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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This article first appeared on KFF Health News and is republished here under a Creative Commons license.
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Yes, you still need to use sunscreen, despite what you’ve heard on TikTok
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Summer is nearly here. But rather than getting out the sunscreen, some TikTokers are urging followers to chuck it out and go sunscreen-free.
They claim it’s healthier to forgo sunscreen to get the full benefits of sunshine.
Here’s the science really says.
Karolina Grabowska/Pexels How does sunscreen work?
Because of Australia’s extreme UV environment, most people with pale to olive skin or other risk factors for skin cancer need to protect themselves. Applying sunscreen is a key method of protecting areas not easily covered by clothes.
Sunscreen works by absorbing or scattering UV rays before they can enter your skin and damage DNA or supportive structures such as collagen.
When UV particles hit DNA, the excess energy can damage our DNA. This damage can be repaired, but if the cell divides before the mistake is fixed, it causes a mutation that can lead to skin cancers.
The energy from a particle of UV (a photon) causes DNA strands to break apart and reconnect incorrectly. This causes a bump in the DNA strand that makes it difficult to copy accurately and can introduce mutations. NASA/David Herring The most common skin cancers are basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). Melanoma is less common, but is the most likely to spread around the body; this process is called metastasis.
Two in three Australians will have at least one skin cancer in their lifetime, and they make up 80% of all cancers in Australia.
Around 99% of skin cancers in Australia are caused by excessive exposure to UV radiation.
Excessive exposure to UV radiation also affects the appearance of your skin. UVA rays are able to penetrate deep into the skin, where they break down supportive structures such as elastin and collagen.
This causes signs of premature ageing, such as deep wrinkling, brown or white blotches, and broken capillaries.
Sunscreen can help prevent skin cancers
Used consistently, sunscreen reduces your risk of skin cancer and slows skin ageing.
In a Queensland study, participants either used sunscreen daily for almost five years, or continued their usual use.
At the end of five years, the daily-use group had reduced their risk of squamous cell carcinoma by 40% compared to the other group.
Ten years later, the daily use group had reduced their risk of invasive melanoma by 73%
Does sunscreen block the health-promoting properties of sunlight?
The answer is a bit more complicated, and involves personalised risk versus benefit trade-offs.
First, the good news: there are many health benefits of spending time in the sun that don’t rely on exposure to UV radiation and aren’t affected by sunscreen use.
Sunscreen only filters UV rays, not all light. Ron Lach/Pexels Sunscreen only filters UV rays, not visible light or infrared light (which we feel as heat). And importantly, some of the benefits of sunlight are obtained via the eyes.
Visible light improves mood and regulates circadian rhythm (which influences your sleep-wake cycle), and probably reduces myopia (short-sightedness) in children.
Infrared light is being investigated as a treatment for several skin, neurological, psychiatric and autoimmune disorders.
So what is the benefit of exposing skin to UV radiation?
Exposing the skin to the sun produces vitamin D, which is critical for healthy bones and muscles.
Vitamin D deficiency is surprisingly common among Australians, peaking in Victoria at 49% in winter and being lowest in Queensland at 6% in summer.
Luckily, people who are careful about sun protection can avoid vitamin D deficiency by taking a supplement.
Exposing the skin to UV radiation might have benefits independent of vitamin D production, but these are not proven. It might reduce the risk of autoimmune diseases such as multiple sclerosis or cause release of a chemical that could reduce blood pressure. However, there is not enough detail about these benefits to know whether sunscreen would be a problem.
What does this mean for you?
There are some benefits of exposing the skin to UV radiation that might be blunted by sunscreen. Whether it’s worth foregoing those benefits to avoid skin cancer depends on how susceptible you are to skin cancer.
If you have pale skin or other factors that increase you risk of skin cancer, you should aim to apply sunscreen daily on all days when the UV index is forecast to reach 3.
If you have darker skin that rarely or never burns, you can go without daily sunscreen – although you will still need protection during extended times outdoors.
For now, the balance of evidence suggests it’s better for people who are susceptible to skin cancer to continue with sun protection practices, with vitamin D supplementation if needed.
Katie Lee, PhD Candidate, Dermatology Research Centre, The University of Queensland and Rachel Neale, Principal research fellow, QIMR Berghofer Medical Research Institute
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Beyond Guarding Against Dementia
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When Age’s Brain-Changes Come Knocking
This is Dr. Amy Friday. She’s a psychologist, specializing in geropsychology and neuropsychological assessments.
