Falling: Is It Due To Age Or Health Issues?

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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 😎

❝What are the signs that a senior is falling due to health issues rather than just aging?❞

Superficial answer: having an ear infection can result in a loss of balance, and is not particularly tied to age as a risk factor

More useful answer: first, let’s consider these two true statements:

  • The risks of falling (both the probability and the severity of consequences) increase with age
  • Health issues (in general) tend to increase with age

With this in mind, it’s difficult to disconnect the two, as neither exist in a vacuum, and each is strongly associated with the other.

So the question is easier to answer by first flipping it, to ask:

❝What are the health issues that typically increase with age, that increase the chances of falling?❞

A non-exhaustive list includes:

  • Loss of strength due to sarcopenia (reduced muscle mass)
  • Loss of mobility due to increased stiffness (many causes, most of which worsen with age)
  • Loss of risk-awareness due to diminished senses (for example, not seeing an obstacle until too late)
  • Loss of risk-awareness due to reduced mental focus (cognitive decline producing absent-mindedness)

Note that in the last example there, and to a lesser extent the third one, reminds us that falls also often do not happen in a vacuum. There is (despite how it may sometimes feel!) no actual change in our physical relationship with gravity as we get older; most falls are about falling over things, even if it’s just one’s own feet:

The 4 Bad Habits That Cause The Most Falls While Walking

Disclaimer: sometimes a person may just fall down for no external reason. An example of why this may happen is if a person’s joint (for example an ankle or a knee) has a particular weakness that means it’ll occasionally just buckle and collapse under one’s own weight. This doesn’t even have to be a lot of weight! The weakness could be due to an old injury, or Ehlers-Danlos Syndrome (with its characteristic joint hypermobility symptoms), or something else entirely.

Now, notice how:

  • all of these things can happen at any age
  • all of these things are more likely to happen the older we get
  • none of these things have to happen at any age

That last one’s important to remember! Aging is often viewed as an implacable Behemoth, but the truth is that it is many-faceted and every single one of those facets can be countered, to a greater or lesser degree.

Think of a room full of 80-year-olds, and now imagine that…

  • One has the hearing of a 20-year-old
  • One has the eyesight of a 20-year-old
  • One has the sharp quick mind of a 20-year-old
  • One has the cardiovascular fitness of a 20-year-old

…etc. Now, none of those things in isolation is unthinkable, so remember, there is no magic law of the universe saying we can’t have each of them:

Age & Aging: What Can (And Can’t) We Do About It?

Which means: that goes for the things that increase the risk of falling, too. In other words, we can combat sarcopenia with protein and resistance training, maintain our mobility, look after our sensory organs as best we can, nourish our brain and keep it sharp, etc etc etc:

Train For The Event Of Your Life! (Mobility As A Long-Term “Athletic” Goal For Personal Safety)

Which doesn’t mean: that we will necessarily succeed in all areas. Your writer here, broadly in excellent health, and whose lower body is still a veritable powerhouse in athletic terms, has a right ankle and left knee that will sometimes just buckle (yay, the aforementioned hypermobility).

So, it becomes a priority to pre-empt the consequences of that, for example:

  • being able to fall with minimal impact (this is a matter of knowing how, and can be learned from “soft” martial arts such as aikido), and
  • ensuring the skeleton can take a knock if necessary (keeping a good balance of vitamins, minerals, protein, etc; keeping an eye on bone density).

See also:

Fall Special ← appropriate for the coming season, but it’s about avoiding falling, and reducing the damage of falling if one does fall, including some exercises to try at home.

Take care!

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  • Radishes vs Endives – 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 radishes to endives, we picked the endives.

    Why?

    These are both great, but there’s a clear winner here in every category!

    In terms of macros, radishes have more carbs while endives have more fiber and protein.

    In the category of vitamins, radishes have more of vitamins B6 and C, while endives have more of vitamins A, B1, B2, B4, B5, B7, B9, E, K, and choline.

    When it comes to minerals, things are not less one-sided: radishes have more selenium, while endives have more calcium, copper, iron, magnesium, manganese, phosphorus, potassium, and zinc.

