The Couple’s Guide to Thriving with ADHD – by Melissa Orlov and Nancie Kohlenberger

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ADHD (what a misleadingly-named condition) is most often undiagnosed in adults, especially older adults, and has far-reaching effects. This book explores those!

Oftentimes ADHD is not a deficit of attention, it’s just a lack of choice about where one’s attention goes. And the H? It’s mostly not what people think it is. The diagnostic criteria have moved far beyond the original name.

But in a marriage, ADHD symptoms such as wandering attention, forgetfulness, impulsiveness, and a focus on the “now” to the point of losing sight of the big picture (the forgotten past and the unplanned future), can cause conflict.

The authors write in a way that is intended for the ADHD and/or non-ADHD partner to read, and ideally, for both to read.

They shine light on why people with or without ADHD tend towards (or away from) certain behaviours, what miscommunications can arise, and how to smooth them over.

Best of all, an integrated plan for getting you both on the same page, so that you can tackle anything that arises, as the diverse team (with quite different individual strengths) that you are.

Bottom line: if you or a loved one has ADHD symptoms, this book can help you navigate and untangle what can otherwise sometimes get a little messy.

Click here to check out The Couple’s Guide to Thriving with ADHD, and learn how to do just that!

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Recommended

  • State of Slim – by Dr. James Hill & Dr. Holly Wyatt
  • The push for Medicare to cover weight-loss drugs: An explainer
    Medicare’s refusal to cover weight-loss drugs leaves older people struggling to access promising medications. It’s time for a change.

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  • The Circadian Rhythm: Far More Than Most People Know

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    The Circadian Rhythm: Far More Than Most People Know

    This is Dr. Satchidananda (Satchin) Panda, the scientist behind the discovery of the blue-light sensing cell type in the retina, and the many things it affects. But, he’s discovered more…

    First, what you probably know (with a little more science)

    Dr. Panda discovered that melanopsin, a photopigment, is “the primary candidate for photoreceptor-mediated entrainment”.

    To put that in lay terms, it’s the brain’s go-to for knowing approximately what time of day or night it is, according to how much light there is (or isn’t), and how long it has (or hasn’t) been there.

    But… the brain’s “go-to” isn’t the only method. By creating mice without melanopsin, he was able to find that they still keep a circadian rhythm, even in complete darkness:

    Melanopsin (Opn4) Requirement for Normal Light-Induced Circadian Phase Shifting

    In other words, it was a helpful, but not completely necessary, means of keeping a circadian rhythm.

    So… What else is going on?

    Dr. Panda and his team did a lot of science that is well beyond the scope of this main feature, but to give you an idea:

    • With jargon: it explored the mechanisms and transcription translation negative feedback loops that regulate chronobiological processes, such as a histone lysine demathlyase 1a (JARID1a) that enhances Clock-Bmal1 transcription, and then used assorted genomic techniques to develop a model for how JARID1a works to moderate the level of Per transcription by regulating the transition between its repression and activation, and discovered that this heavily centered on hepatic gluconeogenesis and glucose homeostasis, facilitated by the protein cryptochrome regulating the fasting signal that occurs when glucagon binds to a G-protein coupled receptor, triggering CREB activation.
    • Without jargon: a special protein tells our body how to respond to eating/fasting at different times of day—and conversely, certain physiological responses triggered by eating/fasting help us know what time of day it is.
    • Simplest: our body keeps on its best cycle if we eat at the same time every day

    This is important, because our circadian rhythm matters for a lot more than sleeping/waking! Take hormones, for example:

    • Obvious hormones: testosterone and estrogen peak in the mornings around 9am, progesterone peaks between 10pm and 2am
    • Forgotten hormones: cortisol peaks in the morning around 8:30am, melatonin peaks between 10pm and 2am
    • More hormones: ghrelin (hunger hormone) peaks around 10am, leptin (satiety hormone) peaks 20 minutes after eating a certain amount of satiety-triggering food (protein does this most quickly), insulin is heavily tied to carbohydrate intake, but will still peak and trough according to when the body expects food.

    What does this mean for us in practical terms?

