The End of Alzheimer’s – by Dr. Dale Bredesen
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This one didn’t use the “The New Science Of…” subtitle that many books do, and this one actually is a “new science of”!
Which is exciting, and/but comes with the caveat that the overall protocol itself is still undergoing testing, but the results so far are promising. The constituent parts of the protocol are for the most already well-established, but have not previously been put together in this way.
Dr. Bredesen argues that Alzheimer’s Disease is not one condition but three (medical consensus agrees at least that it is a collection of conditions, but different schools of thought slice them differently), and outlines 36 metabolic factors that are implicated, and the good news is, most of them are within our control.
Since there’s a lot to put together, he also offers many workarounds and “crutches”, making for very practical advice.
The style of the book is on the hard end of pop-science, that is to say while the feel and tone is very pop-sciencey, there are nevertheless a lot of words that you might know but your spellchecker probably wouldn’t. He does explain everything along the way, but this does mean that if you’re not already well-versed, you can’t just dip in to a later point without reading the earlier parts.
Bottom line: even if you only implement half the advice in this book, you’ll be doing your long-term cognitive health a huge favor.
Click here to check out The End of Alzheimer’s, and keep cognitive decline at bay!
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Your Brain On (And Off) Estrogen
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This is Dr. Lisa Mosconi. She’s a professor of Neuroscience in Neurology and Radiology, and is one of the 1% most influential scientists of the 21st century. That’s not a random number or an exaggeration; it has to do with citation metrics collated over 20 years:
A standardized citation metrics author database annotated for scientific field
What does she want us to know?
Women’s brains age differently from men’s
This is largely, of course, due to menopause, and as such is a generalization, but it’s a statistically safe generalization, because:
- Most women go through menopause—and most women who don’t, avoid it by dying pre-menopause, so the aging also does not occur in those cases
- Menopause is very rarely treated immediately—not least of all because menopause is diagnosed officially when it has been one year since one’s last period, so there’s almost always a year of “probably” first, and often numerous years, in the case of periods slowing down before stopping
- Menopausal HRT is great, but doesn’t completely negate that menopause occurred—because of the delay in starting HRT, some damage can be done already and can take years to reverse.
Medicated and unmedicated menopause proceed very differently from each other, and this fact has historically caused obfuscation of a lot of research into age-related neurodegeneration.
For example, it is well-established that women get Alzheimer’s at nearly twice the rate than men do, and deteriorate more rapidly after onset, too.
Superficially, one might conclude “estrogen is to blame” or maybe “the xx-chromosomal karyotype is to blame”.
The opposite, however, is true with regard to estrogen—estrogen appears to be a protective factor in women’s neurological health, which is why increased neurodegeneration occurs when estrogen levels decline (for example, in menopause).
For a full rundown on this, see:
Alzheimer’s Sex Differences May Not Be What They Appear
It’s not about the extra X
Dr. Mosconi examines this in detail in her book “The XX Brain”. To summarize and oversimplify a little: the XX karyotype by itself makes no difference, or more accurately, the XY karyotype by itself makes no difference (because biologically speaking, female physiological attributes are more “default” than male ones; it is only 12,000ish* years of culture that has flipped the social script on this).
*Why 12,000ish years? It’s because patriarchalism largely began with settled agriculture, for reasons that are fascinating but beyond the scope of this article, which is about health science, not archeology.
The topic of “which is biologically default” is relevant, because the XY karyotype (usually) informs the body “ignore previous instructions about ovaries, and adjust slightly to make them into testes instead”, which in turn (usually) results in a testosterone-driven system instead of an estrogen-driven system. And that is what makes the difference to the brain.
One way we can see that it’s about the hormones not the chromosomes, is in cases of androgen insensitivity syndrome, in which the natal “congratulations, it’s a girl” pronouncement may later be in conflict with the fact it turns out she had XY chromosomes all along, but the androgenic instructions never got delivered successfully, so she popped out with fairly typical female organs. And, relevantly for Dr. Mosconi, a typically female brain that will age in a typically female fashion, because it’s driven by estrogen, regardless of the Y-chromosome.
The good news
The good news from all of this is that while we can’t (with current science, anyway) do much about our chromosomes, we can do plenty about our hormones, and also, the results of changes in same.
Remember, Dr. Mosconi is not an endocrinologist, nor a gynecologist, but a neurologist. As such, she makes the case for how a true interdisciplinary team for treating menopause should not confined to the narrow fields usually associated with “bikini medicine”, but should take into account that a lot of menopause-related changes are neurological in nature.