    You may be thinking: but what about radishes’ shiny red bit? Doesn’t that usually mean more of something important, like carotenoids or anthocyanins or something? And the answer is that the red pigment in radishes is so thinly-distributed on the exterior that it’s barely there and if we’re looking at values per 100g, it’s a tiny fraction of a tiny fraction.

    In both cases, their bitter taste comes mostly from flavonols, of which mostly kaempferol, of which endives have about 20x what radishes have, on average.

    All in all, an overwhelming win for endives.

    Want to learn more?

    You might like to read:

    Enjoy Bitter Foods For Your Heart & Brain

    Take care!

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  • Spiced Fruit & Nut Chutney

    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.

    ‘Tis the season to make the chutney that will then be aged chutney when you want it later! And unlike supermarket varieties with their ingredients list that goes “Sugar, spirit vinegar, inverted glucose-fructose syrup,” this one has an array of health-giving fruits and nuts (just omit the nuts if you or someone you may want to give this to has an allergy), and really nothing bad in here at all. And of course, tasty healthful spices!

    You will need

    • 2 red onions, chopped
    • 1½ cups dried apricots, chopped
    • 1½ cups dried figs, chopped
    • 1 cup raisins
    • ½ cup apple cider vinegar
    • ½ cup slivered almonds
    • ½ lime, chopped and deseeded
    • ¼ bulb garlic, chopped
    • 1 hot pepper, chopped (your choice what kind; omit if you don’t like heat at all; multiply if you want more heat)
    • 2 tablespoons honey or maple syrup (omit for a less sweet chutney; there is sweetness in the dried fruits already, after all)
    • 1 tbsp freshly grated ginger
    • 2 tsp sweet cinnamon
    • 1 tsp nutmeg
    • 1 tsp black pepper
    • ½ teaspoon allspice
    • ½ MSG or 1 tsp low-sodium salt
    • Extra virgin olive oil

    Method

    (we suggest you read everything at least once before doing anything)

    1) Heat some oil in a heavy-based pan that will be large enough for all ingredients to go into eventually. Fry the onions on a gentle heat for around 15 minutes. We don’t need to caramelize them yet (this will happen with time), but we do want them soft and sweet already.

    2) Add the ginger, garlic, and chili, and stir in well.

    3) When the onions start to brown, add the fruit and stir well to mix thoroughly.

    4) Add the honey or maple syrup (if using), and the vinegar; add the remaining spices/seasonings, so everything is in there now except the almonds.

    5) Cook gently for another 30 minutes while stirring. At some point it’ll become thick and sticky; add a little water as necessary. You don’t want to drown it, but you do want it to stay moist. It’ll probably take only a few tablespoons of added water in total, but add them one at a time and stir in before judging whether more is needed. By the end of the 30 minutes, it should be more solid, to the point it can stand up by itself.

    6) Add the almonds, stir to combine, and leave to cool. Put it in jars until you need it (or perhaps give it as gifts).

    Alternative method: if you don’t want to be standing at a stove stirring for about an hour in total, you can use a slow cooker / crock pot instead. Put the same ingredients in the same order, but don’t stir them, just leave them in layers (this is because of the pattern of heat distribution; it’ll be hotter at the bottom, so the things that need to be more cooked should be there, and the design means they won’t burn) for about two hours, then stir well to mix thoroughly, and leave it for another hour or two, before turning it off to let it cool. Put it in jars until you need it (or perhaps give it as gifts).

    Enjoy!

    Want to learn more?

    For those interested in some of the science of what we have going on today:

    Take care!

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  • The Whys and Hows of Cutting Meats Out Of Your Diet

    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.

    When it’s time to tell the meat to beat it…

    Meat in general, and red meat and processed meat in particular, have been associated with so many health risks, that it’s very reasonable to want to reduce, if not outright eliminate, our meat consumption.

    First, in case anyone’s wondering “what health risks?”