    For a start, it means that intermittent fasting can help guard against metabolic and related diseases (including inflammation, and thus also cancer, diabetes, arthritis, and more) a lot more if we practice it with our circadian rhythm in mind.

    So that “8-hour window” for eating, that many intermittent fasting practitioners adhere to, is going to do much, much better if it’s 10am to 6pm, rather than, say, 4pm to midnight.

    Additionally, Dr. Panda and his team found that a 12-hour eating window wasn’t sufficient to help significantly.

    Time-Restricted Feeding Is a Preventative and Therapeutic Intervention against Diverse Nutritional Challenges

    Some other take-aways:

    • For reasons beyond the scope of this article, it’s good to exercise a) early b) before eating, so getting in some exercise between 8.30am and 10am is ideal
    • It also means it’s beneficial to “front-load” eating, so a large breakfast at 10am, and smaller meals/snacks afterwards, is best.
    • It also means that getting sunlight (even if cloud-covered) around 8.30am helps guard against metabolic disorders a lot, since the light remains the body’s go-to way of knowing the time.
      • We realize that sunlight is not available at 8.30am at all latitudes at all times of year. Artificial is next-best.
    • It also means sexual desire will typically peak in men in the mornings (per testosterone) and women in the evenings (per progesterone), but this is just an interesting bit of trivia, and not so relevant to metabolic health

    What to do next…

    Want to stabilize your own circadian rhythm in the best way, and also help Dr. Panda with his research?

    His team’s (free!) app, “My Circadian Clock”, can help you track and organize all of the body’s measurable-by-you circadian events, and, if you give permission, will contribute to what will be the largest-yet human study into the topics covered today, to refine the conclusions and learn more about what works best.

    Check out the iOS app here | Check out the Android app here

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  • The Exercises That Can Fix Sinus Problems (And More)

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    Who nose what benefits you will gain today?

    This is James Nestor, a science journalist and author. He’s written for many publications, including Scientific American, and written a number of books, most notably Breath: The New Science Of A Lost Art.

    Today we’ll be looking at what he has to share about what has gone wrong with our breathing, what problems this causes, and how to fix it.

    What has gone wrong?

    When it comes to breathing, we humans are the pugs of the primate world. In a way, we have the opposite problem to the squashed-faced dogs, though. But, how and why?

    When our ancestors learned first tenderize food, and later to cook it, this had two big effects:

    1. We could now get much more nutrition for much less hunting/gathering
    2. We now did not need to chew our food nearly so much

    Getting much more nutrition for much less hunting/gathering is what allowed us to grow our brains so large—as a species, we have a singularly large brain-to-body size ratio.

    Not needing to chew our food nearly so much, meanwhile, had even more effects… And these effects have become only more pronounced in recent decades with the rise of processed food making our food softer and softer.

    It changed the shape of our jaw and cheekbones, just as the size of our brains taking up more space in our skull moved our breathing apparatus around. As a result, our nasal cavities are anatomically ridiculous, our sinuses are a crime against nature (not least of all because they drain backwards and get easily clogged), and our windpipes are very easily blocked and damaged due to the unique placement of our larynx; we’re the only species that has it there. It allowed us to develop speech, but at the cost of choking much more easily.

    What problems does this cause?

    Our (normal, to us) species-wide breathing problems have resulted in behavioral adaptations such as partial (or in some people’s cases, total or near-total) mouth-breathing. This in turn exacerbates the problems with our jaws and cheekbones, which in turn exacerbates the problems with our sinuses and nasal cavities in general.

    Results include such very human-centric conditions as sleep apnea, as well as a tendency towards asthma, allergies, and autoimmune diseases. Improper breathing also brings about a rather sluggish metabolism for how many calories we consume.

    How are we supposed to fix all that?!

    First, close your mouth if you haven’t already, and breathe through your nose.

    In and out.

    Both are important, and unless you are engaging in peak exercise, both should be through your nose. If you’re not used to this, it may feel odd at first, but practice, and build up your breathing ability.

    Six seconds in and six seconds out is a very good pace.

