From Strength to Strength – by Dr. Arthur Brooks

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For most professions, there are ways in which performance can be measured, and the average professional peak varies by profession, but averages are usually somewhere in the 30–45 range, with a pressure to peak between 25–35.

With a peak by age 45 or perhaps 50 at the latest (aside from some statistical outliers, of course), what then to expect at age 50+? Not long after that, there’s a reason for mandatory retirement ages in some professions.

Dr. Brooks examines the case for accepting that rather than fighting it, and/but making our weaknesses into our strengths as we go. If our fluid intelligence slows, our accumulated crystal intelligence (some might call it “wisdom“) can make up for it, for example.

But he also champions the idea of looking outside of ourselves; of the importance of growing and fostering connections; giving to those around us and receiving support in turn; not transactionally, but just as a matter of mutualism of the kind found in many other species besides our own. Indeed, Dr. Brooks gives the example of a grove of aspen trees (hence the cover art of this book) that do exactly that.

The style is very accessible in terms of language but with frequent scientific references, so very much a “best of both worlds” in terms of readability and information-density.

Bottom line: if ever you’ve wondered at what age you might outlive your usefulness, this book will do as the subtitle suggests, and help you carve out your new place.

Click here to check out From Strength To Strength, and find yours!

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  • Reduce Your Stroke Risk

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    ❝Each year in the U.S., over half a million people have a first stroke; however, up to 80% of strokes may be preventable.❞

    ~ American Stroke Association

    Source: New guideline: Preventing a first stroke may be possible with screening, lifestyle changes

    So, what should we do?

    Some of the risk factors are unavoidable or not usefully avoidable, like genetic predispositions and old age, respectively (i.e. it is possible to avoid old age—by dying young, which is not a good approach).

    Some of the risk factors are avoidable. Let’s look at the most obvious first:

    You cannot drink to your good health

    While overall, the World Health Organization has declared that “the only safe amount of alcohol is zero”, when it comes to stroke risk specifically, it seems that low consumption is not associated with stroke, while moderate to high consumption is associated with a commensurately increased risk of stroke:

    Alcohol Intake as a Risk Factor for Acute Stroke

    Note: there are some studies out there that say that a low to moderate consumption may decrease the risk compared to zero consumption. However, any such study that this writer has seen has had the methodological flaw of not addressing why those who do not drink alcohol, do not drink it. In many cases, someone who drinks no alcohol at all does so because either a) it would cause problems with some medication(s) they are taking, or b) they used to drink heavily, and quit. In either case, their reasons for not drinking alcohol may themselves be reasons for an increased stroke risk—not the lack of alcohol itself.

    Smoke now = stroke later

    This one is straightforward; smoking is bad for pretty much everything, and that includes stroke risk, as it’s bad for your heart and brain both, increasing stroke risk by 200–400%:

    Smoking and stroke: the more you smoke the more you stroke

    So, the advice here of course is: don’t smoke

    Diet matters

    The American Stroke Association’s guidelines recommend, just for a change, the Mediterranean Diet. This does not mean just whatever is eaten in the Mediterranean region though, and there are specifically foods that are included and excluded, and the ratios matter, so here’s a run-down of what the Mediterranean Diet does and doesn’t include:

    The Mediterranean Diet: What Is It Good For? ← what isn’t it good for?!

    You can outrun stroke

    Or out-walk it; that’s fine too. Most important here is frequency of exercise, more than intensity. So basically, getting those 150 minutes moderate exercise per week as a minimum.

    See also: The Doctor Who Wants Us To Exercise Less & Move More

    Which is good, because it means we can get a lot of exercise in that doesn’t feel like “having to do” exercise, for example:

    Do You Love To Go To The Gym? No? Enjoy These “No-Exercise Exercises”!

    Your brain needs downtime too

    Your brain (and your heart) both need you to get good regular sleep:

    Sleep Disorders in Stroke: An Update on Management

    We sometimes say that “what’s good for your heart is good for your brain” (because the heart feeds the brain, and also ultimately clears away detritus), and that’s true here too, so we might also want to prioritize sleep regularity over other factors, even over duration:

    How Regularity Of Sleep Can Be Even More Important Than Duration ← this is about adverse cardiovascular events, including ischemic stroke

    Keep on top of your blood pressure

    High blood pressure is a very modifiable risk factor for stroke. Taking care of the above things will generally take care of this, especially the DASH variation of the Mediterranean diet:

    Hypertension: Factors Far More Relevant Than Salt

    However, it’s still important to actually check your blood pressure regularly, because sometimes an unexpected extra factor can pop up for no obvious reason. As a bonus, you can do this improved version of the usual blood pressure test, still using just a blood pressure cuff:

    Try This At Home: ABI Test For Clogged Arteries

    Consider GLP-1 receptor agonists (or…)

