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These 12 things can reduce your dementia risk – but many Australians don’t know them all

<a href="https://theconversation.com/profiles/joyce-siette-1377445">Joyce Siette</a>, <a href="https://theconversation.com/institutions/western-sydney-university-1092">Western Sydney University</a> and <a href="https://theconversation.com/profiles/laura-dodds-1378067">Laura Dodds</a>, <a href="https://theconversation.com/institutions/western-sydney-university-1092">Western Sydney University</a> Dementia is a <a href="https://www.abs.gov.au/statistics/health/causes-death/provisional-mortality-statistics/jan-may-2022">leading</a> cause of death in Australia. Although dementia mainly affects older people, it is an avoidable part of ageing. In fact, we all have the power to reduce our risk of developing dementia, no matter your age. Research shows your risk of developing dementia could be <a href="https://www.thelancet.com/article/S0140-6736(20)30367-6/fulltext">reduced by up to 40%</a> (and even higher if you live in a <a href="https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(19)30074-9/fulltext">low or middle-income country</a>) by addressing lifestyle factors such as healthy diet, exercise and alcohol consumption. But the first step to reducing population-wide dementia risk is to understand how well people understand the risk factors and the barriers they may face to making lifestyle changes. Our new <a href="https://www.mdpi.com/2673-9259/2/4/21/htm">paper</a>, published this week in the <a href="https://www.mdpi.com/2673-9259/2/4/21/htm">Journal of Ageing and Longevity</a>, found most older people are aware that dementia is a modifiable condition and that they have the power to change their dementia risk. We also found the key barrier to making brain healthy lifestyle choices was a lack of knowledge, which suggests a public awareness campaign is urgently needed. <h2>What we did</h2> We began by <a href="https://www.mdpi.com/2673-9259/2/4/21/htm">reviewing</a> the published research to identify 12 factors shown to reduce dementia risk. We surveyed 834 older Australians about their awareness of the 12 factors, which were: <ol> <li>having a mentally active lifestyle</li> <li>doing physical activity</li> <li>having a healthy diet</li> <li>having strong mental health</li> <li>not smoking</li> <li>not consuming alcohol</li> <li>controlling high blood pressure</li> <li>maintaining a healthy weight</li> <li>managing high cholesterol</li> <li>preventing heart disease</li> <li>not having kidney disease</li> <li>not having diabetes</li> </ol> <a href="https://www.thelancet.com/article/S0140-6736(20)30367-6/fulltext">The Lancet</a> subsequently published its own list of factors that help reduce dementia risk, which covered much the same territory (but included a few others, such as reducing air pollution, treating hearing impairment and being socially engaged). Of course, there is no way to cut your dementia risk to zero. Some people do all the “right” things and still get dementia. But there is <a href="https://www.thelancet.com/article/S0140-6736(20)30367-6/fulltext">good evidence</a> managing lifestyle factors help make it less likely you will get dementia over your lifetime. Our study shows many older Australians are quite aware, with over 75% able to correctly identify more than four of the factors in our list of 12. However, few were able to name the less well-known risk factors, such as preventing heart disease and health conditions like kidney disease. The good news is that close to half of the sample correctly identified more than six of the 12 protective factors, with mentally active lifestyle, physical activity and healthy diet in the top three spots. <h2>Two key issues</h2> Two things stood out as strongly linked with the ability to identify factors influencing dementia risk. Education was key. People who received more than 12 years of formal schooling were more likely to agree that dementia was a modifiable condition. We are first exposed to health management in our school years and thus more likely to form healthier habits. Age was the other key factor. Younger respondents (less than 75 years old) were able to accurately identify more protective factors compared to older respondents. This is why health promotion initiatives and public education efforts about dementia are vital (such as Dementia Awareness Month and <a href="https://www.memorywalk.com.au/">Memory, Walk and Jog initiatives</a>). <h2>How can these findings be used in practice?</h2> Our findings suggest we need to target education across the different age groups, from children to older Australians. This could involve a <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/ajag.13049">whole system approach</a>, from programs targeted at <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5858574/#:%7E:text=Family%20Coaching%20has%20specific%20goals,to%20problem%20solve%20challenging%20situations.">families</a>, to educational sessions for school-aged children, to involving GPs in awareness promotion. We also need to tackle barriers that hinder dementia risk reduction. This means doing activities that motivate you, finding programs that suit your needs and schedule, and are accessible. <h2>What does this mean for you?</h2> Reducing your dementia risk means recognising change starts with you. We are all familiar with the everyday challenges that stop us from starting an exercise program or sticking to a meal plan. There are simple and easy changes we can begin with. Our team has developed a program that can help. We are offering limited <a href="https://www.brainbootcamp.com.au/">free brain health boxes</a>, which include information resources and physical items such as a pedometer. These boxes aim to help rural Australians aged 55 years and over to adopt lifestyle changes that support healthy brain ageing. If you’re interested in signing up, visit our <a href="https://www.brainbootcamp.com.au">website</a>. Now is the time to think about your brain health. Let’s start now.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/191504/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/joyce-siette-1377445">Joyce Siette</a>, Research Theme Fellow, <a href="https://theconversation.com/institutions/western-sydney-university-1092">Western Sydney University</a> and <a href="https://theconversation.com/profiles/laura-dodds-1378067">Laura Dodds</a>, PhD Candidate, <a href="https://theconversation.com/institutions/western-sydney-university-1092">Western Sydney University</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/these-12-things-can-reduce-your-dementia-risk-but-many-australians-dont-know-them-all-191504">original article</a>.

Mind

From eye exams to blood tests and surgery: how doctors use light to diagnose disease

