I’m Moving Forward and Facing the Uncertainty of Aging
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It takes a lot of courage to grow old.
I’ve come to appreciate this after conversations with hundreds of older adults over the past eight years for nearly 200 “Navigating Aging” columns.
Time and again, people have described what it’s like to let go of certainties they once lived with and adjust to new circumstances.
These older adults’ lives are filled with change. They don’t know what the future holds except that the end is nearer than it’s ever been.
And yet, they find ways to adapt. To move forward. To find meaning in their lives. And I find myself resolving to follow this path as I ready myself for retirement.
Patricia Estess, 85, of the Brooklyn borough of New York City spoke eloquently about the unpredictability of later life when I reached out to her as I reported a series of columns on older adults who live alone, sometimes known as “solo agers.”
Estess had taken a course on solo aging. “You realize that other people are in the same boat as you are,” she said when I asked what she had learned. “We’re all dealing with uncertainty.”
Consider the questions that older adults — whether living with others or by themselves — deal with year in and out: Will my bones break? Will my thinking skills and memory endure? Will I be able to make it up the stairs of my home, where I’m trying to age in place?
Will beloved friends and family members remain an ongoing source of support? If not, who will be around to provide help when it’s needed?
Will I have enough money to support a long and healthy life, if that’s in the cards? Will community and government resources be available, if needed?
It takes courage to face these uncertainties and advance into the unknown with a measure of equanimity.
“It’s a question of attitude,” Estess told me. “I have honed an attitude of: ‘I am getting older. Things will happen. I will do what I can to plan in advance. I will be more careful. But I will deal with things as they come up.’”
For many people, becoming old alters their sense of identity. They feel like strangers to themselves. Their bodies and minds aren’t working as they used to. They don’t feel the sense of control they once felt.
That requires a different type of courage — the courage to embrace and accept their older selves.
Marna Clarke, a photographer, spent more than a dozen years documenting her changing body and her life with her partner as they grew older. Along the way, she learned to view aging with new eyes.
“Now, I think there’s a beauty that comes out of people when they accept who they are,” she told me in 2022, when she was 70, just before her 93-year-old husband died.
Arthur Kleinman, a Harvard professor who’s now 83, gained a deeper sense of soulfulness after caring for his beloved wife, who had dementia and eventually died, leaving him grief-stricken.
“We endure, we learn how to endure, how to keep going. We’re marked, we’re injured, we’re wounded. We’re changed, in my case for the better,” he told me when I interviewed him in 2019. He was referring to a newfound sense of vulnerability and empathy he gained as a caregiver.
Herbert Brown, 68, who lives in one of Chicago’s poorest neighborhoods, was philosophical when I met him at his apartment building’s annual barbecue in June.
“I was a very wild person in my youth. I’m surprised I’ve lived this long,” he said. “I never planned on being a senior. I thought I’d die before that happened.”
Truthfully, no one is ever prepared to grow old, including me. (I’m turning 70 in February.)
Chalk it up to denial or the limits of imagination. As May Sarton, a writer who thought deeply about aging, put it so well: Old age is “a foreign country with an unknown language.” I, along with all my similarly aged friends, are surprised we’ve arrived at this destination.
For me, 2025 is a turning point. I’m retiring after four decades as a journalist. Most of that time, I’ve written about our nation’s enormously complex health care system. For the past eight years, I’ve focused on the unprecedented growth of the older population — the most significant demographic trend of our time — and its many implications.
In some ways, I’m ready for the challenges that lie ahead. In many ways, I’m not.
The biggest unknown is what will happen to my vision. I have moderate macular degeneration in both eyes. Last year, I lost central vision in my right eye. How long will my left eye pick up the slack? What will happen when that eye deteriorates?
Like many people, I’m hoping scientific advances outpace the progression of my condition. But I’m not counting on it. Realistically, I have to plan for a future in which I might become partially blind.
It’ll take courage to deal with that.
Then, there’s the matter of my four-story Denver house, where I’ve lived for 33 years. Climbing the stairs has helped keep me in shape. But that won’t be possible if my vision becomes worse.
So my husband and I are taking a leap into the unknown. We’re renovating the house, installing an elevator, and inviting our son, daughter-in-law, and grandson to move in with us. Going intergenerational. Giving up privacy. In exchange, we hope our home will be full of mutual assistance and love.
There are no guarantees this will work. But we’re giving it a shot.
Without all the conversations I’ve had over all these years, I might not have been up for it. But I’ve come to see that “no guarantees” isn’t a reason to dig in my heels and resist change.
