Tips for Improving Memory
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Q&A with 10almonds Subscribers!
Q: Any tips, other than supplements, for improving memory?
A: So many tips! Certainly enough to do a main feature on, so again maybe we’ll do that in another issue soon. Meanwhile, here are the absolute most critical things for you to know, understand, and apply:
- Memory is a muscle. Not literally, but in the sense that it will grow stronger if exercised and will atrophy if neglected.
- Counterpart of the above: your memory is not a finite vessel. You can’t “fill it up with useless things”, so no need to fear doing so.
- Your memory is the product of countless connections in your brain. The more connections lead to a given memory, the more memorable it will be. What use is this knowledge to you? It means that if you want to remember something, try to make as many connections to it as possible, so:
- Involve as many senses as possible.
- When you learn things, try to learn them in context. Then when your mind has reason to think about the context, it’ll be more likely to remember the thing itself too.
- Rehearsal matters. A lot. This means repeatedly going over something in your head. This brings about the neural equivalent of “muscle memory”.
- Enjoy yourself if you can. The more fun something is, the more you will mentally rehearse it, and the more mental connections you’ll make to it.
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Dr. Greger’s Anti-Aging Eight
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Dr. Greger’s Anti-Aging Eight
This is Dr. Michael Greger. We’ve featured him before: Brain Food? The Eyes Have It!
This time, we’re working from his latest book, the excellent “How Not To Age”, which we reviewed all so recently. It is very information-dense, but we’re going to be focussing on one part, his “anti-aging eight”, that is to say, eight interventions he rates the most highly to slow aging in general (other parts of the book pertained to slowing eleven specific pathways of aging, or preserving specific bodily functions against aging, for example).
Without further ado, his “anti-aging eight” are…
- Nuts
- Greens
- Berries
- Xenohormesis & microRNA manipulation
- Prebiotics & postbiotics
- Caloric restriction / IF
- Protein restriction
- NAD+
As you may have noticed, some of these are things might appear already on your grocery shopping list; others don’t seem so “household”. Let’s break them down:
Nuts, greens, berries
These are amongst the most nutrient-dense and phytochemical-useful parts of the diet that Dr. Greger advocates for in his already-famous “Dr. Greger’s Daily Dozen”.
For brevity, we’ll not go into the science of these here, but will advise you: eat a daily portion of nuts, a daily portion of berries, and a couple of daily portions of greens.
Xenohormesis & microRNA manipulation
You might, actually, have these on your grocery shopping list too!
Hormesis, you may recall from previous editions of 10almonds, is about engaging in a small amount of eustress to trigger the body’s self-strengthening response, for example:
Xenohormesis is about getting similar benefits, second-hand.
For example, plants that have been grown to “organic” standards (i.e. without artificial pesticides, herbicides, fertilizers) have had to adapt to their relatively harsher environment by upping their levels of protective polyphenols and other phytochemicals that, as it turns out, are as beneficial to us as they are to the plants:
Hormetic Effects of Phytochemicals on Health and Longevity
Additionally, the flip side of xenohormesis is that some plant compounds can themselves act as a source of hormetic stress that end up bolstering us. For example:
In essence, it’s not just that it has anti-oxidant effect; it also provides a tiny oxidative-stress immunization against serious sources of oxidative stress—and thus, aging.
MicroRNA manipulation is, alas, too complex to truly summarize an entire chapter in a line or two, but it has to do with genetic information from the food that we eat having a beneficial or deleterious effect to our own health:
Diet-derived microRNAs: unicorn or silver bullet?
A couple of quick takeaways (out of very many) from Dr. Greger’s chapter on this is to spring for the better quality olive oil, and skip the cow’s milk:
- Impact of Phenol-Enriched Virgin Olive Oils on the Postprandial Levels of Circulating microRNAs Related to Cardiovascular Disease
- MicroRNA exosomes of pasteurized milk: potential pathogens of Western diseases
Prebiotics & Postbiotics
We’re short on space, so we’ll link you to a previous article, and tell you that it’s important against aging too:
Making Friends With Your Gut (You Can Thank Us Later)
An example of how one of Dr. Greger’s most-recommended postbiotics helps against aging, by the way:
- The mitophagy activator urolithin A is safe and induces a molecular signature of improved mitochondrial and cellular health in humans
- Urolithin A improves muscle strength, exercise performance, and biomarkers of mitochondrial health in a randomized trial in middle-aged adults
(Urolithin can be found in many plants, and especially those containing tannins)
See also: How to Make Urolithin Postbiotics from Tannins
Caloric restriction / Intermittent fasting
This is about lowering metabolic load and promoting cellular apoptosis (programmed cell death; sounds bad; is good) and autophagy (self-consumption; again, sounds bad; is good).