<a href="https://theconversation.com/profiles/matthew-griffith-1539353">Matthew Griffith</a>, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> You’re not feeling well. You’ve had a pounding headache all week, dizzy spells and have vomited up your past few meals. You visit your GP to get some answers and sit while they shine a light in your eyes, order a blood test and request some medical imaging. Everything your GP just did relies on light. These are just some of the optical technologies that have had an enormous impact in how we diagnose disease. <h2>1. On-the-spot tests</h2> Point-of-care diagnostics allow doctors to test patients on the spot and get answers in minutes, rather than sending samples to a lab for analysis. The “flashlight” your GP uses to view the inside of your eye (known as an <a href="https://medlineplus.gov/ency/article/003881.htm">ophthalmoscope</a>) is a great example. This allows doctors to detect abnormal blood flow in the eye, deformations of the cornea (the outermost clear layer of the eye), or swollen optical discs (a round section at the back of the eye where the nerve link to the brain begins). Swollen discs are a sign of elevated pressure inside your head (or in the worst case, a brain tumour) that could be <a href="https://www.hopkinsmedicine.org/health/conditions-and-diseases/headache/increased-intracranial-pressure-icp-headache">causing your headaches</a>. The invention of <a href="https://openmedscience.com/lighting-the-way-in-healthcare-the-transformative-role-of-lasers-in-medicine/">lasers and LEDs</a> has enabled many other miniaturised technologies to be provided at the bedside or clinic rather than in the lab. <a href="https://theconversation.com/whats-a-pulse-oximeter-should-i-buy-one-to-monitor-covid-at-home-174457">Pulse oximetry</a> is a famous example, where a clip attached to your finger reports how well your blood is oxygenated. It does this by <a href="https://www.howequipmentworks.com/pulse_oximeter/">measuring</a> the different responses of oxygenated and de-oxygenated blood to different colours of light. Pulse oximetry is used at hospitals (and <a href="https://theconversation.com/whats-a-pulse-oximeter-should-i-buy-one-to-monitor-covid-at-home-174457">sometimes at home</a>) to monitor your respiratory and heart health. In hospitals, it is also a valuable tool for detecting <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(12)60107-X/fulltext">heart defects in babies</a>. <h2>2. Looking at molecules</h2> Now, back to that blood test. Analysing a small amount of your blood can diagnose <a href="https://theconversation.com/blood-tests-and-diagnosing-illness-what-can-blood-tell-us-about-whats-happening-in-our-body-80327">many different diseases</a>. A machine called an automated “full blood count analyser” tests for general markers of your health. This machine directs focused beams of light through blood samples held in small glass tubes. It counts the number of blood cells, determines their specific type, and reports the level of haemoglobin (the protein in red blood cells that distributes oxygen around your body). In minutes, this machine can provide a <a href="https://www.nuffieldhealth.com/article/inside-the-pathology-lab-what-happens-to-my-blood">snapshot</a> of your overall health. For more specific disease markers, blood serum is separated from the heavier cells by spinning in a rotating instrument called a centrifuge. The serum is then exposed to special chemical stains and enzyme assays that change colour depending on whether specific molecules, which may be the sign of a disease, are present. These colour changes can’t be detected with the naked eye. However, a light beam from an instrument called a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5476943/#R88">spectrometer</a> can detect tiny amounts of these substances in the blood and determine if the biomarkers for diseases are present, and at what levels. <h2>3. Medical imaging</h2> Let’s re-visit those medical images your GP ordered. The development of fibre-optic technology, made famous for transforming high-speed digital communications (such as the NBN), allows light to get inside the body. The result? High-resolution optical imaging. A common example is an <a href="https://www.medicalnewstoday.com/articles/153737#risks-and-side-effects">endoscope</a>, where fibres with a tiny camera on the end are inserted into the body’s natural openings (such as your mouth or anus) to examine your gut or respiratory tracts. Surgeons can insert the same technology through tiny cuts to view the inside of the body on a video screen during <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9553337/">laparoscopic surgery</a> (also known as keyhole surgery) to diagnose and treat disease. <h2>How about the future?</h2> Progress in nanotechnology and a better understanding of the interactions of light with our tissues are leading to new light-based tools to help diagnose disease. These include: <ul> <li> <a href="https://onlinelibrary.wiley.com/doi/full/10.1002/advs.201903441">nanomaterials</a> (materials on an extremely small scale, many thousands of times smaller than the width of a human hair). These are being used in next-generation sensors and new diagnostic tests </li> <li> <a href="https://www.nature.com/articles/s41587-019-0045-y">wearable optical biosensors</a> the size of your fingernail can be included in devices such as watches, contact lenses or finger wraps. These devices allow non-invasive measurements of sweat, tears and saliva, in real time </li> <li> AI tools to analyse how blood serum scatters infrared light. This has allowed researchers to build a <a href="https://www.advancedsciencenews.com/powerful-diagnostic-approach-uses-light-to-detect-virtually-all-forms-of-cancer/">comprehensive database</a> of scatter patterns to detect <a href="https://onlinelibrary.wiley.com/doi/full/10.1002/aisy.202300006">any cancer</a> </li> <li> a type of non-invasive imaging called <a href="https://www.ncbi.nlm.nih.gov/books/NBK554044/">optical coherence tomography</a> for more detailed imaging of the eye, heart and skin </li> <li> fibre optic technology to deliver a tiny microscope into the body on the <a href="https://www.uwa.edu.au/projects/microscope-in-a-needle">tip of a needle</a>. </li> </ul> So the next time you’re at the GP and they perform (or order) some tests, chances are that at least one of those tests depend on light to help diagnose disease.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/231379/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/matthew-griffith-1539353">Matthew Griffith</a>, Associate Professor and ARC Future Fellow and Director, UniSA Microscopy and Microanalysis Facilities, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/from-eye-exams-to-blood-tests-and-surgery-how-doctors-use-light-to-diagnose-disease-231379">original article</a>.

Body

Scurvy is largely a historical disease but there are signs it’s making a comeback

<a href="https://theconversation.com/profiles/lauren-ball-14718">Lauren Ball</a>, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> Scurvy is often considered a historical ailment, conjuring images of sailors on long sea voyages suffering from a lack of fresh fruit and vegetables. Yet doctors in developed countries have recently reported treating cases of scurvy, including Australian doctors who <a href="https://casereports.bmj.com/lookup/doi/10.1136//bcr-2024-261082">reported their findings</a> today in the journal <a href="https://casereports.bmj.com/">BMJ Case Reports</a>. <h2>What is scurvy?</h2> Scurvy is a disease caused by a severe deficiency of vitamin C (ascorbic acid), which is essential for the production of collagen. This protein helps maintain the health of skin, blood vessels, bones and connective tissue. Without enough vitamin C, the body cannot properly repair tissues, heal wounds, or fight infections. This can lead to a range of <a href="https://www.degruyter.com/document/doi/10.1515/9781400884544/html">symptoms</a> including: <ul> <li>fatigue and weakness</li> <li>swollen, bleeding gums or loose teeth</li> <li>joint and muscle pain and tenderness</li> <li>bruising easily</li> <li>dry, rough or discoloured skin (reddish or purple spots due to bleeding under the skin)</li> <li>cuts and sores take longer to heal</li> <li>anaemia (a shortage of red blood cells, leading to further fatigue and weakness)</li> <li>increased susceptibility to infections.</li> </ul> <h2>It historically affected sailors</h2> Scurvy was <a href="https://pubmed.ncbi.nlm.nih.gov/23183299/">common</a> from the 15th to 18th centuries, when naval sailors and other explorers lived on rations or went without fresh food for long periods. You might have heard some of these milestones in the history of the disease: <ul> <li> in 1497-1499, Vasco da Gama’s crew <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(03)13131-5/fulltext#:%7E:text=After%205%20weeks%20at%20sea,lemons%2C%20clearing%20up%20the%20condition">suffered severely from scurvy</a> during their expedition to India, with a large portion of the crew dying from it </li> <li> from the 16th to 18th centuries, scurvy was rampant among European navies and explorers, affecting notable figures such as <a href="https://www.jstor.org/stable/26305889">Ferdinand Magellan and Sir Francis Drake</a>. It was considered one of the greatest threats to sailors’ health during long voyages </li> <li> in 1747, British naval surgeon <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC3536506/">James Lind</a> is thought to have conducted one of the first clinical trials, demonstrating that citrus fruit could prevent and cure scurvy. However, it took several decades for his findings to be widely implemented </li> <li> in 1795, the British Royal Navy officially adopted the <a href="https://journals.sagepub.com/doi/pdf/10.1177/003591572601902602">practice of providing lemon or lime juice to sailors</a>, dramatically reducing the number of scurvy cases. </li> </ul> <h2>Evidence of scurvy re-emerging</h2> In the new case report, doctors in Western Australia <a href="https://casereports.bmj.com/lookup/doi/10.1136//bcr-2024-261082">reported</a> treating a middle-aged man with the condition. In a separate case report, doctors in Canada <a href="https://www.cmaj.ca/content/196/33/E1144">reported</a> treating a 65-year old woman. Both patients presented with leg weakness and compromised skin, yet the doctors didn’t initially consider scurvy. This was based on the <a href="https://www.mdpi.com/2072-6643/12/7/1963">premise</a> that there is abundant vitamin C in our modern food supply, so deficiency should not occur. On both occasions, treatment with high doses of vitamin C (1,000mg per day for at least seven days) resulted in improvements in symptoms and eventually a full recovery. The authors of both case reports are concerned that if scurvy is left untreated, it could lead to inflamed blood vessels (<a href="https://www.mayoclinic.org/diseases-conditions/vasculitis/symptoms-causes/syc-20363435">vasculitis</a>) and potentially <a href="https://www.sciencedirect.com/science/article/pii/S2211419X11001625">cause fatal bleeding</a>. Last year, a major New South Wales hospital undertook a <a href="https://www.mja.com.au/journal/2023/219/10/serum-vitamin-c-status-people-new-south-wales-retrospective-analysis-findings">chart review</a>, where patient records are reviewed to answer research questions. This found vitamin C deficiency was common. More than 50% of patients who had their vitamin C levels tested had either a modest deficiency (29.9%) or significant deficiency (24.5%). Deficiencies were more common among patients from rural and lower socioeconomic areas. Now clinicians are <a href="https://onlinelibrary.wiley.com/doi/full/10.5694/mja2.52146">urged to</a> consider vitamin C deficiency and scurvy as a potential diagnosis and involve the support of a dietitian. <h2>Why might scurvy be re-emerging?</h2> Sourcing and consuming nutritious foods with sufficient vitamin C is unfortunately <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC10260575/">still an issue</a> for some people. Factors that increase the risk of vitamin C deficiency include: <ul> <li> poor diet. People with restricted diets – due to poverty, food insecurity or dietary choices – <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC10296835/">may not get enough</a> vitamin C. This includes those who rely heavily on processed, nutrient-poor foods rather than fresh produce </li> <li> food deserts. In areas where access to fresh, affordable fruits and vegetables is limited (often referred to as food deserts), people may <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC9587807/">unintentionally suffer from a vitamin C deficiency</a>. In some parts of developing countries such as India, lack of access to fresh food is <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC10296835/">recognised as a risk</a> for scurvy </li> <li> the cost-of-living crisis. With greater numbers of people <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC10935407/">unable to pay for fresh produce</a>, people who limit their intake of fruits and vegetables may develop nutrient deficiencies, including scurvy </li> </ul> <ul> <li> weight loss procedures and medications. Restricted dietary intake due to weight loss surgery or weight loss medications may <a href="https://onlinelibrary.wiley.com/doi/full/10.1002/oby.24067">lead to nutrient deficiencies</a>, such as in this <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC3320124/">case report of scurvy</a> from Denmark </li> <li> mental illness and eating disorders. Conditions such as depression and anorexia nervosa can lead to severely restricted diets, increasing the risk of scurvy, such as in this <a href="https://pubmed.ncbi.nlm.nih.gov/32291151/">case report</a> from 2020 in Canada </li> <li> isolation. Older adults, especially those who live alone or in nursing homes, may have <a href="https://doi.org/10.1136//bcr-2024-261082">difficulty</a> preparing balanced meals with sufficient vitamin C </li> <li> certain medical conditions. People with digestive disorders, malabsorption issues, or those on restrictive medical diets (due to severe allergies or intolerances) can develop scurvy if they are <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC8248877/">unable to absorb or consume enough vitamin C</a>. </li> </ul> <h2>How much vitamin C do we need?</h2> Australia’s dietary guidelines <a href="https://www.eatforhealth.gov.au/nutrient-reference-values/nutrients/vitamin-c">recommend</a> adults consume 45mg of vitamin C (higher if pregnant or breastfeeding) each day. This is roughly the amount found in half an orange or half a cup of strawberries. When more vitamin C is <a href="https://www.abs.gov.au/statistics/health/health-conditions-and-risks/australian-health-survey-usual-nutrient-intakes/latest-release">consumed</a> than required, excess amounts leave the body through urine. Signs of scurvy can appear as early as a month after a daily intake of less than 10 mg of vitamin C. Eating vitamin C-rich foods – such as oranges, strawberries, kiwifruit, plums, pineapple, mango, capsicum, broccoli and Brussels sprouts – can resolve symptoms within a few weeks. Vitamin C is also readily available as a supplement if there are reasons why intake through food may be compromised. Typically, the supplements contain 1,000mg per tablet, and the <a href="https://www.eatforhealth.gov.au/nutrient-reference-values/nutrients/vitamin-c">recommended upper limit</a> for daily Vitamin C intake is 2,000mg.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/241894/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/lauren-ball-14718">Lauren Ball</a>, Professor of Community Health and Wellbeing, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/scurvy-is-largely-a-historical-disease-but-there-are-signs-its-making-a-comeback-241894">original article</a>.