    GLP-1 receptor agonists (like Ozempic et al.) seem to have cardioprotective and neuroprotective (thus: anti-stroke) activity independent of their weight loss benefits:

    Neuroprotective Mechanisms of Glucagon-Like Peptide-1-Based Therapies in Ischemic Stroke: An Update Based on Preclinical Research

    Of course, GLP-1 RAs aren’t everyone’s cup of tea, and they do have their downsides (including availability, cost, and the fact benefits reverse themselves if you stop taking them), so if you want a similar effect from a natural approach, there are some foods that work on the body’s incretin responses in the same way as GLP-1 RAs do:

    5 Foods That Naturally Mimic The “Ozempic Effect”

    Better to know sooner rather than too late

    Rather than waiting until one half of our face is drooping to know that there was a stroke risk, here are things to watch out for to know about it before it’s too late:

    6 Signs Of Stroke (One Month In Advance)

    Take care!

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  • 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:

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

    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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  • Everything You Need To Know About The Menopause – by Kate Muir

    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.

    Kate Muir has made a career out of fighting for peri-menopausal health to be taken seriously. Because… it’s actually far more serious than most people know.

    What people usually know:

    • No more periods
    • Hot flushes
    • “I dunno, some annoying facial hairs maybe”

    The reality encompasses a lot more, and Muir covers topics including:

    • Workplace struggles (completely unnecessary ones)
    • Changes to our sex life (not usually good ones, by default!)
    • Relationship between menopause and breast cancer
    • Relationship between menopause and Alzheimer’s

    “Wait”, you say, “correlation is not causation, that last one’s just an age thing”, and that’d be true if it weren’t for the fact that receiving Hormone Replacement Therapy (HRT) or not is strongly correlated with avoiding Alzheimer’s or not.

    The breast cancer thing is not to be downplayed either. Taking estrogen comes with a stated risk of breast cancer… But what they don’t tell you, is that for many people, not taking it comes with a higher risk of breast cancer (but that’s not the doctor’s problem, in that case). It’s one of those situations where fear of litigation can easily overrule good science.

    This kind of thing, and much more, makes up a lot of the meat of this book.

    Hormonal treatment for the menopause is often framed in the wider world as a whimsical luxury, not a serious matter of health…. If you’ve ever wondered whether you might want something different, something better, as part of your general menopause plan (you have a plan for this important stage of your life, right?), this is a powerful handbook for you.

    Additionally, if (like many!) you justifiably fear your doctor may brush you off (or in the case of mood disorders, may try to satisfy you with antidepressants to treat the symptom, rather than HRT to treat the cause), this book will arm you as necessary to help you get what you need.

    Grab your copy of “Everything You Need To Know About The Menopause” from Amazon today!

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  • Yoga Nidra Made Easy – by Dr. Uma Dinsmore-Tuli and Nirlipta Tuli
  • End the Insomnia Struggle – by Dr. Colleen Ehrnstrom and Dr. Alisha Brosse

    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.

    We’ve reviewed sleep books before, and we always try to recommend books that have something a little different than the rest, so what makes this one stand out?

    While there is the usual quick overview of the basics that we’re sure you already know (sleep hygiene etc), most of the attention here is given to cold, hard clinical psychology… in a highly personalized way.

    How, you may ask, can they personalize a book, that is the same for everyone?

    The answer is, by guiding the reader through examining our own situation. With template logbooks, worksheets, and the like—for this reason we recommend getting a paper copy of the book, rather than the Kindle version, in case you’d like to use/photocopy those.

    Essentially, reading this book is much like having your own psychologist (or two) to guide you through finding a path to better sleep.

    The therapeutic approach, by the way, is a combination of Cognitive Behavioral Therapy (CBT) and Acceptance-Commitment Therapy (ACT), which work very well together here.

    Bottom line: if you’ve changed your bedsheets and turned off your electronic devices and need something a little more, this book is the psychological “big guns” for removing the barriers between you and good sleep.

    Click here to check out End the Insomnia Struggle, and end yours once and for all!

    Don’t Forget…

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  • Inhaled Eucalyptus’s Immunomodulatory and Antimicrobial Effects

    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.

    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

    ❝At the first hint of a cough or a cold, I resort to steam inhalation. Some people add herbs or aromatic oils to the boiling water. What do you recommend?❞

    First of all, please do be careful:

    Severe scalds sustained during steam inhalation therapy in an adult population: Analysis of patient outcomes and the financial burden to healthcare services

    Western science’s view is predominantly “this is popular and/but evidence for its usefulness is lacking”:

    Theoretical effectiveness of steam inhalation against SARS-CoV-2 infection: updates on clinical trials, mechanism of actions, and traditional approaches

    But! Traditional Chinese Medicine indicates shuanghuanglian, yuxingcao and qingkailing, which the China Food and Drug Administration has also approved:

    Chinese Medicine in Inhalation Therapy: A Review of Clinical Application and Formulation Development

    Indian scientists are also looking at modern scientific applications of certain Ayurvedic herbs:

    Promising phytochemicals of traditional Indian herbal steam inhalation therapy to combat COVID-19

    In terms of what is likely more available to you, there are several reasons to choose eucalyptus over popular alternatives:

    Immune-modifying and antimicrobial effects of Eucalyptus oil and simple inhalation devices

    For the sake of being methodical, here’s an example product on Amazon, though we’re sure you’d have no trouble finding this in your local pharmacy if you prefer.