For example, he cites the intermittent fasters’ 46% lower risk of dying in the subsequent years of follow-up in this longitudinal study:
For brevity we’ll link to our previous IF article, but we’ll revisit caloric restriction in a main feature on of these days:
Fasting Without Crashing? We sort the science from the hype!
Dr. Greger favours caloric restriction over intermittent fasting, arguing that it is easier to adhere to and harder to get wrong if one has some confounding factor (e.g. diabetes, or a medication that requires food at certain times, etc). If adhered to healthily, the benefits appear to be comparable for each, though.
Protein restriction
In contrast to our recent main feature Protein vs Sarcopenia, in which that week’s featured expert argued for high protein consumption levels, protein restriction can, on the other hand, have anti-aging effects. A reminder that our body is a complex organism, and sometimes what’s good for one thing is bad for another!
Dr. Greger offers protein restriction as a way to get many of the benefits of caloric restriction, without caloric restriction. He further notes that caloric restriction without protein restriction doesn’t decrease IGF-1 levels (a marker of aging).
However, for FGF21 levels (these are good and we want them higher to stay younger), what matters more than lowering proteins in general is lowering levels of the amino acid methionine—found mostly in animal products, not plants—so the source of the protein matters:
For example, legumes deliver only 5–10% of the methionine that meat does, for the same amount of protein, so that’s a factor to bear in mind.
NAD+
This is about nicotinamide adenine dinucleotide, or NAD+ to its friends.
NAD+ levels decline with age, and that decline is a causal factor in aging, and boosting the levels can slow aging:
Therapeutic Potential of NAD-Boosting Molecules: The In Vivo Evidence
Can we get NAD+ from food? We can, but not in useful quantities or with sufficient bioavailability.
Supplements, then? Dr. Greger finds the evidence for their usefulness lacking, in interventional trials.
How to boost NAD+, then? Dr. Greger prescribes…
Exercise! It boosts levels by 127% (i.e., it more than doubles the levels), based on a modest three-week exercise bike regimen:
Skeletal muscle NAMPT is induced by exercise in humans
Another study on resistance training found the same 127% boost:
Take care!
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Antihistamines for Runny Nose?
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It’s Q&A Day at 10almonds!
Have a question or a request? We love to hear from you!
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 😎
❝Do you have any articles about using Anti-Histamines? My nose seems to be running a lot. I don’t have a cold or any allergies that I know of. I tried a Nasal spray Astepro, but it doesn’t do much.?❞
Just for you, we wrote such an article yesterday in response to this question!
The Astepro that you tried, by the way, is a brand name of the azelastine we mentioned near the end, before we got to talking about systemic corticosteroids such as beclometasone dipropionate—this latter might help you if antihistamines haven’t, and if your doctor advises there’s no contraindication (for most people it is safe for there are exceptions, such as if you are immunocompromised and/or currently fighting some infection).
You can find more details on all this in yesterday’s article, which in case you missed it, can be found at:
Antihistamines’ Generation Gap: Are You Ready For Allergy Season?
Enjoy!
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Terminal lucidity: why do loved ones with dementia sometimes ‘come back’ before death?
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Dementia is often described as “the long goodbye”. Although the person is still alive, dementia slowly and irreversibly chips away at their memories and the qualities that make someone “them”.
Dementia eventually takes away the person’s ability to communicate, eat and drink on their own, understand where they are, and recognise family members.
Since as early as the 19th century, stories from loved ones, caregivers and health-care workers have described some people with dementia suddenly becoming lucid. They have described the person engaging in meaningful conversation, sharing memories that were assumed to have been lost, making jokes, and even requesting meals.
It is estimated 43% of people who experience this brief lucidity die within 24 hours, and 84% within a week.
Why does this happen?
Terminal lucidity or paradoxical lucidity?
In 2009, researchers Michael Nahm and Bruce Greyson coined the term “terminal lucidity”, since these lucid episodes often occurred shortly before death.
But not all lucid episodes indicate death is imminent. One study found many people with advanced dementia will show brief glimmers of their old selves more than six months before death.