Body

We tend to underestimate our future expenses – here’s one way to prevent that

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/ray-charles-chuck-howard-1361224">Ray Charles "Chuck" Howard</a>, <a href="https://theconversation.com/institutions/texas-aandm-university-1672">Texas A&M University</a>; <a href="https://theconversation.com/profiles/abigail-sussman-227057">Abigail Sussman</a>, <a href="https://theconversation.com/institutions/university-of-chicago-952">University of Chicago</a>; <a href="https://theconversation.com/profiles/david-j-hardisty-753777">David J. Hardisty</a>, <a href="https://theconversation.com/institutions/university-of-british-columbia-946">University of British Columbia</a>, and <a href="https://theconversation.com/profiles/marcel-lukas-1236384">Marcel Lukas</a>, <a href="https://theconversation.com/institutions/university-of-st-andrews-1280">University of St Andrews</a> <h2>The big idea</h2> When asked to estimate how much money they would spend in the future, people underpredicted the total amount by more than C$400 per month. However, when prompted to think about unexpected spending in addition to typical expenses, people made much more accurate predictions. These are the main findings of a series of <a href="https://doi.org/10.1177%2F00222437211068025">studies and experiments that we conducted</a> and which have just been published in the <a href="https://journals.sagepub.com/home/mrj">Journal of Marketing Research</a>. In our first study, we began by asking 187 members of a Canadian credit union to predict their weekly spending for the next five weeks. Then, at the end of each week, we asked them how much they actually spent. For the first four weeks, people underpredicted their weekly spending by about $100 per week or $400 for the month. In the study’s fifth and final week, we ran an experiment to see if we could improve people’s prediction accuracy. Specifically, we randomly assigned participants to one of two groups. In group one, participants estimated their spending for the next week just as they had done in previous weeks. These folks once again significantly underpredicted their spending. In group two, participants were asked to think of three reasons why their spending for the next week might be different than usual before making their estimate. This led them to make higher and much more accurate predictions – coming within just $7 of what they actually spent. Importantly, participants in each group spent roughly the same amount of money that week, on average. The only difference between the two groups was whether they accurately predicted that amount. <iframe id="WlDv3" class="tc-infographic-datawrapper" style="border: 0;" src="https://datawrapper.dwcdn.net/WlDv3/3/" width="100%" height="400px" frameborder="0" scrolling="no"></iframe> Next, we conducted nine experiments to better understand why people underpredict their spending and whether being prompted to think of unusual expenses helps improve accuracy. In all, over 5,800 people participated in these experiments, including a representative sample of U.S. residents. These experiments revealed two important insights. First, people primarily base their spending predictions on typical expenses like groceries, gasoline and rent. They usually fail to account for irregular – though still common – expenses like car repairs, last-minute concert tickets or one-off health care bills. This is what leads to underprediction. Second, prompting people to think of irregular expenses in addition to typical expenses helps them to make more accurate spending predictions. In our studies, people did not factor in atypical expenses unless we asked them to do so. <h2>Why it matters</h2> Helping people improve the accuracy of their spending predictions could help them improve their financial well-being. Underpredicting expenses can be costly. For example, 12 million Americans <a href="https://www.pewtrusts.org/en/research-and-analysis/reports/2012/07/19/who-borrows-where-they-borrow-and-why">borrow a total of more than $7 billion</a> in payday loans each year because they can’t meet their monthly expenses. These loans typically have extremely high interest rates – <a href="https://www.pewtrusts.org/en/research-and-analysis/data-visualizations/2022/how-well-does-your-state-protect-payday-loan-borrowers">more than 250% in some states</a>. Payday loans also come due in full so quickly that around three in four borrowers <a href="https://www.pewtrusts.org/en/research-and-analysis/reports/2012/07/19/who-borrows-where-they-borrow-and-why">end up borrowing again</a> to pay off the original loan. If consumers could better anticipate how much money they will spend in the future, it might help motivate them to spend less and save more in the present. In fact, one of our studies shows that our suggested prediction strategy <a href="https://doi.org/10.1177/0022243721106802">not only boosted spending estimates</a>, it also increased intentions to save. <h2>What’s next</h2> Members of our research team are currently investigating if, when and why underpredicting one’s expenses may be beneficial. For example, if a person sets an optimistically low budget and actively tracks their spending against it, does that help them reduce their spending? We are also investigating whether people who work in the gig economy show a corresponding tendency to mispredict their future income.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/189100/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/ray-charles-chuck-howard-1361224">Ray Charles "Chuck" Howard</a>, Assistant Professor of Marketing, <a href="https://theconversation.com/institutions/texas-aandm-university-1672">Texas A&M University</a>; <a href="https://theconversation.com/profiles/abigail-sussman-227057">Abigail Sussman</a>, Professor of Marketing, <a href="https://theconversation.com/institutions/university-of-chicago-952">University of Chicago</a>; <a href="https://theconversation.com/profiles/david-j-hardisty-753777">David J. Hardisty</a>, Assistant Professor of Marketing & Behavioral Science, <a href="https://theconversation.com/institutions/university-of-british-columbia-946">University of British Columbia</a>, and <a href="https://theconversation.com/profiles/marcel-lukas-1236384">Marcel Lukas</a>, Lecturer in Banking and Finance, <a href="https://theconversation.com/institutions/university-of-st-andrews-1280">University of St Andrews</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/we-tend-to-underestimate-our-future-expenses-heres-one-way-to-prevent-that-189100">original article</a>. </div>