    If you’re sitting doing a breathing exercise, also good is four seconds in, four seconds hold, four seconds out, four seconds hold, repeat.

    But those frequent holds aren’t practical in general life, so: six seconds in, six seconds out.

    Through your nose only.

    This has benefits immediately, but there are other more long-term benefits from doing not just that, but also what has been called (by Nestor, amongst many others), “Mewing”, per the orthodontist, Dr. John Mew, who pioneered it.

    How (and why) to “mew”:

    Place your tongue against the roof of your mouth. It should be flat against the palate; you’re not touching it with the tip here; you’re creating a flat seal.

    Note: if you were mouth-breathing, you will now be unable to breathe. So, important to make sure you can breathe adequately through your nose first.

    This does two things:

    1. It obliges nose-breathing rather than mouth-breathing
    2. It creates a change in how the muscles of your face interact with the bones of your face

    In a battle between muscle and bone, muscle will always win.

    Aim to keep your tongue there as much as possible; make it your new best habit. If you’re not eating, talking, or otherwise using your tongue to do something, it should be flat against the roof of your mouth.

    You don’t have to exert pressure; this isn’t an exercise regime. Think of it more as a postural exercise, just, inside your mouth.

    Quick note: read the above line again, because it’s important. Doing it too hard could cause the opposite problems, and you don’t want that. You cannot rush this by doing it harder; it takes time and gentleness.

    Why would we want to do that?

    The result, over time, will tend to be much healthier breathing, better sinus health, freer airways, reduced or eliminated sleep apnea, and, as a bonus, what is generally considered a more attractive face in terms of bone structure. We’re talking more defined cheekbones, straighter teeth, and a better mouth position.

    Want to learn more?

    This is the “Mewing” technique that Nestor encourages us to try:

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  • America’s Health System Isn’t Ready for the Surge of Seniors With Disabilities

    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.

    The number of older adults with disabilities — difficulty with walking, seeing, hearing, memory, cognition, or performing daily tasks such as bathing or using the bathroom — will soar in the decades ahead, as baby boomers enter their 70s, 80s, and 90s.

    But the health care system isn’t ready to address their needs.

    That became painfully obvious during the covid-19 pandemic, when older adults with disabilities had trouble getting treatments and hundreds of thousands died. Now, the Department of Health and Human Services and the National Institutes of Health are targeting some failures that led to those problems.

    One initiative strengthens access to medical treatments, equipment, and web-based programs for people with disabilities. The other recognizes that people with disabilities, including older adults, are a separate population with special health concerns that need more research and attention.

    Lisa Iezzoni, 69, a professor at Harvard Medical School who has lived with multiple sclerosis since her early 20s and is widely considered the godmother of research on disability, called the developments “an important attempt to make health care more equitable for people with disabilities.”

    “For too long, medical providers have failed to address change in society, changes in technology, and changes in the kind of assistance that people need,” she said.

    Among Iezzoni’s notable findings published in recent years:

    Most doctors are biased. In survey results published in 2021, 82% of physicians admitted they believed people with significant disabilities have a worse quality of life than those without impairments. Only 57% said they welcomed disabled patients.

    “It’s shocking that so many physicians say they don’t want to care for these patients,” said Eric Campbell, a co-author of the study and professor of medicine at the University of Colorado.

    While the findings apply to disabled people of all ages, a larger proportion of older adults live with disabilities than younger age groups. About one-third of people 65 and older — nearly 19 million seniors — have a disability, according to the Institute on Disability at the University of New Hampshire.

    Doctors don’t understand their responsibilities. In 2022, Iezzoni, Campbell, and colleagues reported that 36% of physicians had little to no knowledge of their responsibilities under the 1990 Americans With Disabilities Act, indicating a concerning lack of training. The ADA requires medical practices to provide equal access to people with disabilities and accommodate disability-related needs.

    Among the practical consequences: Few clinics have height-adjustable tables or mechanical lifts that enable people who are frail or use wheelchairs to receive thorough medical examinations. Only a small number have scales to weigh patients in wheelchairs. And most diagnostic imaging equipment can’t be used by people with serious mobility limitations.