    The aforementioned culprits tend to turn out to be a villain in the story of every second health-related thing we write about here. To name just a few:

    Seasoned subscribers will know that we rarely go more than a few days without recommending the very science-based Mediterranean Diet which studies find beneficial for almost everything we write about. The Mediterranean Diet isn’t vegetarian per se—by default it consists of mostly plants but does include some fish and a very small amount of meat from land animals. But even that can be improved upon:

    So that’s the “why”; now for the “how”…

    It’s said that with a big enough “why” you can always find a “how”, but let’s make things easy!

    Meatless Mondays

    One of the biggest barriers to many people skipping the meat is “what will we even eat?”

    The idea of “Meatless Mondays” means that this question need only be answered once a week, and in doing that a few Mondays in a row, you’ll soon find you’re gradually building your repertoire of meatless meals, and finding it’s not so difficult after all.

    Then you might want to expand to “meat only on the weekends”, for example.

    Flexitarian

    This can be met with derision, “Yes and I’m teetotal, apart from wine”, but there is a practical aspect here:

    The idea is “I will choose vegetarian options, unless it’s really inconvenient for me to do so”, which wipes out any difficulty involved.

    After doing this for a while, you might find that as you get more used to vegetarian stuff, it’s almost never inconvenient to eat vegetarian.

    Then you might want to expand it to “I will choose vegan options, unless it’s really inconvenient for me to do so”

    Like-for-like substitutions

    Pretty much anything that can come from an animal, one can get a plant-based version of it nowadays. The healthiness (and cost!) of these substitutions can vary, but let’s face it, meat is neither the healthiest nor the cheapest thing out there these days either.

    If you have the money and don’t fancy leaping to lentils and beans, this can be a very quick and easy zero-effort change-over. Then once you’re up and running, maybe you can—at your leisure—see what all the fuss is about when it comes to tasty recipes with lentils and beans!

    That’s all we have time for today, but…

    We’re thinking of doing a piece making your favorite recipes plant-based (how to pick the right substitutions so the meal still tastes and “feels” the same), so let us know if you’d like that? Feel free to mention your favorite foods/meals too, as that’ll help us know what there’s a market for!

    You can do that by hitting reply to any of our emails, or using the handy feedback widget at the bottom!

    Curious to know more while you wait?

    Check out: The Vegan Diet: A Complete Guide for Beginnersthis is a well-sourced article from Healthline, who—just like us—like to tackle important health stuff in an easy-to-read, well-sourced format

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Related Posts

  • Darwin’s Bed Rest: Worthwhile Idea?
  • Building Psychological Resilience (Without Undue Hardship)

    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.

    What’s The Worst That Could Happen?

    When we talk about the five lifestyle factors that make the biggest difference to health, stress management would be a worthy addition as number six. We haven’t focused explicitly on that for a while, so let’s get ready to start the New Year on a good footing…

    You’re not going to have a stress-free 2024

    What a tender world that would be! Hopefully your stressors will be small and manageable, but rest assured, things will stress you.

    And that’s key: “rest assured”. Know it now, prepare for it, and build resilience.

    Sounds grim, doesn’t it? It doesn’t have to be, though.

    When the forecast weather is cold and wet, you’re not afraid of it when you have a warm dry house. When the heating bill comes for that warm dry house, you’re not afraid of it when you have money to pay it. If you didn’t have the money and the warm dry house, the cold wet weather could be devastating to you.

    The lesson here is: we can generally handle what we’re prepared for.

    Negative visualization and the PNS

    This is the opposite of what a lot of “think and grow rich”-style gurus would advise. And indeed, it’s not helpful to slide into anxious worrying.

    If you do find yourself spiralling, here’s a tool for getting out of that spiral:

    RAIN: an intervention for dealing with difficult emotions

    For now, however, we’re going to practice Radical Acceptance.

    First, some biology: you may be aware that your Central Nervous System (CNS) branches into the Sympathetic Nervous System (SNS) and the Parasympathetic Nervous System (PNS).

    The PNS is the part that cues our body to relax, and suppresses our fight/flight response. We’re going to activate it.