Money & Banking

"Absolute breakthrough": New hope in search for Motor Neurone Disease cure

Melbourne researchers are one step closer to finding a cure for Motor Neurone Disease, with the help technology and stem cell research. Scientists at The Florey Institute of Neuroscience and Mental Health have developed a world-first technology that will speed up the drug testing process to help find an effective treatment and maybe even a cure for the disease. New machines at the institute can now help determine whether drugs on the market could be used to treat MND in just weeks, a process which previously took decades. "This is an absolute breakthrough, it's at the cutting edge of technology," Florey MND researcher Professor Brad Turner said. Animal cells were previously used to test the efficacy of MND drugs, but now thanks to more than 100 MND patients who donated their skin cells to the institute, researchers have a library of stem cells to work with. The human stem cells can provide scientists with the full scope of the disease, something that they were previously unable to do with just animal cells. "This is really a game-changer in that we can use their own cells, and we can test drugs directly on their own cells," Florey MND researcher and neurologist Dr Thanuja Dharmadasa said. Large scale screening will commence thanks to a $5 million grant from the Australian Medical Research Future Fund. The research is expected to help people like Phil Camden who has been living with the disease for 10 years. "That's the key to all of us living with MND... we want to do what we can while we can," Camden said. "We know we're not doing it to find a cure for us. We're doing it for those in the future, my grandkids and their children." Scientists believe that medication or a cocktail of drugs tailored specifically to a patient is the way forward when it comes to treating the disease. "Therefore your drug treatments are tailed back to the clinical makeup in the dish and we call that personalised medical treatment," Turner said. Image: Nine News

Caring

Is it really possible to have Alzheimer’s yet no symptoms?

<a href="https://theconversation.com/profiles/michael-hornberger-1507154">Michael Hornberger</a>, <a href="https://theconversation.com/institutions/university-of-east-anglia-1268">University of East Anglia</a> Some people seem to be more <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11003087/#:%7E:text=Some%20individuals%20are%20able%20to,into%20a%20widely%20debated%20concept.">resilient</a> to developing Alzheimer’s diseases, despite having the biological hallmarks of the devastating disease. For obvious reasons, scientists are very interested in studying this special group of people. Alzheimer’s disease, the most common form of dementia, is thought to start because of a build-up of two proteins in the brain: amyloid and tau. Once these proteins accumulate, for yet-to-be-determined reasons, they become toxic to brain cells (neurons) and these cells start dying. As a result, people develop symptoms such as memory loss because the brain can’t function properly with all these dead neurons. This cascade of events has been known for many years and is how the disease progresses in most people with Alzheimer’s. Most people, except a special group who are more resilient. But why are they resilient? A recent study in the journal <a href="https://actaneurocomms.biomedcentral.com/articles/10.1186/s40478-024-01760-9">Acta Neuropathologica Communications</a> investigated whether our genes might influence how resilient we are against Alzheimer’s disease symptoms when there are high levels of amyloid in our brain. The scientists conducted a study on the brains of three groups of people. The first group comprised people who had died with Alzheimer’s disease. The second were healthy people who died of natural causes. And the third comprised people who had high levels of Alzheimer’s proteins in the brain but never developed symptoms of the disease during their lifetime – or at least never had a diagnosis of Alzheimer’s disease. The last group, they considered as being resilient to Alzheimer’s disease since they had the proteins in their brains but did not have the symptoms or a diagnosis of Alzheimer’s disease during their lifetime. The scientists found that genes related to the activity of the immune system seem to have been more active in the Alzheimer’s resilient group. This would make sense as it is well established that the immune system helps clear the excess proteins from the brain, so genes that help this process might make us more resilient to developing symptoms of the disease. <h2>How to become resilient – even if you don’t have the genes</h2> This is great if you have inherited these genes from your parents, but what does it mean for the rest of us who do not have those genes? Is there a way we can make ourselves more resilient to developing Alzheimer’s disease regardless of our genes? “Yes” is the short answer. There is now good scientific evidence that <a href="https://theconversation.com/can-alzheimers-really-be-reversed-as-a-new-documentary-claims-230705">lifestyle changes</a> and drugs allow us to reduce our risk of developing Alzheimer’s disease in the future. In particular, physical activity has been shown to reduce our risk of developing Alzheimer’s, probably because it has a well-known beneficial effect on our immune system and hence helps clear those rogue proteins accumulating in our brains. This means that being more physically active might have the same effect on our Alzheimer’s resilience as those lucky people who have the “right” genes. Interestingly, we do not know how physically active the resilient people in the study were and how this might have influenced their resilience to Alzheimer’s disease. As so often in science, it is not clear whether nature (genes) or nurture (lifestyle) contributed to their resilience. The other interesting aspect is that the resilient people in the study died of another cause than Alzheimer’s disease, but they might have developed Alzheimer’s disease eventually if they had lived longer.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/230334/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/michael-hornberger-1507154">Michael Hornberger</a>, Professor of Applied Dementia Research, <a href="https://theconversation.com/institutions/university-of-east-anglia-1268">University of East Anglia</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/is-it-really-possible-to-have-alzheimers-yet-no-symptoms-230334">original article</a>.

Mind

"Rest in love": All Blacks legend and Dancing with the Stars winner dies at 55

The sports and entertainment communities are mourning the loss of former All Blacks hooker and Dancing with the Stars winner Norm Hewitt, who has passed away at the age of 55. Hewitt, a beloved figure both on and off the rugby field, succumbed to a lengthy battle with motor neurone disease, as confirmed by his family in a heartfelt statement. "Although rugby dominated his early life, he established a thriving human relations consultancy after retirement, and his services were much in demand both nationally and internationally," his family shared. "He walked confidently in both Māori and Pākehā worlds and was a particular role model for troubled youth, citing his own background, and offering inspirational teachings that one’s present life need not be one’s future." Hewitt leaves behind his wife Arlene and their two children, Elizabeth and Alexander. Born and raised in Pōrangahau, southern Hawke’s Bay, Hewitt's rugby career was nothing short of illustrious. Over 13 seasons, he played 296 representative matches for Hawke’s Bay, Southland and Wellington, earning 23 caps for the All Blacks. Hewitt was also a pivotal member of the Hurricanes during the formative years of Super Rugby, missing only one match in the first five years. The rugby community has been profoundly affected by Hewitt's passing. Former teammate Ofisa Tonu’u posted a touching tribute on Facebook: "I’m just devastated finding out the news today. I will never forget how you always stuck up for me during the Black Tracker days when no one else would, you always look after all the players and we always followed you into battle. No more pain, brother, you can now rest in Love. Fa’afetai tele lava my uso for having my back as I did yours. I know the other boys will be welcoming you with open arms at the gates. Rest in Love, Normy." Beyond his rugby career, Hewitt transitioned into a public speaker and mentor, focusing heavily on violence prevention programmes and advocacy. He worked with the SPCA as an animal cruelty and anti-violence publicity officer, visiting schools to spread his message. In 2005, Hewitt showcased his versatility by winning the first season of Dancing with the Stars alongside professional dancer Carol-Ann Hickmore. Hewitt's life was not without its struggles. In 1999, he made a public apology for a drunken incident in Queenstown, marking a turning point as he renounced alcohol and dedicated himself to helping others facing similar challenges. The outpouring of tributes was immediate, with The All Blacks expressing their sorrow: “We are saddened by the loss of All Black #938 Norm Hewitt who passed away yesterday in Wellington. Hewitt played 9 Tests and 14 Games between 1993 and 1998. Our thoughts are with Norm’s family and loved ones at this time.” Podcaster Martin Devlin shared his personal experience: “RIP Norm Hewitt. Not a lot of people know how kind & generous this man was. A truly wonderful person. Reached out to me and helped me considerably a long time ago when things were very rough. Love & respect.” Richard Hills echoed the sentiments of many: “This is bloody sad. A sad way to lose a kiwi icon so young. He had a really rough childhood and upbringing and faced it and turned his life around to become not only a rugby legend but also helped others who’d been through similar issues.” Norm Hewitt’s legacy will endure through the lives he touched and the positive change he inspired. His story is a testament to the strength of the human spirit and the profound impact one individual can have on the world. Image: Radio New Zealand