Lucidity has also been reported in other conditions that affect the brain or thinking skills, such as meningitis, schizophrenia, and in people with brain tumours or who have sustained a brain injury.
Moments of lucidity that do not necessarily indicate death are sometimes called paradoxical lucidity. It is considered paradoxical as it defies the expected course of neurodegenerative diseases such as dementia.
But it’s important to note these episodes of lucidity are temporary and sadly do not represent a reversal of neurodegenerative disease.
Sadly, these episodes of lucidity are only temporary. Pexels/Kampus Production Why does terminal lucidity happen?
Scientists have struggled to explain why terminal lucidity happens. Some episodes of lucidity have been reported to occur in the presence of loved ones. Others have reported that music can sometimes improve lucidity. But many episodes of lucidity do not have a distinct trigger.
A research team from New York University speculated that changes in brain activity before death may cause terminal lucidity. But this doesn’t fully explain why people suddenly recover abilities that were assumed to be lost.
Paradoxical and terminal lucidity are also very difficult to study. Not everyone with advanced dementia will experience episodes of lucidity before death. Lucid episodes are also unpredictable and typically occur without a particular trigger.
And as terminal lucidity can be a joyous time for those who witness the episode, it would be unethical for scientists to use that time to conduct their research. At the time of death, it’s also difficult for scientists to interview caregivers about any lucid moments that may have occurred.
Explanations for terminal lucidity extend beyond science. These moments of mental clarity may be a way for the dying person to say final goodbyes, gain closure before death, and reconnect with family and friends. Some believe episodes of terminal lucidity are representative of the person connecting with an afterlife.
Why is it important to know about terminal lucidity?
People can have a variety of reactions to seeing terminal lucidity in a person with advanced dementia. While some will experience it as being peaceful and bittersweet, others may find it deeply confusing and upsetting. There may also be an urge to modify care plans and request lifesaving measures for the dying person.
Being aware of terminal lucidity can help loved ones understand it is part of the dying process, acknowledge the person with dementia will not recover, and allow them to make the most of the time they have with the lucid person.
For those who witness it, terminal lucidity can be a final, precious opportunity to reconnect with the person that existed before dementia took hold and the “long goodbye” began.
Yen Ying Lim, Associate Professor, Turner Institute for Brain and Mental Health, Monash University and Diny Thomson, PhD (Clinical Neuropsychology) Candidate and Provisional Psychologist, Monash University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Debunking the myth that vaccines cause autism
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The myth that autism is linked to childhood vaccines first appeared in a 1998 study by British physician Dr. Andrew Wakefield. The study was later retracted, and Wakefield was discredited. But nearly three decades after the study’s publication, the myth persists, championed by activists, political leaders, and even potential health officials.
There is overwhelming evidence that there is no link between vaccines and autism. “No one has any real or solid evidence that vaccines cause autism,” says Catherine Lord, a psychologist and autism researcher at the University of California, Los Angeles.
Here are just some of the many reasons that we know vaccines don’t cause autism.
The Wakefield study has been thoroughly discredited
In 1998, the Lancet published a study describing a small group of children who reportedly had bowel inflammation and developed autism within a month of getting the measles, mumps, and rubella (MMR) vaccine. The study proposed that the vaccination triggered bowel inflammation and developmental delays, including autism. Lead author Andrew Wakefield coined the term “autistic enterocolitis” to describe the condition he and his colleagues claimed to have discovered.
The study received significant media attention and immediate criticism from scientists, who pointed out the study’s small size, lack of controls, and insufficient evidence to support its conclusions.
Subsequent research published over the next few years refuted Wakefield’s findings. A 1999 Lancet study found no link between autism and the MMR vaccine, and a 2001 study found no evidence of a link or the existence of so-called autistic enterocolitis.
In 2010, the Lancet finally retracted Wakefield’s fraudulent study, noting that “several elements” of the study were “incorrect” and that the experiments carried out on children had not been approved by an ethics board. The journal’s editor called the paper’s conclusions “utterly false.”
A few months later, Wakefield was stripped of his medical license by the United Kingdom’s General Medical Council. The council deemed Wakefield “dishonest and irresponsible” and concluded that he conducted unethical experiments on children.
The committee’s investigation also revealed that, less than a year before he published his study claiming that the MMR vaccine was linked to bowel inflammation that triggered autism, Wakefield filed a patent for a standalone measles vaccine and inflammatory bowel disease treatment.