In other words, she helps people optimize their aging experience, particularly in the context of brain changes as we get older.
What does she want us to know?
First: be not afraid
Ominous first words, but the fact is, there’s a lot to find scary about the prospect of memory loss, dementia, and death.
However, as she points out:
- Death will come for us all sooner or later, barring technology as yet unknown
- Dementia can be avoided, or at least stalled, or at least worked around
- Memory loss, as per the above, can be avoided/stalled/managed
We’ve written a little on these topics too:
…or if the death is not yours:
As for avoiding dementia, the below-linked feature is about Alzheimer’s in particular (which accounts for more than half of all cases of dementia), but the advice goes for most of the other kinds too:
How To Reduce Your Alzheimer’s Risk
And finally, about memory loss specifically:
How To Boost Your Memory Immediately (Without Supplements)
this one is especially about cementing into one’s brain the kinds of memories that people most fear losing with age. People don’t worry about forgetting their PIN codes; they worry about forgetting their cherished memories with loved ones. So, if that’s important to you, do consider checking out this one!
What is that about managing or working around the symptoms?
If we’re missing a limb, we (usually) get a prosthetic, and/or learn how to operate without that limb.
If we’re missing sight or hearing, partially or fully, there are disability aids for those kinds of things too (glasses are a disability aid! Something being very common does not make it not a disability; you literally have less of an ability—in this case, the ability to see), and/or we learn how to operate with our different (or missing) sense.
Dr. Friday makes the case for this being the same with memory loss, dementia, and other age-related symptoms (reduced focus, increased mental fatigue, etc):
❝We are all screwed up. Here’s my flavor … what’s yours? This is a favorite saying of mine, because we ARE all screwed up in one way or another, and when we acknowledge it we can feel closer in our screwed-up-edness.
We are all experiencing “normal aging,” so that tip-of-the-tongue phenomenon that starts in our thirties and slowly gets worse is REAL. But what if you’re having more problems than normal aging? Is it time to throw in the towel and hide? I’m hoping that there is a group of people who say HELL NO to that idea.
Let’s use lessons from research and clinical practice to help all of us work around our weaknesses, and capitalize on our strengths. ❞
Examples of this might include:
- Writing down the things most important to you (a short list of information and/or statements that you feel define you and what matters most to you), so that you can read it later
- Making sure you have support (partner, family, friends, etc) who are on the same page about this topic—and thus will actually support you and advocate for you, instead of arguing about what is in your best interest without consulting you.
- Labelling stuff around the house, so that you get less confused about what is what and where it is
- Having a named go-to advocate that you can call / ask to be called, if you are in trouble somewhere and need help that you can rely on
- Getting a specialized, simpler bank account; hiring an accountant if relevant and practicable.
The thing is, we all want to keep control. Sometimes we can do that! Sometimes we can’t, and if we’re going to lose some aspect of control, it’ll generally go a lot better if we do it on our own terms, so that we ourselves can look out for future-us in our planning.
Want to know more?
You might enjoy her blog, which includes also links to her many videos on the topic, including such items as:
- Neuroplasticity – #1 Way To Increase Brain Health
- Which Diet PREVENTS Alzheimer’s? | Best Brain Health Diet
- Stop Anxiety About Dementia & Do I Have Dementia?
For the rest, see:
This Beautiful Brain | The Science Of Brain Health
Enjoy!
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Blackberries vs Blueberries – Which is Healthier?
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Our Verdict
When comparing blackberries to blueberries, we picked the blackberries.
Why?
They’re both great! But the humble blackberry stands out (and is an example of “foods that are darker are often more nutrient-dense”).
In terms of macronutrients, they’re quite similar, being both berry fruits that are mostly water, but blackberries do have 2x the fiber (and for what it’s worth, 2x the protein, though this is a small number obviously), while blueberries have 2x the carbohydrates. An easy win for blackberries.
When it comes to vitamins, blackberries have notably more of vitamin A, B3, B5, B9, C, and E, as well as choline, while blueberries have a little more of vitamins B1, B2, and B6. A fair win for blackberries.
In the category of minerals, blackberries have a lot more calcium, copper, iron, magnesium, manganese, phosphorus, potassium, selenium, and zinc. Blueberries are not higher in any minerals. Another easy win for blackberries.
Blueberries are famous for their antioxidants, but blackberries actually equal them. The polyphenolic content varies from one fruit to another, but they are both loaded with an abundance (thousands) of antioxidants, especially anthocyanins. Blackberries and blueberries tie in this category.