Caring

Walking can prevent low back pain, a new study shows

<a href="https://theconversation.com/profiles/tash-pocovi-1293184">Tash Pocovi</a>, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie University</a>; <a href="https://theconversation.com/profiles/christine-lin-346821">Christine Lin</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/mark-hancock-1463059">Mark Hancock</a>, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie University</a>; <a href="https://theconversation.com/profiles/petra-graham-892602">Petra Graham</a>, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie University</a>, and <a href="https://theconversation.com/profiles/simon-french-713564">Simon French</a>, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie University</a> Do you suffer from low back pain that recurs regularly? If you do, you’re not alone. Roughly <a href="https://pubmed.ncbi.nlm.nih.gov/31208917/">70% of people</a> who recover from an episode of low back pain will experience a new episode in the following year. The recurrent nature of low back pain is a major contributor to the <a href="https://www.thelancet.com/journals/lanrhe/article/PIIS2665-9913(23)00098-X/fulltext">enormous burden</a> low back pain places on individuals and the health-care system. In our new study, published today in <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)00755-4/fulltext">The Lancet</a>, we found that a program combining walking and education can effectively reduce the recurrence of low back pain. <h2>The WalkBack trial</h2> We randomly assigned 701 adults who had recently recovered from an episode of low back pain to receive an individualised walking program and education (intervention), or to a no treatment group (control). Participants in the intervention group were guided by physiotherapists across six sessions, over a six-month period. In the first, third and fifth sessions, the physiotherapist helped each participant to develop a personalised and progressive walking program that was realistic and tailored to their specific needs and preferences. The remaining sessions were short check-ins (typically less than 15 minutes) to monitor progress and troubleshoot any potential barriers to engagement with the walking program. Due to the COVID pandemic, most participants received the entire intervention via telehealth, using video consultations and phone calls. The program was designed to be manageable, with a target of five walks per week of roughly 30 minutes daily by the end of the six-month program. Participants were also encouraged to continue walking independently after the program. Importantly, the walking program was combined with education provided by the physiotherapists during the six sessions. This education aimed to give people a better understanding of pain, reduce fear associated with exercise and movement, and give people the confidence to self-manage any minor recurrences if they occurred. People in the control group received no preventative treatment or education. This reflects what <a href="https://www.sciencedirect.com/science/article/abs/pii/S2468781222001308?via%3Dihub">typically occurs</a> after people recover from an episode of low back pain and are discharged from care. <h2>What the results showed</h2> We monitored the participants monthly from the time they were enrolled in the study, for up to three years, to collect information about any new recurrences of low back pain they may have experienced. We also asked participants to report on any costs related to their back pain, including time off work and the use of health-care services. The intervention reduced the risk of a recurrence of low back pain that limited daily activity by 28%, while the recurrence of low back pain leading participants to seek care from a health professional decreased by 43%. Participants who received the intervention had a longer average period before they had a recurrence, with a median of 208 days pain-free, compared to 112 days in the control group. Overall, we also found this intervention to be cost-effective. The biggest savings came from less work absenteeism and less health service use (such as physiotherapy and massage) among the intervention group. This trial, like all studies, had some limitations to consider. Although we tried to recruit a wide sample, we found that most participants were female, aged between 43 and 66, and were generally well educated. This may limit the extent to which we can generalise our findings. Also, in this trial, we used physiotherapists who were up-skilled in health coaching. So we don’t know whether the intervention would achieve the same impact if it were to be delivered by other clinicians. <h2>Walking has multiple benefits</h2> We’ve all heard the saying that “prevention is better than a cure” – and it’s true. But this approach has been largely neglected when it comes to low back pain. Almost all <a href="https://www.sciencedirect.com/science/article/pii/S0140673618304896?via%3Dihub">previous studies</a> have focused on treating episodes of pain, not preventing future back pain. A limited number of <a href="https://pubmed.ncbi.nlm.nih.gov/26752509/">small studies</a> have shown that exercise and education can help prevent low back pain. However, most of these studies focused on exercises that are not accessible to everyone due to factors such as high cost, complexity, and the need for supervision from health-care or fitness professionals. On the other hand, walking is a free, accessible way to exercise, including for people in rural and remote areas with limited access to health care. Walking also delivers many other <a href="https://www.vichealth.vic.gov.au/sites/default/files/VH_Benefits-of-Walking-Summary2020.pdf">health benefits</a>, including better heart health, improved mood and sleep quality, and reduced risk of several chronic diseases. While walking is not everyone’s favourite form of exercise, the intervention was well-received by most people in our study. Participants <a href="https://pubmed.ncbi.nlm.nih.gov/37271689/">reported</a> that the additional general health benefits contributed to their ongoing motivation to continue the walking program independently. <h2>Why is walking helpful for low back pain?</h2> We don’t know exactly why walking is effective for preventing back pain, but <a href="https://www.e-jer.org/journal/view.php?number=2013600295">possible reasons</a> could include the combination of gentle movements, loading and strengthening of the spinal structures and muscles. It also could be related to relaxation and stress relief, and the release of “feel-good” endorphins, which <a href="https://my.clevelandclinic.org/health/body/23040-endorphins">block pain signals</a> between your body and brain – essentially turning down the dial on pain. It’s possible that other accessible and low-cost forms of exercise, such as swimming, may also be effective in preventing back pain, but surprisingly, <a href="https://pubmed.ncbi.nlm.nih.gov/34783263/">no studies</a> have investigated this. Preventing low back pain is not easy. But these findings give us hope that we are getting closer to a solution, one step at a time.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/231682/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/tash-pocovi-1293184">Tash Pocovi</a>, Postdoctoral research fellow, Department of Health Sciences, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie University</a>; <a href="https://theconversation.com/profiles/christine-lin-346821">Christine Lin</a>, Professor, Institute for Musculoskeletal Health, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/mark-hancock-1463059">Mark Hancock</a>, Professor of Physiotherapy, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie University</a>; <a href="https://theconversation.com/profiles/petra-graham-892602">Petra Graham</a>, Associate Professor, School of Mathematical and Physical Sciences, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie University</a>, and <a href="https://theconversation.com/profiles/simon-french-713564">Simon French</a>, Professor of Musculoskeletal Disorders, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie University</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/walking-can-prevent-low-back-pain-a-new-study-shows-231682">original article</a>.