    Activating the PNS is easy for most people in comfortable circumstances (e.g., you are not currently exposed to stressful stimuli). It may well be activated already, and if it’s not, a few deep breaths is usually all it takes.

    If you’d like a quick and easy Mindfulness-Based Stress Reduction (MBSR) technique, here you go:

    No-Frills, Evidence-Based Mindfulness

    Activating the PNS is hard for most people in difficult circumstances (e.g., you either are currently exposed to stressful stimuli, or you are in one of the emotional spirals we discussed earlier).

    However, we can trick our bodies and brains by—when we are safe and unstressed—practicing imagining those stressful stimuli. Taking a moment to not just imagine it experientially, but immersively. This, in CBT and DBT, is the modern equivalent to the old samurai who simply accepted, before battle, that they were already dead—and thus went into battle with zero fear of death.

    A less drastic example is the zen master who had a favorite teacup, and feared it would get broken. So he would tell himself “the cup is already broken”. One day, it actually broke, and he simply smiled ruefully and said “Of course”.

    How this ties together: practice the mindfulness-based stress reduction we linked above, while imagining the things that do/would stress you the most.

    Since it’s just imagination, this is a little easier than when the thing is actually happening. Practicing this way means that when and if the thing actually happens (an unfortunate diagnosis, a financial reversal, whatever it may be), our CNS is already well-trained to respond to stress with a dose of PNS-induced calm.

    You can also leverage hormesis, a beneficial aspect of (in this case, optional and chosen by you) acute stress:

    Dr. Elissa Epel | The Stress Prescription

    Psychological resilience training

    This (learned!) ability to respond to stress in an adaptive fashion (without maladaptive coping strategies such as unhelpful behavioral reactivity and/or substance use) is a key part of what in psychology is called resilience:

    Psychological resilience: an update on definitions, a critical appraisal, and research recommendations

    And yes, the CBT/DBT/MBSR methods we’ve been giving you are the evidence-based gold standard.

    Only the best for 10almonds subscribers! 😎

    Road to resilience: a systematic review and meta-analysis of resilience training programmes and interventions

    ❝That was helpful, but not cheery; can we finish the year on a cheerier note?❞

    We can indeed:

    How To Get Your Brain On A More Positive Track (Without Toxic Positivity)

    Take care!

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  • Cancer is increasingly survivable – but it shouldn’t depend on your ability to ‘wrangle’ the health system

    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.

    One in three of us will develop cancer at some point in our lives. But survival rates have improved to the point that two-thirds of those diagnosed live more than five years.

    This extraordinary shift over the past few decades introduces new challenges. A large and growing proportion of people diagnosed with cancer are living with it, rather than dying of it.

    In our recently published research we examined the cancer experiences of 81 New Zealanders (23 Māori and 58 non-Māori).

    We found survivorship not only entailed managing the disease, but also “wrangling” a complex health system.

    Surviving disease or surviving the system

    Our research focused on those who had lived longer than expected (four to 32 years since first diagnosis) with a life-limiting or terminal diagnosis of cancer.

    Common to many survivors’ stories was the effort it took to wrangle the system or find others to advocate on their behalf, even to get a formal diagnosis and treatment.

    By wrangling we refer to the practices required to traverse complex and sometimes unwelcoming systems. This is an often unnoticed but very real struggle that comes on top of managing the disease itself.

    The common focus of the healthcare system is on symptoms, side effects of treatment and other biological aspects of cancer. But formal and informal care often falls by the wayside, despite being key to people’s everyday experiences.

    A woman at a doctor's appointment
    Survival is often linked to someone’s social connections and capacity to access funds. Getty Images

    The inequities of cancer survivorship are well known. Analyses show postcodes and socioeconomic status play a strong role in the prevalence of cancer and survival.

    Less well known, but illustrated in our research, is that survival is also linked to people’s capacity to manage the entire healthcare system. That includes accessing a diagnosis or treatment, or identifying and accessing alternative treatments.