Thimerosal was removed from childhood vaccines in 2001—with no effect on autism rates
A 2003 study published by a conservative group known for promoting anti-science myths—including that HIV doesn’t cause AIDS—first proposed that the preservative thimerosal in childhood vaccines is linked to autism. This supposed link was subsequently disproven.
Thimerosal is added in small amounts to some vaccines to prevent dangerous bacterial and fungal contamination. The substance contains ethylmercury, a form of mercury that the body quickly and safely processes in small doses.
Ethylmercury is different from methylmercury, a far more dangerous form of mercury that is toxic at low doses. By contrast, the small amount of thimerosal in some vaccines is harmless to humans and is equal to the amount of mercury in a can of tuna.
The preservative was removed from childhood vaccines as a precautionary measure in 2001. With the exception of some flu shots, no childhood vaccine contains the preservative and hasn’t for more than two decades. Autism rates have not decreased as a result of thimerosal being removed from childhood immunization vaccines. While some types of the annual flu vaccine contain thimerosal, you can get one without it.
Extensive research also shows that neither thimerosal nor methylmercury at any dose is linked to autism. A 2008 study of statewide California data found that autism rates “increased consistently for children born from 1989 through 2003, inclusive of the period when exposure to [thimerosal-containing vaccines] has declined.”
Autism rates are the same in vaccinated and unvaccinated children
Vaccine opponents often falsely claim that vaccinated children are more likely than unvaccinated children to develop autism. Decades of research disprove this false claim.
A 2002 analysis of every child born in Denmark over eight years found that children who received MMR vaccines were no more likely to be diagnosed with autism than unvaccinated children.
A 2015 study of over 95,000 U.S. siblings found that MMR vaccination is not associated with increased autism diagnosis. This was true even among the siblings of children with autism, who are seven times more likely to develop autism than children without an autistic sibling.
And a 2018 study found some evidence that children with autism—and their siblings—were more likely to be unvaccinated or under-vaccinated than children without autism.
Vaccination also has no impact on autism rates at the population level, regardless of the age at which children get vaccinated.
“In comparing countries that have different timing and levels of vaccination … there’s no difference in autism,” says Lord. “You can look at different countries with different rates of autism, and there’s no relationship between the rates of autism and vaccinations.”
Countries such as Taiwan, Tunisia, Turkey, and Morocco, which have some of the world’s lowest autism rates, have childhood immunization rates that are nearly identical to countries with the highest autism rates, including Sweden, Japan, Brunei, and Singapore.
Improved awareness and diagnosis play a role in rising autism rates
Autism was first described in 1911 when it was considered to be a form of severe schizophrenia. Over a century later, our understanding of autism has changed drastically, as have diagnostic standards.
A 2013 scientific article describing how medical and social perceptions of autism have evolved explains that “the diagnoses of schizophrenia, psychosis and autism in children were largely interchangeable during the 1940s and 1950s.” Beginning in the 1960s, methods of diagnosing autism improved, “increasing the number of children who were considered to display autistic traits.”
The autism diagnosis was changed to autism spectrum disorder in 2013. “This category is now very broad, which was an intentional choice to help provide services to the greatest number of people who might need them,” writes Gideon Meyerowitz-Katz, an epidemiologist and creator of the popular Health Nerd blog.
“Rather than the severe intellectual disability of the 1940s and 50s, [autism spectrum disorder] is a group of behaviours that can be any severity as long as they are persistent and impact people’s daily functioning in a significant way.”
For more information about autism, 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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He Fell Ill on a Cruise. Before He Boarded the Rescue Boat, They Handed Him the Bill.
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Vincent Wasney and his fiancée, Sarah Eberlein, had never visited the ocean. They’d never even been on a plane. But when they bought their first home in Saginaw, Michigan, in 2018, their real estate agent gifted them tickets for a Royal Caribbean cruise.
After two years of delays due to the coronavirus pandemic, they set sail in December 2022.
The couple chose a cruise destined for the Bahamas in part because it included a trip to CocoCay, a private island accessible to Royal Caribbean passengers that featured a water park, balloon rides, and an excursion swimming with pigs.
It was on that day on CocoCay when Wasney, 31, started feeling off, he said.
The next morning, as the couple made plans in their cabin for the last full day of the trip, Wasney made a pained noise. Eberlein saw him having a seizure in bed, with blood coming out of his mouth from biting his tongue. She opened their door to find help and happened upon another guest, who roused his wife, an emergency room physician.