Body

"I'm a prisoner in my own body": Rob Burrow's heartbreaking last message

An emotional final message from rugby legend Rob Burrow has been released in the days after his death. The former footballer <a href="https://oversixty.com.au/health/caring/rugby-league-hero-dies-at-just-41" target="_blank" rel="noopener">died</a> at the age of 41 on Sunday after a lengthy battle with motor neurone disease, with his former club, the Leeds Rhinos, sharing the news of his passing. Before he died, Burrow was involved in the making of a documentary about his life by the BBC, titled There's Only One Burrow, only agreeing to appear in the program on the condition it only be used after his death. In the documentary, Burrow spoke of how the cruel disease impacted his life and how he hoped to raise awareness for MND research. "I want to live in a world free of MND. By the time you watch this I will no longer be here," he said in the video. "In a world full of adversity, we must still dare to dream. I'm just a lad from Yorkshire who got to live out his dream of playing rugby league." <blockquote class="instagram-media" style="background: #FFF; border: 0; border-radius: 3px; box-shadow: 0 0 1px 0 rgba(0,0,0,0.5),0 1px 10px 0 rgba(0,0,0,0.15); margin: 1px; max-width: 540px; min-width: 326px; padding: 0; width: calc(100% - 2px);" data-instgrm-captioned="" data-instgrm-permalink="https://www.instagram.com/reel/C7xPgSxM6lY/?utm_source=ig_embed&utm_campaign=loading" data-instgrm-version="14"> <div style="padding: 16px;"> <div style="display: flex; flex-direction: row; align-items: center;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 40px; margin-right: 14px; width: 40px;"> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 100px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 60px;"> </div> </div> </div> <div style="padding: 19% 0;"> </div> <div style="display: block; height: 50px; margin: 0 auto 12px; width: 50px;"> </div> <div style="padding-top: 8px;"> <div style="color: #3897f0; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: 550; line-height: 18px;">View this post on Instagram</div> </div> <div style="padding: 12.5% 0;"> </div> <div style="display: flex; flex-direction: row; margin-bottom: 14px; align-items: center;"> <div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(0px) translateY(7px);"> </div> <div style="background-color: #f4f4f4; height: 12.5px; transform: rotate(-45deg) translateX(3px) translateY(1px); width: 12.5px; flex-grow: 0; margin-right: 14px; margin-left: 2px;"> </div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(9px) translateY(-18px);"> </div> </div> <div style="margin-left: 8px;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 20px; width: 20px;"> </div> <div style="width: 0; height: 0; border-top: 2px solid transparent; border-left: 6px solid #f4f4f4; border-bottom: 2px solid transparent; transform: translateX(16px) translateY(-4px) rotate(30deg);"> </div> </div> <div style="margin-left: auto;"> <div style="width: 0px; border-top: 8px solid #F4F4F4; border-right: 8px solid transparent; transform: translateY(16px);"> </div> <div style="background-color: #f4f4f4; flex-grow: 0; height: 12px; width: 16px; transform: translateY(-4px);"> </div> <div style="width: 0; height: 0; border-top: 8px solid #F4F4F4; border-left: 8px solid transparent; transform: translateY(-4px) translateX(8px);"> </div> </div> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center; margin-bottom: 24px;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 224px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 144px;"> </div> </div> <p style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; line-height: 17px; margin-bottom: 0; margin-top: 8px; overflow: hidden; padding: 8px 0 7px; text-align: center; text-overflow: ellipsis; white-space: nowrap;"><a style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: normal; line-height: 17px; text-decoration: none;" href="https://www.instagram.com/reel/C7xPgSxM6lY/?utm_source=ig_embed&utm_campaign=loading" target="_blank" rel="noopener">A post shared by BBC SPORT (@bbcsport)</a> </div> </blockquote> His pre-recorded final words were shown to his friends and family on screen, reacting to his words. "I'm a fighter, to be honest. I might not be able to tackle MND but I'll certainly be swinging, I'm not going to give in, not until my last breath," he said. "I'm a prisoner in my own body, that's the way MND gets you. The lights are on but no one is home." Recalling his diagnosis, he said, "My family told me I was slurring my speech a bit but I didn't take notice or believe them." In an emotional segment of the widow, Burrow's wife Lindsey spoke of how she learnt of her husband's devastating disease. "I remember that moment being told it's not good news. Asking how long and them saying two years. Rob said 'thank god it's me and not the kids'. That's all he was bothered about," she recalled. When asked about his children, Burrow became emotional, saying, "I had no idea how my family would cope. They've become a beacon of hope for families in the same situation as ours." "I have had such a great life. I have been gifted with the most incredible wife and three children. I hope they know how much I love them." Burrows finishes the piece, saying. "As a father of three young children, I would never want someone to go through this." "I hope I have left a mark on this disease. I hope you choose to live in the moment. I hope you find inspiration." "My final message to you is whatever your personal battle to be brave and face it." "Every single day is precious. Don't waste a moment. In a world full of adversity we must still dare to dream. Rob Burrow over and out." Image credits: BBC

Caring

Rugby League hero dies at just 41

Rugby League legend Rob Burrow has passed away at the age of 41 after a lengthy battle with motor neurone disease. The British footballer spent his career with the Leeds Rhinos and helped them win eight Super League titles, and while he never played in Australia, he won the World Club Challenge over NRL opponents three times. Just two years after his retirement in 2017, Burrows was diagnosed with MND. Despite his rapidly progressing condition, Burrows stayed in the public eye to raise money and awareness for MND, and soon became the face of the fight against the disease in the UK. He worked with former teammate Kevin Sinfield to raise millions for a new care centre for MND patients, as the pair competed in <a href="https://oversixty.com.au/health/caring/terminally-ill-rugby-player-carried-across-marathon-finish-line-by-his-best-mate" target="_blank" rel="noopener">marathons</a> today, with Sinfield often pushing Burrow the entire way. His former football club announced Burrow’s death on Sunday, just one day before the groundbreaking of the new Rob Burrow Centre for MND at Seacroft Hospital, which will go ahead at his request. “It is with deep sadness that we announce the death of our beloved son, husband, father, brother and friend,” the club said. “Rob has always been a true inspiration throughout his life whether that was on the rugby league field or during his battle with MND. He never allowed others to define what he could achieve and believed in his own ability to do more." “The outpouring of love and support that Rob and the whole Burrow family have received over the last four and a half years meant so much to Rob." “For those who knew Rob throughout his life, his determination and spirit in the face of MND over the last four and a half years came as no surprise. Rob never accepted that he couldn’t do something. He just found his way of doing it better than anyone else." “He will continue to inspire us all every day. In a world full of adversity. We must dare to dream.” Prince William, who awarded Burrow with a Commander of the British Empire (CBE) honour in January 2024, was among those to mourn his death on social media. “A legend of rugby league, Rob Burrow had a huge heart,” he wrote. “He taught us ‘in a world full of adversity, we must dare to dream’. Catherine and I send our love." Burrow is survived by wife Lindsey and their three children Macy, Maya and Jackson. Image credits: SplashNews.com/Matt West/BPI/Phil Noble-Reuters/POOL supplied by Splash News/Shutterstock Editorial

Caring

Major TV star's 7-year-old undergoes third open heart surgery

Jimmy Kimmel's seven-year-old son has undergone his third, and hopefully final open heart surgery after being born with congenital heart disease. In 2017, Jimmy <a href="https://www.youtube.com/watch?v=MmWWoMcGmo0" target="_blank" rel="noopener">revealed</a> that Billy was only three days old when had to undergo his first open heart surgery, after doctors found “a hole in the wall of the left and right side of his heart” that was preventing enough oxygen from reaching his blood. Billy was only seven months old when he had to undergo his second open heart surgery, and over the weekend he had to undergo his third major surgery at the Children's Hospital Los Angeles. A few days later, the TV host took to Instagram to share an update following his son's successful surgery. "We went into this experience with a lot of optimism and nearly as much fear and came out with a new valve inside a happy, healthy kid," Kimmel wrote, alongside a picture of his youngest son smiling in a hospital bed. He then thanked all the surgeons, doctors and other medical staff who "came through for us with immeasurable kindness and expertise." "Walking around this hospital, meeting parents at their most vulnerable, children in pain and the miracle workers who do everything in their considerable power to save them is a humbling experience," Kimmel continued. <blockquote class="instagram-media" style="background: #FFF; border: 0; border-radius: 3px; box-shadow: 0 0 1px 0 rgba(0,0,0,0.5),0 1px 10px 0 rgba(0,0,0,0.15); margin: 1px; max-width: 540px; min-width: 326px; padding: 0; width: calc(100% - 2px);" data-instgrm-permalink="https://www.instagram.com/p/C7fE-p4S7YN/?utm_source=ig_embed&utm_campaign=loading" data-instgrm-version="14"> <div style="padding: 16px;"> <div style="display: flex; flex-direction: row; align-items: center;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 40px; margin-right: 14px; width: 40px;"> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 100px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 60px;"> </div> </div> </div> <div style="padding: 19% 0;"> </div> <div style="display: block; height: 50px; margin: 0 auto 12px; width: 50px;"> </div> <div style="padding-top: 8px;"> <div style="color: #3897f0; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: 550; line-height: 18px;">View this post on Instagram</div> </div> <div style="padding: 12.5% 0;"> </div> <div style="display: flex; flex-direction: row; margin-bottom: 14px; align-items: center;"> <div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(0px) translateY(7px);"> </div> <div style="background-color: #f4f4f4; height: 12.5px; transform: rotate(-45deg) translateX(3px) translateY(1px); width: 12.5px; flex-grow: 0; margin-right: 14px; margin-left: 2px;"> </div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(9px) translateY(-18px);"> </div> </div> <div style="margin-left: 8px;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 20px; width: 20px;"> </div> <div style="width: 0; height: 0; border-top: 2px solid transparent; border-left: 6px solid #f4f4f4; border-bottom: 2px solid transparent; transform: translateX(16px) translateY(-4px) rotate(30deg);"> </div> </div> <div style="margin-left: auto;"> <div style="width: 0px; border-top: 8px solid #F4F4F4; border-right: 8px solid transparent; transform: translateY(16px);"> </div> <div style="background-color: #f4f4f4; flex-grow: 0; height: 12px; width: 16px; transform: translateY(-4px);"> </div> <div style="width: 0; height: 0; border-top: 8px solid #F4F4F4; border-left: 8px solid transparent; transform: translateY(-4px) translateX(8px);"> </div> </div> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center; margin-bottom: 24px;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 224px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 144px;"> </div> </div> <p style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; line-height: 17px; margin-bottom: 0; margin-top: 8px; overflow: hidden; padding: 8px 0 7px; text-align: center; text-overflow: ellipsis; white-space: nowrap;"><a style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: normal; line-height: 17px; text-decoration: none;" href="https://www.instagram.com/p/C7fE-p4S7YN/?utm_source=ig_embed&utm_campaign=loading" target="_blank" rel="noopener">A post shared by Jimmy Kimmel (@jimmykimmel)</a> </div> </blockquote> He then highlighted the hospital's dedication to providing help to families "regardless of their ability to pay". Jimmy then extended his thanks to his family and friends and the "loving strangers who took time to pray for and send positive energy to our baby". He gave a special shout out to his wife Molly – for "being stronger than is reasonable for any Mum to be". The pair also share daughter Jane, nine. The late night TV host then praised his son for being "the toughest (and funniest) 7 year-old we know." "There are so many parents and children who aren't fortunate enough to go home after five days," he added and encouraged his followers to send their thoughts and prayers to these families. Image: Instagram/ X