We recently reviewed another book by Dr. Mosconi:
The Menopause Brain – by Dr. Lisa Mosconi
…and as we noted there, many sources will mention “brain fog” as a symptom of menopause, Dr. Mosconi can (and will) point to a shadowy patch on a brain scan and say “that’s the brain fog, there”.
And so on, for other symptoms that are often dismissed as “all in your head”, as though that’s a perfectly acceptable place for problems to be.
This is critical, because it’s treating real neurological things as the real things they are.
Dr. Mosconi’s advice, beyond HRT
Dr. Mosconi notes that brain health tends to dip during perimenopause but often recovers, showing the brain’s resilience to hormonal shifts. As such, all is not lost if for whatever reason, hormone replacement therapy isn’t a viable option for you.
Estrogen plays a crucial role in brain energy, and women’s declining estrogen levels during menopause increase the need for antioxidants to protect brain health—something not often talked about.
Specifically, Dr. Mosconi tells us, women need more antioxidants and have different metabolic responses to diets compared to men.*
*Yes, even though men usually have negligible estrogen, because their body (and thus brain, being also part of their body) is running on testosterone instead, which is something that will only happen if either you are producing normal male amounts of testosterone (requires normal male testes) or you are taking normal male amounts of testosterone (requires big bottles of testosterone; this isn’t the kind of thing you can get from a low dose of testogel as sometimes prescribed as part of menopausal HRT to perk your metabolism up).
Note: despite women being a slight majority on Earth, and despite an aging population in wealthy nations, meaning “a perimenopausal woman” is thus the statistically average person in, for example, the US, and despite the biological primacy of femaleness… Medicine still mostly looks to men as the “default person”, which in this case can result in seriously low-balled estimates of what antioxidants are needed.
In terms of supplements, therefore, she recommends:
- Antioxidants: key for brain health, especially in women. Rich sources include fruits (especially berries) and vegetables. Then there’s the world’s most-consumed antioxidant, which is…
- Coffee: Italian-style espresso has the highest antioxidant power. Adding a bit of fat (e.g. oat milk) helps release caffeine more slowly, reducing jitters. Taking it alongside l-theanine also “flattens the curve” and thus improves its overall benefits.
- Flavonoids: important for both men and women but particularly essential for women. Found in many fruits and vegetables.
- Chocolate: dark chocolate is an excellent source of antioxidants and flavonoids!
- Turmeric: a natural neuroprotectant with anti-inflammatory properties, best boosted by taking with black pepper, which improves absorption as well as having many great qualities of its own.
- B Vitamins: B6, B9, and B12 are essential for anti-aging and brain health; deficiency in B6 is rare, while deficiency in B9 (folate) and especially B12 is very common later in life.
- Vitamins C & E: important antioxidants, but caution is needed with fat-soluble vitamins to avoid toxicity.
- Omega-3s: important for brain health; can be consumed in the diet, but supplements may be necessary.
- Caution with zinc: zinc can support immunity and endocrine health (and thus, indirectly, brain health) but may be harmful in excess, particularly for brain health.
- Probiotics & Prebiotics: beneficial for gut health, and in Dr. Mosconi’s opinion, hard to get sufficient amounts from diet alone.
For more pointers, you might want to check out the MIND diet, that is to say, the “Mediterranean-DASH Intervention for Neurodegenerative Delay” upgrade to make the Mediterranean diet even brain-healthier than it is by default:
Four Ways To Upgrade The Mediterranean Diet
Want to know more from Dr. Mosconi?
Here’s her TED talk:
Click Here If The Embedded Video Doesn’t Load Automatically!
Enjoy!
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Once-A-Week Strategy to Stop Procrastination – by Brad Meir
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Procrastination is perhaps the most frustrating bad habit to kick!
We know we should do the things. We know why we should do the things. We want to do the things. We’re afraid of what will happen if we don’t do the things. And then we… don’t do the things? What is going on?!
Brad Meir has answers, and—what a relief—solutions. But enough about him, because first he wants to focus a little on you:
Why do you procrastinate? No, you’re probably not “just lazy”, and he’ll guide you through figuring out what it is that makes you procrastinate. There’s an exploration of various emotions here, as well as working out: what type of procrastinator are you?
Then, per what you figured out with his guidance, exercises, and tests, it’s time for an action plan.
But, importantly: one you can actually do, because it won’t fall foul of the problems you’ve been encountering so far. The exact mechanism you’ll use may vary a bit based on you, but some tools here are good for everyone—as well as an outline of the mistakes you could easily make, and how to avoid falling into those traps. And, last but very definitely not least, his “once a week plan”, per the title.
All in all, a highly recommendable and potentially life-changing book.
Grab Your Copy of “Once-A-Week Strategy to Stop Procrastination” NOW (don’t put it off!)