Adding up the sections makes for an easy, easy win for blackberries—but diversity is always best, so enjoy both!
Want to learn more?
You might like to read:
- Cherries vs Blueberries – Which is Healthier?
- Strawberries vs Cherries – Which is Healthier?
- Strawberries vs Raspberries – Which is Healthier?
- Goji Berries vs Blueberries – Which is Healthier?
Take care!
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Health Tips for Males Too
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It’s Q&A Day at 10almonds!
Have a question or a request? You can always hit “reply” to any of our emails, or use the feedback widget at the bottom!
In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!
As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!
So, no question/request too big or small
❝Articles are very informative and helpful. Maybe it’s me but things seem to lean more toward females. That being said don’t forget us males❞
Rest assured, we could never forget you! We try to make as much as possible of our content applicable to as many as possible of our readers, but of course not everything can be relevant for everyone.
This is, presumably, in response to our recent feature on menopausal health, because previous to that, our next-most-recent main feature that centred women’s health was a month ago—that was about breast cancer, and did have a section on breast cancer in men too. You might also enjoy the book we reviewed recently about prostate health, or our regular sponsor offering testosterone therapy. Please feel free to check out our articles on saw palmetto against male pattern baldness and BPH, as well as mental health issues that disproportionally affect men.
And of course, if you have specific questions/requests about men’s health (or any other health topic) we’re only ever an email away (or use the handy feedback widget, as you did to make this request)!
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Hair-Loss Remedies, By Science
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10almonds Gets Hairy
Hair loss is a thing that at some point affects most men and a large minority of women. It can be a source of considerable dysphoria for both, as it’s often seen as a loss of virility/femininity respectively, and is societally stigmatized in various ways.
Today we’re going to focus on the most common kind: androgenic alopecia, which is called “male pattern baldness” in men and “female pattern baldness” in women, despite being the same thing.
We won’t spend a lot of time on the science of why this happens (we’re going to focus on the remedies instead), but suffice it to say that genes and hormones both play a role, with dihydrogen testosterone (DHT) being the primary villain in this case.
We’ve talked before about the science of 5α-reductase inhibitors to block the conversion of regular testosterone* to DHT, its more potent form:
One Man’s Saw Palmetto Is Another Woman’s Serenoa Repens…
*We all make this to a greater or lesser degree, unless we have had our ovaries/testes removed.
Finasteride
Finasteride is a 5α-reductase inhibitor that performs similarly to saw palmetto, but comes in tiny pills instead of needing to take a much higher dose of supplement (5mg of finasteride is comparable in efficacy to a little over 300mg of saw palmetto).
Does it work? Yes!
Any drawbacks? A few:
- It’ll take 3–6 months to start seeing effects. This is because of the hormonal life-cycle of human hairs.
- Common side-effects include ED.
- It is popularly labelled/prescribed as “only for men”
On that latter point: the warnings about this are severe, detailing how women must not take it, must not even touch it if it has been cut up or crushed.
However… That’s because it can carry a big risk to our unborn fetuses. So, if we are confident we definitely don’t have one of those, it’s not actually applicable to us.
That said, finasteride’s results in women aren’t nearly so clear-cut as in men (though also, there has been less research, largely because of the above). Here’s an interesting breakdown in more words than we have room for here:
Finasteride for Women: Everything You Need to Know
Spironolactone
This one’s generally prescribed to women, not men, largely because it’s the drug sometimes popularly known as a “chemical castration” drug, which isn’t typically great marketing for men (although it can be applied topically, which will have less of an effect on the rest of the body). For women, this risk is simply not an issue.
We’ll be brief on this one, but we’ll just drop this, so that you know it’s an option that works:
❝Spironolactone is an effective and safe treatment of androgenic alopecia which can enhance the efficacy when combined with other conventional treatments such as minoxidil.
Topical spironolactone is safer than oral administration and is suitable for both male and female patients, and is expected to become a common drug for those who do not have a good response to minoxidil❞
Minoxidil
This one is available (to men and women) without prescription. It’s applied topically, and works by shortcutting the hair’s hormonal growth cycle, to reduce the resting phase and kick it into a growth phase.
Does it work? Yes!