    Survivorship is strongly related to material resources, social connections, and understandings of how the health system works and what is available. For instance, one participant who was contemplating travelling overseas to get surgery not available in New Zealand said:

    We don’t trust the public system. So thankfully we had private health insurance […] But if we went overseas, health insurance only paid out to $30,000 and I think the surgery was going to be a couple of hundred thousand. I remember Dad saying and crying and just being like, I’ll sell my business […] we’ll all put in money. It was really amazing.

    Assets of survivorship

    In New Zealand, the government agency Pharmac determines which medications are subsidised. Yet many participants were advised by oncologists or others to “find ways” of taking costly, unsubsidised medicines.

    This often meant finding tens of thousands of dollars with no guarantees. Some had the means, but for others it meant drawing on family savings, retirement funds or extending mortgages. This disproportionately favours those with access to assets and influences who survives.

    But access to economic capital is only one advantage. People also have cultural resources – often described as cultural capital.

    In one case, a participant realised a drug company was likely to apply to have a medicine approved. They asked their private oncologist to lobby on their behalf to obtain the drug through a compassionate access scheme, without having to pay for it.

    Others gained community support through fundraising from clubs they belonged to. But some worried about where they would find the money, or did not want to burden their community.

    I had my doctor friend and some others that wanted to do some public fundraising. But at the time I said, “Look, most of the people that will be contributing are people from my community who are poor already, so I’m not going to do that option”.

    Accessing alternative therapies, almost exclusively self-funded, was another layer of inequity. Some felt forced to negotiate the black market to access substances such as marijuana to treat their cancer or alleviate the side effects of orthodox cancer treatment.

    Cultural capital is not a replacement for access to assets, however. Māori survivorship was greatly assisted by accessing cultural resources, but often limited by lack of material assets.

    Persistence pays

    The last thing we need when faced with the possibility of cancer is to have to push for formal diagnosis and care. Yet this was a common experience.

    One participant was told nothing could be found to explain their abdominal pain – only to find later they had pancreatic cancer. Another was told their concerns about breathing problems were a result of anxiety related to a prior mental health history, only to learn later their earlier breast cancer had spread to their lungs.

    Persistence is another layer of wrangling and it often causes distress.

    Once a diagnosis was given, for many people the public health system kicked in and delivered appropriate treatment. However, experiences were patchy and variable across New Zealand.

    Issues included proximity to hospitals, varying degrees of specialisation available, and the requirement of extensive periods away from home and whānau. This reflects an ongoing unevenness and lack of fairness in the current system.

    When facing a terminal or life-limiting diagnosis, the capacity to wrangle the system makes a difference. We shouldn’t have to wrangle, but facing this reality is an important first step.

    We must ensure it doesn’t become a continuing form of inequity, whereby people with access to material resources and social and cultural connections can survive longer.

    Kevin Dew, Professor of Sociology, Te Herenga Waka — Victoria University of Wellington; Alex Broom, Professor of Sociology & Director, Sydney Centre for Healthy Societies, University of Sydney; Chris Cunningham, Professor of Maori & Public Health, Massey University; Elizabeth Dennett, Associate Professor in Surgery, University of Otago; Kerry Chamberlain, Professor of Social and Health Psychology, Massey University, and Richard Egan, Associate Professor in Health Promotion, University of Otago

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

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  • What’s the difference between Alzheimer’s and dementia?

    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.

    What’s the difference? is a new editorial product that explains the similarities and differences between commonly confused health and medical terms, and why they matter.

    Changes in thinking and memory as we age can occur for a variety of reasons. These changes are not always cause for concern. But when they begin to disrupt daily life, it could indicate the first signs of dementia.

    Another term that can crop up when we’re talking about dementia is Alzheimer’s disease, or Alzheimer’s for short.

    So what’s the difference?

    Lightspring/Shutterstock

    What is dementia?

    Dementia is an umbrella term used to describe a range of syndromes that result in changes in memory, thinking and/or behaviour due to degeneration in the brain.

    To meet the criteria for dementia these changes must be sufficiently pronounced to interfere with usual activities and are present in at least two different aspects of thinking or memory.

    For example, someone might have trouble remembering to pay bills and become lost in previously familiar areas.