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The Blue Zones, Second Edition – by Dan Buettner
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Eat beans & greens, take walks, have a purpose; you can probably list off the top of your head some of the “advices from Blue Zones”, so what makes this book stand out?
This is perhaps one of the most thoughtful investigations; the author (a National Geographic researcher) toured and researched all the Blue Zones, took many many notes (we get details), and asked a lot of questions that others skipped.
For example, a lot of books about the Blue Zones mention the importance of community—but they don’t go into much detail of what that looks like… And they certainly don’t tend to explain what we should do about it.
And that’s because community is often viewed as environmental in a way that we can’t control. If we want to take supplements, eat a certain way, exercise, etc, we can do all those things alone if we want. But if we want community? We’re reliant on other people—and that’s a taboo in the US, and US-influenced places.
So, one way this book excels is in describing how exactly people foster community in the Blue Zones (hint: the big picture—the form of the community—is different in each place, but the individual actions taken are similar), with particular attention to the roles actively taken on by the community elders.
In a similar vein, “reduce stress” is good, but what mindsets and mechanisms do they use that are still reproducible if we are not, for example, Okinawan farmers? Again, Buettner delivers in spades.
Bottom line: this is the Blue Zones book that digs deeper than others, and makes the advices much more applicable no matter where we live.
Click here to check out The Blue Zones, and build these 9 things into your life!
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The Whole-Body Approach to Osteoporosis – by Keith McCormick
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You probably already know to get enough calcium and vitamin D, and do some resistance training. What does this book offer beyond that advice?
It’s pretty comprehensive, as it turns out. It covers the above, plus the wide range of medications available, what supplements help or harm or just don’t have enough evidence either way yet, things like that.
Amongst the most important offerings are the signs and symptoms that can help monitor your bone health (things you can do at home! Like examinations of your fingernails, hair, skin, tongue, and so forth, that will reveal information about your internal biochemical make-up), as well as what lab tests to ask for. Which is important, as osteoporosis is one of those things whereby we often don’t learn something is wrong until it’s too late.
The author is a chiropractor, which doesn’t always have a reputation as the most robustly science-based of physical therapy options, but he…
- doesn’t talk about chiropractic
- did confer with a flock of experts (osteopaths, nutritionists, etc) to inform/check his work
- does refer consistently to good science, and explains it well
- includes 16 pages of academic references, and yes, they are very reputable publications
Bottom line: this one really does give what the subtitle promises: a whole body approach to avoiding (or reversing) osteoporosis.
Click here to check out The Whole Body Approach To Osteoporosis; sooner is better than later!
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In This Oklahoma Town, Most Everyone Knows Someone Who’s Been Sued by the Hospital
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McALESTER, Okla. — It took little more than an hour for Deborah Hackler to dispense with the tall stack of debt collection lawsuits that McAlester Regional Medical Center recently brought to small-claims court in this Oklahoma farm community.
Hackler, a lawyer who sues patients on behalf of the hospital, buzzed through 51 cases, all but a handful uncontested, as is often the case. She bantered with the judge as she secured nearly $40,000 in judgments, plus 10% in fees for herself, according to court records.
It’s a payday the hospital and Hackler have shared frequently over the past three decades, records show. The records indicate McAlester Regional Medical Center and an affiliated clinic have filed close to 5,000 debt collection cases since the early 1990s, most often represented by the father-daughter law firm of Hackler & Hackler.
Some of McAlester’s 18,000 residents have been taken to court multiple times. A deputy at the county jail and her adult son were each sued recently, court records show. New mothers said they compare stories of their legal run-ins with the medical center.
“There’s a lot that’s not right,” Sherry McKee, a dorm monitor at a tribal boarding school outside McAlester, said on the courthouse steps after the hearing. The hospital has sued her three times, most recently over a $3,375 bill for what she said turned out to be vertigo.
In recent years, major health systems in Virginia, North Carolina, and elsewhere have stopped suing patients following news reports about lawsuits. And several states, such as Maryland and New York, have restricted the legal actions hospitals can take against patients.
But with some 100 million people in the U.S. burdened by health care debt, medical collection cases still clog courtrooms across the country, researchers have found. In places like McAlester, a hospital’s debt collection machine can hum away quietly for years, helped along by powerful people in town. An effort to limit hospital lawsuits failed in the Oklahoma Legislature in 2021.
In McAlester, the lawsuits have provided business for some, such as the Adjustment Bureau, a local collection agency run out of a squat concrete building down the street from the courthouse, and for Hackler, a former president of the McAlester Area Chamber of Commerce. But for many patients and their families, the lawsuits can take a devastating toll, sapping wages, emptying retirement accounts, and upending lives.
