patients can then practise and improve these abilities by, for example, pedalling an exercise bike or walking on a treadmill while composing a poem, making a shopping list, or playing a word game.
The goal is for patients to be able to divide their attention more efficiently across two tasks and to ignore distractions, improving speed and balance.
There are times when we do think better when moving
Let’s not forget that a good walk can help unclutter our mind and promote creative thought. And, some research shows walking can improve our ability to search and respond to visual events in the environment.
But often, it’s better to focus on one thing at a time
We often overlook the emotional and energy costs of multi-tasking when time-pressured. In many areas of life – home, work and school – we think it will save us time and energy. But the reality can be different.
Multi-tasking can sometimes sap our reserves and create stress, raising our cortisol levels, especially when we’re time-pressured. If such performance is sustained over long periods, it can leave you feeling fatigued or just plain empty.
Deep thinking is energy demanding by itself and so caution is sometimes warranted when acting at the same time – such as being immersed in deep thought while crossing a busy road, descending steep stairs, using power tools, or climbing a ladder.
So, pick a good time to ask someone a vexed question – perhaps not while they’re cutting vegetables with a sharp knife. Sometimes, it’s better to focus on one thing at a time.
Peter Wilson, Professor of Developmental Psychology, Australian Catholic University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Stress Resets – by Dr. Jennifer Taitz
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You may be thinking: “that’s a bold claim in the subtitle; does the book deliver?”
And yes, yes it does.
The “resets” themselves are divided into categories:
- Mind resets, which are mostly CBT,
- Body resets, which include assorted somatic therapies such as vagus nerve resets, the judicious use of ice-water, what 1-minute sprints of exercise can do for your mental state, and why not to use the wrong somatic therapy for the wrong situation!
- Behavior resets, which are more about the big picture, and not falling into common traps.
What common traps, you ask? This is about how we often have maladaptive responses to stress, e.g. we’re short of money so we overspend, we have an important deadline so we over-research and procrastinate, we’re anxious so we hyperfixate on the problem, we’re grieving so we look to substances to try to cope, we’re exhausted so we stay up late to try to claw back some lost time. Things where our attempt to cope actually makes things worse for us.
Instead, Dr. Taitz advises us of how to get ourselves from “knowing we shouldn’t do that” to actually not doing that, and how to respond more healthily to stress, how to turn general stress into eustress, or as she puts it, how to “turn your knots into bows”.
The style is… “Academic light”, perhaps we could say. It’s a step above pop-science, but a step below pure academic literature, which does make it a very pleasant read as well as informative. There are often footnotes at the bottom of each page to bridge any knowledge-gap, and for those who want to know the evidence of these evidence-based approaches, she does provide 35 pages of hard science sources to back up her claims.
Bottom line: if you’d like to learn how better to manage stress from an evidence-based perspective that’s not just “do minfdulness meditation”, then this book gives a lot of ways.
Click here to check out Stress Resets, and indeed soothe your body and mind in minutes!
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Quit Drinking – by Rebecca Dolton
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Many “quit drinking” books focus on tips you’ve heard already—cut down like this, rearrange your habits like that, make yourself accountable like so, add a reward element this way, etc.
Dolton takes a different approach.
She focuses instead on the underlying processes of addiction, so as to not merely understand them to fight them, but also to use them against the addiction itself.
This is not just a social or behavioral analysis, by the way, and goes into some detail into the physiological factors of the addiction—including such things as the little-talked about relationship between addiction and gut flora. Candida albans, found in most if not all humans to some extent, gets really out of control when given certain kinds of sugars (including those from alcohol); it grows, eventually puts roots through the intestinal walls (ouch!) and the more it grows, the more it demands the sugars it craves, so the more you feed it.
Quite a motivator to not listen to such cravings! It’s not even you that wants it, it’s the Candida!
Anyway, that’s just one example; there are many. The point here is that this is a well-researched, well-written book that sets itself apart from many of its genre.
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