Caring

Independent you: preventing, and recovering from, elder abuse

From implementing safeguards to stop it from beginning to taking back control if it does, there is a lot of power in your hands to avoid elder abuse. Previously, we explored the warning signs of elder abuse and how <a href="https://www.oversixty.com.au/finance/retirement-income/are-you-a-victim-of-elder-abuse-without-even-realising-it">it is possible to be a victim without even realising it</a>. And with more wealth owned by people over 60 now than ever before, the potential for abuse only continues to grow. So, how can you prevent elder abuse happening to you? And if you are already experiencing it, what can you do to regain control over your finances, independence and wellbeing? Prevention better than cure The best way to avoid the impacts of elder abuse is to protect yourself against it beginning in the first place. Awareness is the first step, so having <a href="https://www.oversixty.com.au/finance/retirement-income/are-you-a-victim-of-elder-abuse-without-even-realising-it">read this article and knowing the warning signs</a>, you’re already ahead of the game! Other preventative actions include: <ul> <li>Maintaining contact: social interactions are important not just for warding off loneliness but providing access to other points of view and avenues for support. </li> <li>External advisers: engage your own advisers – don’t simply employ who someone tells you to. They should be an impartial, qualified set of eyes to monitor things for you and point out anything that doesn’t seem right. This includes a financial advisor, lawyer, accountant, doctor and so on. A support person attending appointments with you may give you extra assurance.</li> <li>Power of attorney/guardianship: nominate multiple people, so that no one individual has all the say. It can be useful to include someone who is not a relative for impartiality, such as a trusted friend or your lawyer. </li> <li>Superannuation beneficiaries: super is separate from your will, but beneficiary nominations can only be spouse, child, dependent or interdependent otherwise it will go to you Will. In your Will you can direct to other people or charities. Some beneficiaries lapse, so will need to be renewed.</li> <li>Wills: review your will to ensure it reflects YOUR wishes, not someone else’s. People can jostle over not only their own inheritance but may try to influence you to leave others out. </li> <li>Documenting everything: keep a written record, especially where money is concerned – such as acting as Bank of Mum and Dad for adult kids to purchase property. Outline how much is given, what if any interest/repayments are expected and when, and what happens if their relationship subsequently breaks down.</li> <li>Encouraging independence: people who have come to expect handouts can become abusive if those handouts stop or requests for more are denied. Support and encourage others, especially your kids, to be financially independent and self-sufficient.</li> </ul> Taking back control Sadly, prevention is no longer an option for an <a href="https://www.aihw.gov.au/family-domestic-and-sexual-violence/population-groups/older-people?xd_co_f=YjAzZDU4YTUtYzA5YS00YTNkLWJkNDQtNjdiZTM5ZmY5ZjQx#abuse">estimated 598,000 Australians</a> already experiencing elder abuse. However, it is still possible to break the cycle. Don’t be embarrassed or stick your head in the sand hoping things will improve. You have done nothing wrong. You are entitled to enjoy your retirement years. To take back control over your affairs, your wellbeing and your independence: <ul> <li>Ensure your physical safety first and foremost.</li> <li>Seek medical attention for your physical and mental health (the latter is crucial for making good decisions around the other points on this list).</li> <li>Get support from another relative, close friend, neighbour, or other trusted person. Don’t be alone.</li> <li>Secure a roof over your head. Having a stable place to live gives you the security and focus to tackle other concerns.</li> <li>Freeze access to your money – bank accounts, credit cards etc. This will stop (further) unauthorised withdrawals or purchases being charged to you.</li> <li>Seek professional advice. Your financial adviser, tax accountant and lawyer will be able to guide you through protecting your home, money, guardianship and estate planning matters.</li> <li>Make informed changes. Don’t do anything rashly – make necessary changes once you have sought independent advice and considered your options. This may involve making changes to your power of attorney, will, superannuation, bank accounts, even your phone number in extreme cases.</li> <li>Consider counselling. Your abuser may not realise the severity of their actions. An independent counsellor may be able to help them see this and change their ways, and ultimately salvage your relationship.</li> </ul> If you or someone you know is experiencing elder abuse, seek help straight away. Speak to a trusted relative or friend. Seek independent legal and financial advice about your affairs. Or call the government’s free elder abuse line on 1800 353 374. And if your life is in danger, call triple zero (000) immediately. Helen Baker is a licensed Australian financial adviser and author of On Your Own Two Feet: The Essential Guide to Financial Independence for all Women. Helen is among the 1% of financial planners who hold a master’s degree in the field. Proceeds from book sales are donated to charities supporting disadvantaged women and children. Find out more at <a href="http://www.onyourowntwofeet.com.au/">www.onyourowntwofeet.com.au</a> Disclaimer: The information in this article is of a general nature only and does not constitute personal financial or product advice. Any opinions or views expressed are those of the authors and do not represent those of people, institutions or organisations the owner may be associated with in a professional or personal capacity unless explicitly stated. Helen Baker is an authorised representative of BPW Partners Pty Ltd AFSL 548754. Image credits: Getty Images

Caring

Princess of Wales and King Charles: one in two people develop cancer during their lives – the diseases and treatments explained