    Iezzoni has experienced these issues directly. She relies on a wheelchair and can’t transfer to a fixed-height exam table. She told me she hasn’t been weighed in years.

    Among the medical consequences: People with disabilities receive less preventive care and suffer from poorer health than other people, as well as more coexisting medical conditions. Physicians too often rely on incomplete information in making recommendations. There are more barriers to treatment and patients are less satisfied with the care they do get.

    Egregiously, during the pandemic, when crisis standards of care were developed, people with disabilities and older adults were deemed low priorities. These standards were meant to ration care, when necessary, given shortages of respirators and other potentially lifesaving interventions.

    There’s no starker example of the deleterious confluence of bias against seniors and people with disabilities. Unfortunately, older adults with disabilities routinely encounter these twinned types of discrimination when seeking medical care.

    Such discrimination would be explicitly banned under a rule proposed by HHS in September. For the first time in 50 years, it would update Section 504 of the Rehabilitation Act of 1973, a landmark statute that helped establish civil rights for people with disabilities.

    The new rule sets specific, enforceable standards for accessible equipment, including exam tables, scales, and diagnostic equipment. And it requires that electronic medical records, medical apps, and websites be made usable for people with various impairments and prohibits treatment policies based on stereotypes about people with disabilities, such as covid-era crisis standards of care.

    “This will make a really big difference to disabled people of all ages, especially older adults,” said Alison Barkoff, who heads the HHS Administration for Community Living. She expects the rule to be finalized this year, with provisions related to medical equipment going into effect in 2026. Medical providers will bear extra costs associated with compliance.

    Also in September, NIH designated people with disabilities as a population with health disparities that deserves further attention. This makes a new funding stream available and “should spur data collection that allows us to look with greater precision at the barriers and structural issues that have held people with disabilities back,” said Bonnielin Swenor, director of the Johns Hopkins University Disability Health Research Center.

    One important barrier for older adults: Unlike younger adults with disabilities, many seniors with impairments don’t identify themselves as disabled.

    “Before my mom died in October 2019, she became blind from macular degeneration and deaf from hereditary hearing loss. But she would never say she was disabled,” Iezzoni said.

    Similarly, older adults who can’t walk after a stroke or because of severe osteoarthritis generally think of themselves as having a medical condition, not a disability.

    Meanwhile, seniors haven’t been well integrated into the disability rights movement, which has been led by young and middle-aged adults. They typically don’t join disability-oriented communities that offer support from people with similar experiences. And they don’t ask for accommodations they might be entitled to under the ADA or the 1973 Rehabilitation Act.

    Many seniors don’t even realize they have rights under these laws, Swenor said. “We need to think more inclusively about people with disabilities and ensure that older adults are fully included at this really important moment of change.”

    KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.

    Subscribe to KFF Health News’ free Morning Briefing.

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Related Posts

  • State of Slim – by Dr. James Hill & Dr. Holly Wyatt
  • What causes food cravings? And what can we do about them?

    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.

    Many of us try to eat more fruits and vegetables and less ultra-processed food. But why is sticking to your goals so hard?

    High-fat, sugar-rich and salty foods are simply so enjoyable to eat. And it’s not just you – we’ve evolved that way. These foods activate the brain’s reward system because in the past they were rare.

    Now, they’re all around us. In wealthy modern societies we are bombarded by advertising which intentionally reminds us about the sight, smell and taste of calorie-dense foods. And in response to these powerful cues, our brains respond just as they’re designed to, triggering an intense urge to eat them.

    Here’s how food cravings work and what you can do if you find yourself hunting for sweet or salty foods.

    Fascinadora/Shutterstock

    What causes cravings?

    A food craving is an intense desire or urge to eat something, often focused on a particular food.

    We are programmed to learn how good a food tastes and smells and where we can find it again, especially if it’s high in fat, sugar or salt.

    Something that reminds us of enjoying a certain food, such as an eye-catching ad or delicious smell, can cause us to crave it.

    Three people holding a cone of french fries.
    Our brains learn to crave foods based on what we’ve enjoyed before. fon thachakul/Shutterstock

    The cue triggers a physical response, increasing saliva production and gastric activity. These responses are relatively automatic and difficult to control.