Any drawbacks? A few:
- Whereas you’ll remember finasteride takes 3–6 months to see any effect, this one will have an effect very quickly
- Specifically, the immediate effect is: your rate of hair loss will appear to dramatically speed up
- This happens because when hairs are kicked into their growth phase if they were in a resting phase, the first part of that growth phase is to shed each old hair to make room for the new one
- You’ll then need the same 3–6 months as with finasteride, to see the regrowth effects
- If you stop using it, you will immediately shed whatever hair you gained by this method
Why do people choose this over finasteride? For one of three reasons, mainly:
- They are women, and not offered finasteride
- They are men, and do not want the side effects of finasteride
- They just saw an ad and tried it
As to how it works:
Some final notes:
There are some other contraindications and warnings with each of these drugs by the way, so do speak with your doctor/pharmacist. For example:
- Finasteride can tax the liver a little
- Spironolactone can reduce bone turnover
- Minoxidil is a hypotensive; this shouldn’t be an issue for most people, but for some people it could be a problem
There are other hair loss remedies and practices, but the above three are the heavy-hitters, so that’s what we spent our time/space on today. We’ll perhaps cover the less powerful (but less risky) options one of these days.
Meanwhile, take care!
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Why Chronic Obstructive Pulmonary Disease (COPD) Is More Likely Than You Think
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Chronic Obstructive Pulmonary Disease (COPD): More Likely Than You Think
COPD is not so much one disease, as rather a collection of similar (and often overlapping) diseases. The main defining characteristic is that they are progressive lung diseases. Historically the most common have been chronic bronchitis and emphysema, though Long COVID and related Post-COVID conditions appear to have been making inroads.
Lung cancer is generally considered separately, despite being a progressive lung disease, but there is crossover too:
COPD prevalence is increased in lung cancer, independent of age, sex and smoking history
COPD can be quite serious:
“But I don’t smoke”
Great! In fact we imagine our readership probably has disproportionately few smokers compared to the general population, being as we all are interested in our health.
But, it’s estimated that 30,000,000 Americans have COPD, and approximately half don’t know it. Bear in mind, the population of the US is a little over 340,000,000, so that’s a little under 9% of the population.
Click here to see a state-by-state breakdown (how does your state measure up?)
How would I know if I have it?
It typically starts like any mild respiratory illness. Likely shortness of breath, especially after exercise, a mild cough, and a frequent need to clear your throat.
Then it will get worse, as the lungs become more damaged; each of those symptoms might become stronger, as well as chest tightness and a general lack of energy.
Later stages, you guessed it, the same but worse, and—tellingly—weight loss.
The reason for the weight loss is because you are getting less oxygen per breath, making carrying your body around harder work, meaning you burn more calories.
What causes it?
Lots of things, with smoking being up at the top, or being exposed to a lot of second-hand smoke. Working in an environment with a lot of air pollution (for example, working around chemical fumes) can cause it, as can inhaling dust. New Yorkers: yes, that dust too. It can also develop from other respiratory illnesses, and some people even have a genetic predisposition to it:
Alpha-1 antitrypsin deficiency: a commonly overlooked cause of lung disease
Is it treatable?
Treatment varies depending on what form of it you have, and most of the medical interventions are beyond the scope of this article. Suffice it to say, there are medications that can be taken (including bronchodilators taken via an inhaler device), corticosteroids, antibiotics and antivirals of various kinds if appropriate. This is definitely a “see your doctor” item though, because there are is far too much individual variation for us to usefully advise here.
However!
There are habits we can do to a) make COPD less likely and b) make COPD at least a little less bad if we get it.
Avoiding COPD:
- Don’t smoke. Just don’t.
- Avoid second-hand smoke if you can
- Avoid inhaling other chemicals/dust that may be harmful
- Breathe through your nose, not your mouth; it filters the air in a whole bunch of ways
- Seriously, we know it seems like nostril hairs surely can’t do much against tiny particles, but tiny particles are attracted to them and get stuck in mucous and dealt with by our immune system, so it really does make a big difference
Managing COPD:
- Continue the above things, of course
- Exercise regularly, even just light walking helps; we realize it will be difficult
- Maintain a healthy weight if you can
- This means both ways; COPD causes weight loss and that needs to be held in check. But similarly, you don’t want to be carrying excessive weight either; that will tire you even more.
- Look after the rest of your health; everything else will now hit you harder, so even small things need to be taken seriously
- If you can, get someone to help / do your household cleaning for you, ideally while you are not in the room.
Where can I get more help/advice?
As ever, speak to your doctor if you are concerned this may be affecting you. You can also find a lot of resources via the COPD Foundation’s website.
Take care of yourself!
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- Don’t smoke. Just don’t.