Thank you to everyone who has taken time to share your experiences and insights about aging. Thank you for your openness, honesty, and courage. These conversations will become even more important in the years ahead, as baby boomers like me make their way through their 70s, 80s, and beyond. May the conversations continue.
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Switchcraft – by Dr. Elaine Fox
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How do we successfully balance “a mind is like a parachute: it only works if it’s open”, with the importance of also actually having some kind of personal integrity and consistency?
Dr. Fox recommends that we focus on four key attributes:
- Mental agility
- Self-awareness
- Emotional awareness
- Situational awareness
If this sounds a little wishy-washy, it isn’t—she delineates and explains each in detail. And most importantly: how we can build and train each one.
Mental agility, for example, is not about being able to rapidly solve chess problems or “answer these riddles three”. It’s more about:
- Adaptability
- Balancing our life
- Challenging (and if appropriate, changing) our perspective
- Developing our mental competence
This sort of thing is the “meat” of the book. Meanwhile, self-awareness is more a foundational conscious knowledge of one’s own “pole star” values, while emotional awareness is a matter of identifying and understanding and accepting what we feel—anything less is self-sabotage! And situational awareness is perhaps most interesting:
Dr. Fox advocates for “trusting one’s gut feelings”. With a big caveat, though!
If we trust our gut feelings without developing their accuracy, we’re just going to go about being blindly prejudiced and often wrong. So, a whole section of the book is devoted to honing this and improving our ability to judge things as they really are—rather than as we expect.
Bottom line: this book is a great tool for not only challenging our preconceptions about how we think, but giving us the resources to be adaptable and resilient without sacrificing integrity.
Click here to check out Switchcraft on Amazon and level up your thinking!
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Mindsight – by Dr. Daniel Siegel
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A lot of books these days bear the subtitle “The New Science Of…”, but usually it’s not new, and often it’s not even science. So how does this one measure up?
- Is it new? The core ideas are mostly very old, but some of the interventions are new in presentation—and backed by relatively recent research—so we can give him this one on a technicality at least
- It is science? Yes! The author is a clinician (a psychatric clinician, specifically) and there’s nothing here that doesn’t have its foundations in robust science.
So, what’s this “mindsight”, then? Dr. Siegel wants to express to us a concept “for which no word currently exists”, so he had to make one up, to convey the idea of having a conscious awareness of what is going on in our brain, on an experiential basis. In other words: “mindfulness”. There was totally already a word for this, which he goes on to lampshade not very far into the book.
Nevertheless, we’ll forgive him a little copywriting swizzle with the title, because the content here is genuinely top-tier.
In the book, many ideas from many other pop-psychology books are covered, in useful, practical, no-nonsense fashion, laying out tools and interventions to strengthen various parts of our brain and our relationship with same.
Bottom line: this is the most comprehensive, science-centric, book on mindfulness that this reviewer has read.
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Fall Special
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Some fall-themed advice…
It is now, nominally at least, fall. We’re going to talk about the other kind of “fall” though, the kind that results in broken hips and more.
If you’re thinking “not me; that happens to older more infirm people”, rest assured, it can and statistically probably will happen to you at some point. So, how to play the odds?
First, be robust!
We may not be able to make ourselves like children who bounce easily, but we also don’t have to crumble into dust at the slightest knock, either. There are two important ways we can start to make ourselves robust from the inside out, and they are simple: diet and exercise.
- Diet: The Bare-Bones Truth About Osteoporosis
- Exercise: Osteoporosis Exercises
“But I don’t have osteoporosis”—great! But osteoporosis is preceded by osteopenia, which is generally asymptomatic at first, and also if we’re not very careful about it, we will lose about 1% bone density per year from the age of about 35 onwards, with that rate of loss climbing sharply from the age of 50 onwards, and even more steeply in cases of untreated menopause.
So in other words, don’t take your bone strength for granted; there’s a first time for everything, and you don’t want to find out the hard (and yet, dare we say it, brittle) way.
Second, be dynamic!
Be able to fall and get up safely. If your later life is going to be a triathlon of things you need to train for now, then being able to fall and get up safely should be at the top of the list.
Being able to “deep squat” will help you a lot here, in being able to get up with minimal (or no) use of your hands. We shared a great instructional video about this last week.
It also means that the more your lower body can still take your weight while your torso is closer to the ground (without your legs buckling and collapsing, for instance), the softer and gentler you’ll hit the floor if you do fall, because the final “drop” will be from a lower height.
If at all possible, consider taking some classes of a martial art that involves safely falling—aikido is typically the softest and gentlest and is famously great for people of all ages, but judo or jujitsu will suffice if aikido isn’t available where you are. You don’t have to get a black belt (unless you want to), and any decent instructor will be happy to guide you through the basics of safely falling and then send you on your merry way, if that’s all you wanted.