McKee said she wasn’t sure how long it would take to pay off the recent judgment. Her $3,375 debt exceeds her monthly salary, she said.
“This affects a large number of people in a small community,” said Janet Roloff, an attorney who has spent years assisting low-income clients with legal issues such as evictions in and around McAlester. “The impact is great.”
Settled more than a century ago by fortune seekers who secured land from the Choctaw Nation to mine coal in the nearby hills, McAlester was once a boom town. Vestiges of that era remain, including a mammoth, 140-foot-tall Masonic temple that looms over the city.
Recent times have been tougher for McAlester, now home by one count to 12 marijuana dispensaries and the state’s death row. The downtown is pockmarked by empty storefronts, including the OKLA theater, which has been dark for decades. Nearly 1 in 5 residents in McAlester and the surrounding county live below the federal poverty line.
The hospital, operated by a public trust under the city’s authority, faces its own struggles. Paint is peeling off the front portico, and weeds poke up through the parking lots. The hospital has operated in the red for years, according to independent audit reports available on the state auditor’s website.
“I’m trying to find ways to get the entire community better care and more care,” said Shawn Howard, the hospital’s chief executive. Howard grew up in McAlester and proudly noted he started his career as a receptionist in the hospital’s physical therapy department. “This is my hometown,” he said. “I am not trying to keep people out of getting care.”
The hospital operates a clinic for low-income patients, whose webpage notes it has “limited appointments” at no cost for patients who are approved for aid. But data from the audits shows the hospital offers very little financial assistance, despite its purported mission to serve the community.
In the 2022 fiscal year, it provided just $114,000 in charity care, out of a total operating budget of more than $100 million, hospital records show. Charity care totaling $2 million or $3 million out of a $100 million budget would be more in line with other U.S. hospitals.
While audits show few McAlester patients get financial aid, many get taken to court.
Renee Montgomery, the city treasurer in an adjoining town and mother of a local police officer, said she dipped into savings she’d reserved for her children and grandchildren after the hospital sued her last year for more than $5,500. She’d gone to the emergency room for chest pain.
Dusty Powell, a truck driver, said he lost his pickup and motorcycle when his wages were garnished after the hospital sued him for almost $9,000. He’d gone to the emergency department for what turned out to be gastritis and didn’t have insurance, he said.
“Everyone in this town probably has a story about McAlester Regional,” said another former patient who spoke on the condition she not be named, fearful to publicly criticize the hospital in such a small city. “It’s not even a secret.”
The woman, who works at an Army munitions plant outside town, was sued twice over bills she incurred giving birth. Her sister-in-law has been sued as well.
“It’s a good-old-boy system,” said the woman, who lowered her voice when the mayor walked into the coffee shop where she was meeting with KFF Health News. Now, she said, she avoids the hospital if her children need care.
Nationwide, most people sued in debt collection cases never challenge them, a response experts say reflects widespread misunderstanding of the legal process and anxiety about coming to court.
At the center of the McAlester hospital’s collection efforts for decades has been Hackler & Hackler.
Donald Hackler was city attorney in McAlester for 13 years in the ’70s and ’80s and a longtime member of the local Lions Club and the Scottish Rite Freemasons.
Daughter Deborah Hackler, who joined the family firm 30 years ago, has been a deacon at the First Presbyterian Church of McAlester and served on the board of the local Girl Scouts chapter, according to the McAlester News-Capital newspaper, which named her “Woman of the Year” in 2007. Since 2001, she also has been a municipal judge in McAlester, hearing traffic cases, including some involving people she has sued on behalf of the hospital, municipal and county court records show.
For years, the Hacklers’ debt collection cases were often heard by Judge James Bland, who has retired from the bench and now sits on the hospital board. Bland didn’t respond to an inquiry for interview.
Hackler declined to speak with KFF Health News after her recent court appearance. “I’m not going to visit with you about a current client,” she said before leaving the courthouse.
Howard, the hospital CEO, said he couldn’t discuss the lawsuits either. He said he didn’t know the hospital took its patients to court. “I had to call and ask if we sue people,” he said.
Howard also said he didn’t know Deborah Hackler. “I never heard her name before,” he said.
Despite repeated public records requests from KFF Health News since September, the hospital did not provide detailed information about its financial arrangement with Hackler.
McAlester Mayor John Browne, who appoints the hospital’s board of trustees, said he, too, didn’t know about the lawsuits. “I hadn’t heard anything about them suing,” he said.