Wasney was able to climb into a wheelchair brought by the ship’s medical crew to take him down to the medical facility, where he was given anticonvulsants and fluids and monitored before being released.
Wasney had had seizures in the past, starting about 10 years ago, but it had been a while since his last one. Imaging back then showed no tumors, and doctors concluded he was likely epileptic, he said. He took medicine initially, but after two years without another seizure, he said, his doctors took him off the medicine to avoid liver damage.
Wasney had a second seizure on the ship a few hours later, back in his cabin. This time he stopped breathing, and Eberlein remembered his lips being so purple, they almost looked black. Again, she ran to find help but, in her haste, locked herself out. By the time the ship’s medical team got into the cabin, Wasney was breathing again but had broken blood vessels along his chest and neck that he later said resembled tiger stripes.
Wasney was in the ship’s medical center when he had a third seizure — a grand mal, which typically causes a loss of consciousness and violent muscle contractions. By then, the ship was close enough to port that Wasney could be evacuated by rescue boat. He was put on a stretcher to be lowered by ropes off the side of the ship, with Eberlein climbing down a rope ladder to join him.
But before they disembarked, the bill came.
The Patient: Vincent Wasney, 31, who was uninsured at the time.
Medical Services: General and enhanced observation, a blood test, anticonvulsant medicine, and a fee for services performed outside the medical facility.
Service Provider: Independence of the Seas Medical Center, the on-ship medical facility on the cruise ship operated by Royal Caribbean International.
Total Bill: $2,500.22.
What Gives: As part of Royal Caribbean’s guest terms, cruise passengers “agree to pay in full” all expenses incurred on board by the end of the cruise, including those related to medical care. In addition, Royal Caribbean does not accept “land-based” health insurance plans.
Wasney said he was surprised to learn that, along with other charges like wireless internet, Royal Caribbean required he pay his medical bills before exiting the ship — even though he was being evacuated urgently.
“Are we being held hostage at this point?” Eberlein remembered asking. “Because, obviously, if he’s had three seizures in 10 hours, it’s an issue.”
Wasney said he has little memory of being on the ship after his first seizure — seizures often leave victims groggy and disoriented for a few hours afterward.
But he certainly remembers being shown a bill, the bulk of which was the $2,500.22 in medical charges, while waiting for the rescue boat.
Still groggy, Wasney recalled saying he couldn’t afford that and a cruise employee responding: “How much can you pay?”
They drained their bank accounts, including money saved for their next house payment, and maxed out Wasney’s credit card but were still about $1,000 short, he said.
Ultimately, they were allowed to leave the ship. He later learned his card was overdrafted to cover the shortfall, he said.
Royal Caribbean International did not respond to multiple inquiries from KFF Health News.
Once on land, in Florida, Wasney was taken by ambulance to the emergency room at Broward Health Medical Center in Fort Lauderdale, where he incurred thousands of dollars more in medical expenses.
He still isn’t entirely sure what caused the seizures.
On the ship he was told it could have been extreme dehydration — and he said he does remember being extra thirsty on CocoCay. He also has mused whether trying escargot for the first time the night before could have played a role. Eberlein’s mother is convinced the episode was connected to swimming with pigs, he said. And not to be discounted, Eberlein accidentally broke a pocket mirror three days before their trip.
Wasney, who works in a stone shop, was uninsured when they set sail. He said that one month before they embarked on their voyage, he finally felt he could afford the health plan offered through his employer and signed up, but the plan didn’t start until January 2023, after their return.
They also lacked travel insurance. As inexperienced travelers, Wasney said, they thought it was for lost luggage and canceled trips, not unexpected medical expenses. And because the cruise was a gift, they were never prompted to buy coverage, which often happens when tickets are purchased.
The Resolution: Wasney said the couple returned to Saginaw with essentially no money in their bank account, several thousand dollars of medical debt, and no idea how they would cover their mortgage payment. Because he was uninsured at the time of the cruise, Wasney did not try to collect reimbursement for the cruise bill from his new health plan when his coverage began weeks later.
The couple set up payment plans to cover the medical bills for Wasney’s care after leaving the ship: one each with two doctors he saw at Broward Health, who billed separately from the hospital, and one with the ambulance company. He also made payments on a bill with Broward Health itself. Those plans do not charge interest.
But Broward Health said Wasney missed two payments to the hospital, and that bill was ultimately sent to collections.