    It’s less-well known that dementia can also occur in children. This is due to progressive brain damage associated with more than 100 rare genetic disorders. This can result in similar cognitive changes as we see in adults.

    So what’s Alzheimer’s then?

    Alzheimer’s is the most common type of dementia, accounting for about 60-80% of cases.

    So it’s not surprising many people use the terms dementia and Alzheimer’s interchangeably.

    Changes in memory are the most common sign of Alzheimer’s and it’s what the public most often associates with it. For instance, someone with Alzheimer’s may have trouble recalling recent events or keeping track of what day or month it is.

    Elderly woman looking at calendar
    People with dementia may have trouble keeping track of dates. Daisy Daisy/Shutterstock

    We still don’t know exactly what causes Alzheimer’s. However, we do know it is associated with a build-up in the brain of two types of protein called amyloid-β and tau.

    While we all have some amyloid-β, when too much builds up in the brain it clumps together, forming plaques in the spaces between cells. These plaques cause damage (inflammation) to surrounding brain cells and leads to disruption in tau. Tau forms part of the structure of brain cells but in Alzheimer’s tau proteins become “tangled”. This is toxic to the cells, causing them to die. A feedback loop is then thought to occur, triggering production of more amyloid-β and more abnormal tau, perpetuating damage to brain cells.

    Alzheimer’s can also occur with other forms of dementia, such as vascular dementia. This combination is the most common example of a mixed dementia.

    Vascular dementia

    The second most common type of dementia is vascular dementia. This results from disrupted blood flow to the brain.

    Because the changes in blood flow can occur throughout the brain, signs of vascular dementia can be more varied than the memory changes typically seen in Alzheimer’s.

    For example, vascular dementia may present as general confusion, slowed thinking, or difficulty organising thoughts and actions.

    Your risk of vascular dementia is greater if you have heart disease or high blood pressure.

    Frontotemporal dementia

    Some people may not realise that dementia can also affect behaviour and/or language. We see this in different forms of frontotemporal dementia.

    The behavioural variant of frontotemporal dementia is the second most common form (after Alzheimer’s disease) of younger onset dementia (dementia in people under 65).

    People living with this may have difficulties in interpreting and appropriately responding to social situations. For example, they may make uncharacteristically rude or offensive comments or invade people’s personal space.

    Semantic dementia is also a type of frontotemporal dementia and results in difficulty with understanding the meaning of words and naming everyday objects.

    Dementia with Lewy bodies

    Dementia with Lewy bodies results from dysregulation of a different type of protein known as α-synuclein. We often see this in people with Parkinson’s disease.

    So people with this type of dementia may have altered movement, such as a stooped posture, shuffling walk, and changes in handwriting. Other symptoms include changes in alertness, visual hallucinations and significant disruption to sleep.

    Do I have dementia and if so, which type?

    If you or someone close to you is concerned, the first thing to do is to speak to your GP. They will likely ask you some questions about your medical history and what changes you have noticed.

    Sometimes it might not be clear if you have dementia when you first speak to your doctor. They may suggest you watch for changes or they may refer you to a specialist for further tests.

    There is no single test to clearly show if you have dementia, or the type of dementia. A diagnosis comes after multiple tests, including brain scans, tests of memory and thinking, and consideration of how these changes impact your daily life.

    Not knowing what is happening can be a challenging time so it is important to speak to someone about how you are feeling or to reach out to support services.

    Dementia is diverse

    As well as the different forms of dementia, everyone experiences dementia in different ways. For example, the speed dementia progresses varies a lot from person to person. Some people will continue to live well with dementia for some time while others may decline more quickly.

    There is still significant stigma surrounding dementia. So by learning more about the various types of dementia and understanding differences in how dementia progresses we can all do our part to create a more dementia-friendly community.

    The National Dementia Helpline (1800 100 500) provides information and support for people living with dementia and their carers. To learn more about dementia, you can take this free online course.

    Nikki-Anne Wilson, Postdoctoral Research Fellow, Neuroscience Research Australia (NeuRA), UNSW Sydney

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

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