    What else influences our choices?

    While the effect of cues on our physical response is relatively automatic, what we do next is influenced by complex factors.
    Whether or not you eat the food might depend on things like cost, whether it’s easily available, and if eating it would align with your health goals.

    But it’s usually hard to keep healthy eating in mind. This is because we tend to prioritise a more immediate reward, like the pleasure of eating, over one that’s delayed or abstract – including health goals that will make us feel good in the long term.

    Stress can also make us eat more. When hungry, we choose larger portions, underestimate calories and find eating more rewarding.

    Looking for something salty or sweet

    So what if a cue prompts us to look for a certain food, but it’s not available?

    Previous research suggested you would then look for anything that makes you feel good. So if you saw someone eating a doughnut but there were none around, you might eat chips or even drink alcohol.

    But our new research has confirmed something you probably knew: it’s more specific than that.

    If an ad for chips makes you look for food, it’s likely a slice of cake won’t cut it – you’ll be looking for something salty. Cues in our environment don’t just make us crave food generally, they prompt us to look for certain food “categories”, such as salty, sweet or creamy.

    Food cues and mindless eating

    Your eating history and genetics can also make it harder to suppress food cravings. But don’t beat yourself up – relying on willpower alone is hard for almost everyone.

    Food cues are so powerful they can prompt us to seek out a certain food, even if we’re not overcome by a particularly strong urge to eat it. The effect is more intense if the food is easily available.

    This helps explain why we can eat an entire large bag of chips that’s in front of us, even though our pleasure decreases as we eat. Sometimes we use finishing the packet as the signal to stop eating rather than hunger or desire.

    Is there anything I can do to resist cravings?

    We largely don’t have control over cues in our environment and the cravings they trigger. But there are some ways you can try and control the situations you make food choices in.

    • Acknowledge your craving and think about a healthier way to satisfy it. For example, if you’re craving chips, could you have lightly-salted nuts instead? If you want something sweet, you could try fruit.
    • Avoid shopping when you’re hungry, and make a list beforehand. Making the most of supermarket “click and collect” or delivery options can also help avoid ads and impulse buys in the aisle.
    • At home, have fruit and vegetables easily available – and easy to see. Also have other nutrient dense, fibre-rich and unprocessed foods on hand such as nuts or plain yoghurt. If you can, remove high-fat, sugar-rich and salty foods from your environment.
    • Make sure your goals for eating are SMART. This means they are specific, measurable, achievable, relevant and time-bound.
    • Be kind to yourself. Don’t beat yourself up if you eat something that doesn’t meet your health goals. Just keep on trying.

    Gabrielle Weidemann, Associate Professor in Psychological Science, Western Sydney University and Justin Mahlberg, Research Fellow, Pyschology, Monash University

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

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  • Marathons in Mid- and Later-Life

    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

    We had several requests pertaining to veganism, meatless mondays, and substitutions in recipes—so we’re going to cover those on a different day!

    As for questions we’re answering today…

    Q: Is there any data on immediate and long term effects of running marathons in one’s forties?

    An interesting and very specific question! We didn’t find an overabundance of studies specifically for the short- and long-term effects of marathon-running in one’s 40s, but we did find a couple of relevant ones:

    The first looked at marathon-runners of various ages, and found that…

    • there are virtually no relevant running time differences (p<0.01) per age in marathon finishers from 20 to 55 years
    • the majority of middle-aged and elderly athletes have training histories of less than seven years of running

    From which they concluded:

    ❝The present findings strengthen the concept that considers aging as a biological process that can be considerably speeded up or slowed down by multiple lifestyle related factors.❞

    See the study: Performance, training and lifestyle parameters of marathon runners aged 20–80 years: results of the PACE-study

    The other looked specifically at the impact of running on cartilage, controlled for age (45 and under vs 46 and older) and activity level (marathon-runners vs sedentary people).

    The study had the people, of various ages and habitual activity levels, run for 30 minutes, and measured their knee cartilage thickness (using MRI) before and after running.