In a statement, Broward Health spokesperson Nina Levine said Wasney’s bill was reduced by 73% because he was uninsured.
“We do everything in our power to provide the best care with the least financial impact, but also cannot stress enough the importance of taking advantage of private and Affordable Care Act health insurance plans, as well as travel insurance, to lower risks associated with unplanned medical issues,” she said.
The couple was able to make their house payment with $2,690 they raised through a GoFundMe campaign that Wasney set up. Wasney said a lot of that help came from family as well as friends he met playing disc golf, a sport he picked up during the pandemic.
“A bunch of people came through for us,” Wasney said, still moved to tears by the generosity. “But there’s still the hospital bill.”
The Takeaway: Billing practices differ by cruise line, but Joe Scott, chair of the cruise ship medicine section of the American College of Emergency Physicians, said medical charges are typically added to a cruise passenger’s onboard account, which must be paid before leaving the ship. Individuals can then submit receipts to their insurers for possible reimbursement.
More from Bill of the Month
- Sign Here? Financial Agreements May Leave Doctors in the Driver’s Seat Apr 30, 2024
- A Mom’s $97,000 Question: How Was Her Baby’s Air-Ambulance Ride Not Medically Necessary? Mar 25, 2024
- Without Medicare Part B’s Shield, Patient’s Family Owes $81,000 for a Single Air-Ambulance Flight Feb 27, 2024
He recommended that those planning to take a cruise purchase travel insurance that specifically covers their trips. “This will facilitate reimbursement if they do incur charges and potentially cover a costly medical evacuation if needed,” Scott said.
Royal Caribbean suggests that passengers who receive onboard care submit their paid bills to their health insurer for possible reimbursement. Many health plans do not cover medical services received on cruise ships, however. Medicare will sometimes cover medically necessary health care services on cruise ships, but not if the ship is more than six hours away from a U.S. port.
Travel insurance can be designed to address lots of out-of-town mishaps, like lost baggage or even transportation and lodging for a loved one to visit if a traveler is hospitalized.
Travel medical insurance, as well as plans that offer “emergency evacuation and repatriation,” are two types that can specifically assist with medical emergencies. Such plans can be purchased individually. Credit cards may offer travel medical insurance among their benefits, as well.
But travel insurance plans come with limitations. For instance, they may not cover care associated with preexisting conditions or what the plans consider “risky” activities, such as rock climbing. Some plans also require that travelers file first with their primary health insurance before seeking reimbursement from travel insurance.
As with other insurance, be sure to read the fine print and understand how reimbursement works.
Wasney said that’s what they plan to do before their next Royal Caribbean cruise. They’d like to go back to the Bahamas on basically the same trip, he said — there’s a lot about CocoCay they didn’t get to explore.
Bill of the Month is a crowdsourced investigation by KFF Health News and NPR that dissects and explains medical bills. Do you have an interesting medical bill you want to share with us? Tell us about it!
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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Do We Simply Not Care About Old People?
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The covid-19 pandemic would be a wake-up call for America, advocates for the elderly predicted: incontrovertible proof that the nation wasn’t doing enough to care for vulnerable older adults.
The death toll was shocking, as were reports of chaos in nursing homes and seniors suffering from isolation, depression, untreated illness, and neglect. Around 900,000 older adults have died of covid-19 to date, accounting for 3 of every 4 Americans who have perished in the pandemic.
But decisive actions that advocates had hoped for haven’t materialized. Today, most people — and government officials — appear to accept covid as a part of ordinary life. Many seniors at high risk aren’t getting antiviral therapies for covid, and most older adults in nursing homes aren’t getting updated vaccines. Efforts to strengthen care quality in nursing homes and assisted living centers have stalled amid debate over costs and the availability of staff. And only a small percentage of people are masking or taking other precautions in public despite a new wave of covid, flu, and respiratory syncytial virus infections hospitalizing and killing seniors.
In the last week of 2023 and the first two weeks of 2024 alone, 4,810 people 65 and older lost their lives to covid — a group that would fill more than 10 large airliners — according to data provided by the CDC. But the alarm that would attend plane crashes is notably absent. (During the same period, the flu killed an additional 1,201 seniors, and RSV killed 126.)
“It boggles my mind that there isn’t more outrage,” said Alice Bonner, 66, senior adviser for aging at the Institute for Healthcare Improvement. “I’m at the point where I want to say, ‘What the heck? Why aren’t people responding and doing more for older adults?’”