The benefits of this are twofold:
- Obviously, if you fall, you will have better technique and thus be less likely to incur injury
- As you are falling, you will be less afraid, and thus less likely to tense up mid-fall (tensing up will exacerbate any falling injury)
Click here to find an aikido teacher near you (you can search by country, state, and city)
Third, be balanced!
Spending even just a few minutes each day working on your balance can go a long way.
Standing on one leg (and then the other) is a very good obvious starting point. Please, do so safely. The shower is not the best place to take up this practice, for instance. A nice safe grassy area is great. Your carpeted living room or bedroom is next-best.
Another great approach is the practice of bāguàzhǎng circle-walking.
Bāguà is tai chi’s lesser-known cousin, and those arts are two of the three main schools of wǔdāngquán. But, fear not, you don’t have to don orange robes and live atop the Wudang mountains to get what you need in this case.
To give a text-based summary: bāguàzhǎng circle-walking involves walking in a small circle, with a low center of gravity, moving one’s weight very purposefully from one leg to the other, keeping complete stability the whole time that one is (often!) on one leg.
Once you get good at this, you’ll see that this is essentially a super-enhanced version of the “standing on one leg” exercise, because it’s about keeping balance while on one leg, and/but while moving also.
Naturally, if you do get good at this, you’ll be very unlikely to fall in the first place.
Here’s a visual primer. This video will show the basic footwork, and the video that follows it (it’ll prompt you if you want to watch it) shows how to bring it up to a standard walking speed, without losing fluidity of movement:
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The Dopamine Myth
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The Dopamine Myth
There’s a popular misconception that, since dopamine is heavily involved in addictions, it’s the cause.
We see this most often in the context of non-chemical addictions, such as:
- gambling
- videogames
- social media
And yes, those things will promote dopamine production, and yes, that will feel good. But dopamine isn’t the problem.
Myth: The Dopamine Detox
There’s a trend we’ve mentioned before (it got a video segment a few Fridays back) about the idea of a “dopamine detox“, and how unscientific the idea is.
For a start…
- You cannot detox from dopamine, because dopamine is not a toxin
- You cannot abstain from dopamine, because your brain regulates your dopamine levels to keep them correct*
- If you could abstain from dopamine (and did), you would die, horribly.
*unless you have a serious mental illness, for example:
- forms of schizophrenia and/or psychosis that involve too much dopamine, or
- forms of depression and/or neurodegenerative diseases such as Parkinson’s (and several kinds of dementia) in which you have too little dopamine
- bipolar disorder in which dopamine levels can swing too far each way
See also: Dopamine fasting: misunderstanding science spawns a maladaptive fad
Myth: Dopamine is all about pleasure
Dopamine is a pleasure-giving neurotransmitter, but it serves more purposes than that! It also plays a central role in many neurological processes, including:
- Motivation
- Learning and memory
- Motor functions
- Language faculties
- Linear task processing
Note for example how someone taking dopaminergic drugs (prescription or otherwise; could be anything from modafinil to cocaine) is not blissed out… They’re probably in a good mood, sure, but they’re focused, organized, quick-thinking, and so forth! This is not an ad for cocaine; cocaine is very bad for the health. But you see the features? So, what if we could have a little more dopamine… healthily?
Dopamine—à la carte
Let’s look at the examples we gave earlier of non-chemical addictions that are dopaminergic in nature:
- gambling
- videogames
- social media
They’re not actually that rewarding, are they?
- Gamblers lose more than they win
- Gamers cease to care about a game once they have won
- Social media more often results in “doomscrolling”
This is because what prompts the most dopamine is actually the anticipation of reward… not the thing itself, whose reward-pleasure is very fleeting. Nobody looks back at an hour of doomscrolling and thinks “well, that was fun; I’m glad I did that”.
See the science: Liking, Wanting and the Incentive-Sensitization Theory of Addiction
But what if we anticipated a reward from things that are not deleterious to health and productivity? Things that are neutral, or even good for us?
Examples of this include:
- Sex! (remember though, it’s not a race to the finish-line)
- Good, nourishing food (bonus: some foods boost dopamine production nutritionally)
- Exercise/sport (also prompts release of endorphins, win/win!)
- Gamified learning apps (e.g. Duolingo)
- Gamified health/productivity apps (anything with bells and whistles and things that go “ding” and measure streaks etc)
Want to know more?