    They found that regardless of age or habitual activity level, running compressed the cartilage tissue to a similar extent. From this, it can be concluded that neither age nor marathon-running result in long-term changes to cartilage response to running.

    Or in lay terms: there’s no reason that marathon-running at 40 should ruin your knees (unless you are doing something wrong).

    That may or may not have been a concern you have, but it’s what the study looked at, so hey, it’s information.

    Here’s the study: Functional cartilage MRI T2 mapping: evaluating the effect of age and training on knee cartilage response to running

    Q: Information on [e-word] dysfunction for those who have negative reactions to [the most common medications]?

    When it comes to that particular issue, one or more of these three factors are often involved:

    • Hormones
    • Circulation
    • Psychology

    The most common drugs (that we can’t name here) work on the circulation side of things—specifically, by increasing the localized blood pressure. The exact mechanism of this drug action is interesting, albeit beyond the scope of a quick answer here today. On the other hand, the way that they work can cause adverse blood-pressure-related side effects for some people; perhaps you’re one of them.

    To take matters into your own hands, so to speak, you can address each of those three things we just mentioned:

    Hormones

    Ask your doctor (or a reputable phlebotomy service) for a hormone test. If your free/serum testosterone levels are low (which becomes increasingly common in men over the age of 45), they may prescribe something—such as testosterone shots—specifically for that.

    This way, it treats the underlying cause, rather than offering a workaround like those common pills whose names we can’t mention here.

    Circulation

    Look after your heart health; eat for your heart health, and exercise regularly!

    Cold showers/baths also work wonders for vascular tone—which is precisely what you need in this matter. By rapidly changing temperatures (such as by turning off the hot water for the last couple of minutes of your shower, or by plunging into a cold bath), your blood vessels will get practice at constricting and maintaining that constriction as necessary.

    Psychology

    [E-word] dysfunction can also have a psychological basis. Unfortunately, this can also then be self-reinforcing, if recalling previous difficulties causes you to get distracted/insecure and lose the moment. One of the best things you can do to get out of this catch-22 situation is to not worry about it in the moment. Depending on what you and your partner(s) like to do in bed, there are plenty of other equally respectable options, so just switch track!

    Having a conversation about this in advance will probably be helpful, so that everyone’s on the same page of the script in that eventuality, and it becomes “no big deal”. Without that conversation, misunderstandings and insecurities could arise for your partner(s) as well as yourself (“aren’t I desirable enough?” etc).

    So, to recap, we recommend:

    • Have your hormones checked
    • Look after your circulation
    • Make the decision to have fun!

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    Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!

    Learn to Age Gracefully

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  • Younger Next Year – by Chris Crowley & Dr. Henry Lodge

    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.

    Is it diet and exercise? Well, of course that’s a component. Specific kinds of exercise, too. But, as usual when we feature a book, there’s more:

    In this case, strong throughout is the notion of life being a marathon not a sprint—and training for it accordingly.

    Doing the things now that you’ll really wish you’d started doing sooner, and finding ways to build them into daily life.

    Not just that, though! The authors take a holistic approach to life and health, and thus also cover work life, social life, and so forth. Now, you may be thinking “I’m already in the 80 and beyond category; I don’t work” and well, the authors advise that you do indeed work. You don’t have to revamp your career, but science strongly suggests that people who work longer, live longer.

    Of course that doesn’t have to mean going full-throttle like a 20-year-old determined to make their mark on the world (you can if you want, though). It could be volunteering for a charity, or otherwise just finding a socially-engaging “work-like” activity that gives you purpose.

    About the blend of motivational pep talk and science—this book is heavily weighted towards the former. It has, however, enough science to keep it on the right track throughout. Hence the two authors! Crowley for motivational pep, and Dr. Lodge for the science (with extra input from brain surgeon Dr. Hamilton, too).

    Bottom line: if you want to feel the most prepared possible for the coming years and decades, this is a great book that covers a lot of bases.

    Click here to check out “Younger Next Year” and get de-aging!

    Don’t Forget…

    Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!

    Learn to Age Gracefully

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