It’s a good question. Do we simply not care?
I put this big-picture question, which rarely gets asked amid debates over budgets and policies, to health care professionals, researchers, and policymakers who are older themselves and have spent many years working in the aging field. Here are some of their responses.
The pandemic made things worse. Prejudice against older adults is nothing new, but “it feels more intense, more hostile” now than previously, said Karl Pillemer, 69, a professor of psychology and gerontology at Cornell University.
“I think the pandemic helped reinforce images of older people as sick, frail, and isolated — as people who aren’t like the rest of us,” he said. “And human nature being what it is, we tend to like people who are similar to us and be less well disposed to ‘the others.’”
“A lot of us felt isolated and threatened during the pandemic. It made us sit there and think, ‘What I really care about is protecting myself, my wife, my brother, my kids, and screw everybody else,’” said W. Andrew Achenbaum, 76, the author of nine books on aging and a professor emeritus at Texas Medical Center in Houston.
In an environment of “us against them,” where everybody wants to blame somebody, Achenbaum continued, “who’s expendable? Older people who aren’t seen as productive, who consume resources believed to be in short supply. It’s really hard to give old people their due when you’re terrified about your own existence.”
Although covid continues to circulate, disproportionately affecting older adults, “people now think the crisis is over, and we have a deep desire to return to normal,” said Edwin Walker, 67, who leads the Administration on Aging at the Department of Health and Human Services. He spoke as an individual, not a government representative.
The upshot is “we didn’t learn the lessons we should have,” and the ageism that surfaced during the pandemic hasn’t abated, he observed.
Ageism is pervasive. “Everyone loves their own parents. But as a society, we don’t value older adults or the people who care for them,” said Robert Kramer, 74, co-founder and strategic adviser at the National Investment Center for Seniors Housing & Care.
Kramer thinks boomers are reaping what they have sown. “We have chased youth and glorified youth. When you spend billions of dollars trying to stay young, look young, act young, you build in an automatic fear and prejudice of the opposite.”
Combine the fear of diminishment, decline, and death that can accompany growing older with the trauma and fear that arose during the pandemic, and “I think covid has pushed us back in whatever progress we were making in addressing the needs of our rapidly aging society. It has further stigmatized aging,” said John Rowe, 79, professor of health policy and aging at Columbia University’s Mailman School of Public Health.
“The message to older adults is: ‘Your time has passed, give up your seat at the table, stop consuming resources, fall in line,’” said Anne Montgomery, 65, a health policy expert at the National Committee to Preserve Social Security and Medicare. She believes, however, that baby boomers can “rewrite and flip that script if we want to and if we work to change systems that embody the values of a deeply ageist society.”
Integration, not separation, is needed. The best way to overcome stigma is “to get to know the people you are stigmatizing,” said G. Allen Power, 70, a geriatrician and the chair in aging and dementia innovation at the Schlegel-University of Waterloo Research Institute for Aging in Canada. “But we separate ourselves from older people so we don’t have to think about our own aging and our own mortality.”
The solution: “We have to find ways to better integrate older adults in the community as opposed to moving them to campuses where they are apart from the rest of us,” Power said. “We need to stop seeing older people only through the lens of what services they might need and think instead of all they have to offer society.”
That point is a core precept of the National Academy of Medicine’s 2022 report Global Roadmap for Healthy Longevity. Older people are a “natural resource” who “make substantial contributions to their families and communities,” the report’s authors write in introducing their findings.
Those contributions include financial support to families, caregiving assistance, volunteering, and ongoing participation in the workforce, among other things.
“When older people thrive, all people thrive,” the report concludes.
Future generations will get their turn. That’s a message Kramer conveys in classes he teaches at the University of Southern California, Cornell, and other institutions. “You have far more at stake in changing the way we approach aging than I do,” he tells his students. “You are far more likely, statistically, to live past 100 than I am. If you don’t change society’s attitudes about aging, you will be condemned to lead the last third of your life in social, economic, and cultural irrelevance.”
As for himself and the baby boom generation, Kramer thinks it’s “too late” to effect the meaningful changes he hopes the future will bring.
“I suspect things for people in my generation could get a lot worse in the years ahead,” Pillemer said. “People are greatly underestimating what the cost of caring for the older population is going to be over the next 10 to 20 years, and I think that’s going to cause increased conflict.”
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.
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