That’s all we have time for today, but you might want to check out:
10 Best Ways to Increase Dopamine Levels Naturally ← Science-based and well-sourced article!
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Rutin For Your Circulation & More
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Rutin is a bioflavonoid so potent it’s also been called “vitamin P”, and it’s found most abundantly in buckwheat, as well appearing in citrus and some stone fruits (apricots, plums, etc) as well as figs and apples—it’s also found in asparagus, and green and black tea.
So, what does it do?
Quite a lot: The Pharmacological Potential of Rutin
There’s much more there than we have room to cover here, but we’ll pick out a few salient properties to focus on.
First, a word of warning
A lot of the extant science for rutin is in non-human animals. Sometimes, what works for non-human animals doesn’t work for humans; we saw a clear example of this here:
Conjugated Linoleic Acid For Weight Loss?
…in which CLA worked for weight loss in mice, hamsters, chickens, and pigs, but stubbornly not humans.
The state of affairs with the science for rutin isn’t nearly that bad and there are human studies showing efficacy, and indeed, rutin is given to (human) patients with capillary fragility, varicose veins, bruising, or hemorrhoids, for example:
So, we’ll try to give you humans-only sources so far as we can today!
Improving blood flow
Rutin does improve various blood metrics, including various kinds of blood pressure (diastolic, systolic, mean arterial, pulse) and heart rate. At least, it did in humans with type 2 diabetes, and we may reasonably assume these results may be extrapolated to humans without type 2 (or any other) diabetes:
As you may gather from the title, it did also significantly improve serum antioxidant levels, and quality of life (which latter was categorized as: emotional limitations, energy and freshness, mental health, social performance, and general health).
We couldn’t find studies for cardioprotective effects in humans (and of course those couldn’t be RCTs, they’d have to be observational studies, because no ethics board allows inducing heart attacks in humans for the sake of science), but here’s a study using rats (with and without diabetes), showing proof of principle at least:
Anti-Alzheimer’s potential
As ever, a good general rule of thumb is “what’s good for the blood is good for the brain”, and that’s true in this case too.
The title says it all, here:
In case that is not clear: everything in that title after the word “inhibits” is bad for the brain and is implicated in Alzheimer’s disease pathogenesis and progression; in other words, rutin is good against all those bad, Alzheimer’s-favoring things.
Other neuroprotective activity
You may remember from the above-linked research that it helps protect against damage caused by Advanced Glycation End-products (AGEs) (the golden-brown stuff that appears as a result of dry-cooking proteins and fats); it also helps against damage caused by acrylamide (the golden-brown stuff that appears as a result of dry-cooking starches).
Note: in both cases “dry-cooking” includes cooking with oil; it simply means “without water”.
Again, this was a rat study, because no ethics board would have let the researchers fry human brains for science.
Want to try some?
As well as simply enjoying the fruits and vegetables that contain it, it is possible to take a rutin supplement.
We don’t sell it, but here for your convenience is an example product on Amazon 😎
Enjoy!
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Get Rid Of Female Facial Hair Easily
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Dr. Sam Ellis, dermatologist, explains:
Hair today; gone tomorrow
While a little peach fuzz is pretty ubiquitous, coarser hairs are less common in women especially earlier in life. However, even before menopause, such hair can be caused by main things, ranging from PCOS to genetics and more. In most cases, the underlying issue is excess androgen production, for one reason or another (i.e. there are many possible reasons, beyond the scope of this article).
Options for dealing with this include…
- Topical, such as eflornithine (e.g. Vaniqa) thins terminal hairs (those are the coarse kind); a course of 6–8 weeks continued use is needed.
- Hormonal, such as estrogen (opposes testosterone and suppresses it), progesterone (downregulates 5α-reductase, which means less serum testosterone is converted to the more powerful dihydrogen testosterone (DHT) form), and spironolactone or other testosterone-blockers; not hormones themselves, but they do what it says on the tin (block testosterone).
- Non-medical, such as electrolysis, laser, and IPL. Electrolysis works on all hair colors but takes longer; laser needs to be darker hair against paler skin* (because it works by superheating the pigment of the hair while not doing the same to the skin) but takes more treatments, and IPL is a less-effective more-convenient at-home option, that works on the same principles as laser (and so has the same color-based requirements), and simply takes even longer than laser.
*so for example:
- Black hair on white skin? Yes
- Red hair on white skin? Potentially; it depends on the level of pigmentation. But it’s probably not the best option.
- Gray/blonde hair on white skin? No
- Black hair on mid-tone skin? Yes, but a slower pace may be needed for safety
- Anything else on mid-tone skin? No
- Anything on dark skin? No
For more on all of this, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
Too Much Or Too Little Testosterone?
Take care!
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