At the century-old courthouse in downtown McAlester, it’s not hard to find the lawsuits, though. Every month or two, another batch fills the docket in the small-claims court, now presided over by Judge Brian McLaughlin.
After court recently, McLaughlin, who is not from McAlester, shook his head at the stream of cases and patients who almost never show up to defend themselves, leaving him to issue judgment after judgment in the hospital’s favor.
“All I can do is follow the law,” said McLaughlin. “It doesn’t mean I like it.”
About This Project
“Diagnosis: Debt” is a reporting partnership between KFF Health News and NPR exploring the scale, impact, and causes of medical debt in America.
The series draws on original polling by KFF, court records, federal data on hospital finances, contracts obtained through public records requests, data on international health systems, and a yearlong investigation into the financial assistance and collection policies of more than 500 hospitals across the country.
Additional research was conducted by the Urban Institute, which analyzed credit bureau and other demographic data on poverty, race, and health status for KFF Health News to explore where medical debt is concentrated in the U.S. and what factors are associated with high debt levels.
The JPMorgan Chase Institute analyzed records from a sampling of Chase credit card holders to look at how customers’ balances may be affected by major medical expenses. And the CED Project, a Denver nonprofit, worked with KFF Health News on a survey of its clients to explore links between medical debt and housing instability.
KFF Health News journalists worked with KFF public opinion researchers to design and analyze the “KFF Health Care Debt Survey.” The survey was conducted Feb. 25 through March 20, 2022, online and via telephone, in English and Spanish, among a nationally representative sample of 2,375 U.S. adults, including 1,292 adults with current health care debt and 382 adults who had health care debt in the past five years. The margin of sampling error is plus or minus 3 percentage points for the full sample and 3 percentage points for those with current debt. For results based on subgroups, the margin of sampling error may be higher.
Reporters from KFF Health News and NPR also conducted hundreds of interviews with patients across the country; spoke with physicians, health industry leaders, consumer advocates, debt lawyers, and researchers; and reviewed scores of studies and surveys about medical debt.
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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Older adults need another COVID-19 vaccine
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What you need to know
- The CDC recommends people 65 and older and immunocompromised people receive an additional dose of the updated COVID-19 vaccine this spring—if at least four months have passed since they received a COVID-19 vaccine.
- Updated COVID-19 vaccines are effective at protecting against severe illness, hospitalization, death, and long COVID.
- The CDC also shortened the isolation period for people who are sick with COVID-19.
Last week, the CDC said people 65 and older should receive an additional dose of the updated COVID-19 vaccine this spring. The recommendation also applies to immunocompromised people, who were already eligible for an additional dose.
Older adults made up two-thirds of COVID-19-related hospitalizations between October 2023 and January 2024, so enhancing protection for this group is critical.
The CDC also shortened the isolation period for people who are sick with COVID-19, although the contagiousness of COVID-19 has not changed.
Read on to learn more about the CDC’s updated vaccination and isolation recommendations.
Who is eligible for another COVID-19 vaccine this spring?
The CDC recommends that people ages 65 and older and immunocompromised people receive an additional dose of the updated COVID-19 vaccine this spring—if at least four months have passed since they received a COVID-19 vaccine. It’s safe to receive an updated COVID-19 vaccine from Pfizer, Moderna, or Novavax, regardless of which COVID-19 vaccines you received in the past.
Updated COVID-19 vaccines are available at pharmacies, local clinics, or doctor’s offices. Visit Vaccines.gov to find an appointment near you.
Under- and uninsured adults can get the updated COVID-19 vaccine for free through the CDC’s Bridge Access Program. If you’re over 60 and unable to leave your home, call the Aging Network at 1-800-677-1116 to learn about free at-home vaccination options.
What are the benefits of staying up to date on COVID-19 vaccines?
Staying up to date on COVID-19 vaccines prevents severe illness, hospitalization, death, and long COVID.
Additionally, the CDC says staying up to date on COVID-19 vaccines is a safer and more reliable way to build protection against COVID-19 than getting sick from COVID-19.
What are the new COVID-19 isolation guidelines?
According to the CDC’s general respiratory virus guidance, people who are sick with COVID-19 or another common respiratory illness, like the flu or RSV, should isolate until they’ve been fever-free for at least 24 hours without the use of fever-reducing medication and their symptoms improve.
After that, the CDC recommends taking additional precautions for the next five days: wearing a well-fitting mask, limiting close contact with others, and improving ventilation in your home if you live with others.
If you’re sick with COVID-19, you can infect others for five to 12 days, or longer. Moderately or severely immunocompromised patients may remain infectious beyond 20 days.
For more information, talk to your health care provider.
This article first appeared on Public Good News and is republished here under a Creative Commons license.
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