    Take care!

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  • Surgery won’t fix my chronic back pain, so what will?

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    This week’s ABC Four Corners episode Pain Factory highlighted that our health system is failing Australians with chronic pain. Patients are receiving costly, ineffective and risky care instead of effective, low-risk treatments for chronic pain.

    The challenge is considering how we might reimagine health-care delivery so the effective and safe treatments for chronic pain are available to millions of Australians who suffer from chronic pain.

    One in five Australians aged 45 and over have chronic pain (pain lasting three or more months). This costs an estimated A$139 billion a year, including $12 billion in direct health-care costs.

    The most common complaint among people with chronic pain is low back pain. So what treatments do – and don’t – work?

    Opioids and invasive procedures

    Treatments offered to people with chronic pain include strong pain medicines such as opioids and invasive procedures such as spinal cord stimulators or spinal fusion surgery. Unfortunately, these treatments have little if any benefit and are associated with a risk of significant harm.

    Spinal fusion surgery and spinal cord stimulators are also extremely costly procedures, costing tens of thousands of dollars each to the health system as well as incurring costs to the individual.

    Addressing the contributors to pain

    Recommendations from the latest Australian and World Health Organization clinical guidelines for low back pain focus on alternatives to drug and surgical treatments such as:

    • education
    • advice
    • structured exercise programs
    • physical, psychological or multidisciplinary interventions that address the physical or psychological contributors to ongoing pain.
    Woman sits on exercise ball and uses stretchy band
    Pain education is central. Monkey Business Images/Shutterstock

    Two recent Australian trials support these recommendations and have found that interventions that address each person’s physical and psychological contributors to pain produce large and sustained improvements in pain and function in people with chronic low back pain.

    The interventions have minimal side effects and are cost-effective.

    In the RESOLVE trial, the intervention consists of pain education and graded sensory and movement “retraining” aimed to help people understand that it’s safe to move.

    In the RESTORE trial, the intervention (cognitive functional therapy) involves assisting the person to understand the range of physical and psychological contributing factors related to their condition. It guides patients to relearn how to move and to build confidence in their back, without over-protecting it.

    Why isn’t everyone with chronic pain getting this care?

    While these trials provide new hope for people with chronic low back pain, and effective alternatives to spinal surgery and opioids, a barrier for implementation is the out-of-pocket costs. The interventions take up to 12 sessions, lasting up to 26 weeks. One physiotherapy session can cost $90–$150.

    In contrast, Medicare provides rebates for just five allied health visits (such as physiotherapists or exercise physiologists) for eligible patients per year, to be used for all chronic conditions.

    Private health insurers also limit access to reimbursement for these services by typically only covering a proportion of the cost and providing a cap on annual benefits. So even those with private health insurance would usually have substantial out-of-pocket costs.

    Access to trained clinicians is another barrier. This problem is particularly evident in regional and rural Australia, where access to allied health services, pain specialists and multidisciplinary pain clinics is limited.

    Higher costs and lack of access are associated with the increased use of available and subsidised treatments, such as pain medicines, even if they are ineffective and harmful. The rate of opioid use, for example, is higher in regional Australia and in areas of socioeconomic disadvantage than metropolitan centres and affluent areas.

    So what can we do about it?

    We need to reform Australia’s health system, private and public, to improve access to effective treatments for chronic pain, while removing access to ineffective, costly and high-risk treatments.

    Better training of the clinical workforce, and using technology such as telehealth and artificial intelligence to train clinicians or deliver treatment may also improve access to effective treatments. A recent Australian trial, for example, found telehealth delivered via video conferencing was as effective as in-person physiotherapy consultations for improving pain and function in people with chronic knee pain.

    Advocacy and improving the public’s understanding of effective treatments for chronic pain may also be helpful. Our hope is that coordinated efforts will promote the uptake of effective treatments and improve the care of patients with chronic pain.

    Christine Lin, Professor, University of Sydney; Christopher Maher, Professor, Sydney School of Public Health, University of Sydney; Fiona Blyth, Professor, University of Sydney; James Mcauley, Professor of Psychology, UNSW Sydney, and Mark Hancock, Professor of Physiotherapy, Macquarie University

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

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