<a href="https://theconversation.com/profiles/gavin-metcalf-1340598">Gavin Metcalf</a>, <a href="https://theconversation.com/institutions/anglia-ruskin-university-1887">Anglia Ruskin University</a> The Princess of Wales released a <a href="https://x.com/KensingtonRoyal/status/1771235267837321694?s=20">moving video message</a> on March 22 to address speculation about her health. In it, the future queen disclosed that she’d been <a href="https://www.bbc.co.uk/news/health-68641710">diagnosed with cancer</a> following tests conducted after she underwent major abdominal surgery at a clinic in London in January. Catherine explained that she was undergoing “preventative chemotherapy” – but emphasised that her surgery had been successful, and that she was “well” and “getting stronger every day”. The message was the <a href="https://www.theguardian.com/uk-news/2024/mar/22/princess-kate-cancer-royal-family-health-annus-horribilis">second announcement</a> of a royal family cancer diagnosis in recent weeks. On February 5, Buckingham Palace <a href="https://www.royal.uk/a-statement-from-buckingham-palace-5Feb24">published a statement</a> that King Charles III had been diagnosed with an undisclosed form of <a href="https://www.bbc.co.uk/news/uk-68208157">cancer, unrelated</a> to the treatment he had been receiving for an enlarged prostate. <figure><iframe src="https://www.youtube.com/embed/3xzKooCaRXU?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> The statement said that he had begun “regular treatments”. The king postponed all public-facing duties during his treatment, but <a href="https://www.bbc.co.uk/news/uk-68213383">reportedly continued</a> with his “constitutional role as head of state, including completing paperwork and holding private meetings”. Cancer is the <a href="https://www.who.int/news-room/fact-sheets/detail/cancer">leading cause of death</a> worldwide. <a href="https://www.nhs.uk/conditions/cancer/#:%7E:text=The%20cancerous%20cells%20can%20invade,of%20cancer%20during%20their%20lifetime.">One in two</a> people will develop some form of cancer in their lifetime – so the condition will affect almost every family. However, many cancers can be cured if, as appears to be the case with the king, the condition is <a href="https://www.bbc.co.uk/news/uk-68213383">detected early</a> and treated effectively. <h2>What is cancer?</h2> Our bodies are made up of more than 100 billion cells, and cancer typically starts with changes in a small group of cells – or even a single one. We have different cell types depending upon where in the body they are and the function that the cell has. The size, amount and function of each of these cells is normally tightly regulated by genes – groups of codes held within our DNA – that instruct cells how to grow and divide. However, changes (mutations) to DNA can alter the way cells grow and multiply – often forming a lump, or solid tumour. Cancers can also develop in blood cells, such as white blood cell cancer which is known as leukaemia. This type of cancer does not form solid tumours; instead, the cancer builds up in the blood or sometimes the marrow in the core of bones, where blood cells are produced. In all, there are <a href="https://www.cancerresearchuk.org/about-cancer/what-is-cancer/how-cancer-starts/types-of-cancer#:%7E:text=For%20example%2C%20nerves%20and%20muscles,of%20cell%20they%20start%20in.">more than 200</a> types of cancer, but all start with mutations in the DNA contained within each and every cell. <h2>What exactly are mutations?</h2> Think of your DNA as a big recipe book, and your genes as individual recipes for making different dishes. Mutations are smudges or missing words from this recipe that can result in key ingredients not being added into the mix. <figure><iframe src="https://www.youtube.com/embed/8BJ8_5Gyhg8?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> Regardless of the type of cancer or the cells from which it develops, mutations in our genes can result in a cell no longer understanding its instructions. These mutations can happen by chance when dividing, but can also be the result of lifestyle choices such as <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6141049/">smoking</a>, <a href="https://www.ndph.ox.ac.uk/news/new-genetic-study-confirms-that-alcohol-is-a-direct-cause-of-cancer#:%7E:text=These%20mutations%20both%20disrupt%20the,aldehyde%20dehydrogenase%202%20(ALDH2).">drinking</a>, and <a href="https://www.cancer.gov/about-cancer/causes-prevention/risk/obesity/physical-activity-fact-sheet">inactivity</a>. Research has found that in order for a normal cell to turn into a cancerous cell, anywhere from <a href="https://www.sanger.ac.uk/news_item/1-10-mutations-are-needed-drive-cancer-scientists-find/">one to ten different mutations</a> are normally required. <h2>How is cancer treated?</h2> Treatment options for cancer depend on a variety of factors, including where your cancer is, how large it is, and whether it has spread to other parts of the body. The main treatments for cancer include surgery, chemotherapy, and radiotherapy. Chemotherapy uses drugs to target and kill cells that are rapidly dividing in our bodies. This approach is effective at targeting fast-growing cells in various cancers – but also has negative side effects. It also targets healthy cells that rapidly divide, such as hair and the cells lining our digestive system. This can lead to commonly reported <a href="https://www.nhs.uk/conditions/chemotherapy/side-effects/">side-effects</a> such as hair loss, nausea and diarrhoea. <a href="https://www.cancerresearchuk.org/about-cancer/treatment/chemotherapy?gad_source=1&gclid=Cj0KCQjw-_mvBhDwARIsAA-Q0Q6tyQxTuBzU7vVD7SHjQ5dF-fRdqnL7S74-k5LXyTqODydsrPfJVsoaAkgyEALw_wcB&gclsrc=aw.ds">Chemotherapy</a> can be used both preventatively – as in the case of the princess – and therapeutically. <figure><iframe src="https://www.youtube.com/embed/FkZn5u3MIiY?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> Preventative chemotherapy, also known as <a href="https://www.cancer.gov/publications/dictionaries/cancer-terms/def/adjuvant-therapy">adjuvant chemotherapy</a>, is given after surgery or other primary treatments to eliminate any remaining cancer cells in the body. It aims to reduce the risk of the cancer returning (known as recurrence). Therapeutic chemotherapy is used as a treatment option for cancer that has spread or is well established, such as advanced-stage cancers. <a href="https://www.cancerresearchuk.org/about-cancer/treatment/surgery/about">Surgery</a> involves the physical removal of cancerous tissues as well as nearby lymph nodes – small glands which act as filters in your body that cancers can spread through – to eliminate the tumour. Surgery is often used to remove localised cancers that haven’t spread throughout the body. <a href="https://www.cancerresearchuk.org/about-cancer/treatment/radiotherapy">Radiotherapy</a> uses high-energy radiation beams that are able to target specific areas where tumour cells are located to destroy or shrink the tumour. Radiotherapy can be applied externally or internally. Chemotherapy, surgery, and radiotherapy are often combined in cancer treatment to improve outcomes for patients. Thanks to developments in cancer research over the last 50 years, survival rates have improved greatly – although the rate of improvement has <a href="https://news.cancerresearchuk.org/2024/02/02/world-cancer-day-2024/#:%7E:text=Improvements%20in%20cancer%20survival%20have%20slowed%20in%20recent%20years&text=Survival%20increased%20three%20to%20five,consistently%20lags%20behind%20comparable%20countries.">slowed recently</a>. Cancer survival depends on various factors such as age – people under 40 have a <a href="https://www.cancer.gov/about-cancer/causes-prevention/risk/age">greater chance</a> of survival – overall health and fitness, as well as family history. <h2>What you should do</h2> Particular changes in your body or warning symptoms could indicate the presence of cancer. These include, but are not limited to: <ul> <li>Unexplained weight loss;</li> <li>Fatigue that doesn’t improve with rest;</li> <li>Changes in bowel or bladder habits;</li> <li>Persistent cough or coughing up blood;</li> <li>Difficulty swallowing;</li> <li>Persistent pain;</li> <li>Noticing lumps, such as in a breast or testicle.</li> </ul> The symptoms may not necessarily be the result of cancer. But it is important to get checked by a doctor if you notice anything out of the ordinary or have had persistent symptoms that don’t ease. Early detection and treatment can <a href="https://www.science.org/doi/full/10.1126/science.aay9040">significantly improve</a> outcomes for many types of cancer.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/226456/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/gavin-metcalf-1340598">Gavin Metcalf</a>, Cancer Biologist and Lecturer in Biomedical Science, <a href="https://theconversation.com/institutions/anglia-ruskin-university-1887">Anglia Ruskin University</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/princess-of-wales-and-king-charles-one-in-two-people-develop-cancer-during-their-lives-the-diseases-and-treatments-explained-226456">original article</a>.

Caring

Kate Middleton is having ‘preventive chemotherapy’ for cancer. What does this mean?

<a href="https://theconversation.com/profiles/ian-olver-1047">Ian Olver</a>, <a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</a> Catherine, Princess of Wales, is undergoing treatment for cancer. In a video thanking followers for their messages of support after her major abdominal surgery, the Princess of Wales explained, “tests after the operation found cancer had been present.” “My medical team therefore advised that I should undergo a course of preventative chemotherapy and I am now in the early stages of that treatment,” she said in the two-minute video. No further details have been released about the Princess of Wales’ treatment. But many have been asking what preventive chemotherapy is and how effective it can be. Here’s what we know about this type of treatment. <h2>It’s not the same as preventing cancer</h2> To <a href="https://www.cancer.org.au/about-us/how-we-help/prevention">prevent cancer developing</a>, lifestyle changes such as diet, exercise and sun protection are <a href="https://www.cancer.org.au/about-us/how-we-help/prevention">recommended</a>. Tamoxifen, a hormone therapy drug can be used to reduce the risk of cancer for some patients at <a href="https://www.mayoclinic.org/diseases-conditions/breast-cancer/in-depth/breast-cancer/art-20045353">high risk of breast cancer</a>. Aspirin <a href="https://www.cancer.gov/about-cancer/causes-prevention/research/aspirin-cancer-risk">can also be used</a> for those at high risk of bowel and other cancers. <h2>How can chemotherapy be used as preventive therapy?</h2> In terms of treating cancer, prevention refers to giving chemotherapy after the cancer has been removed, to prevent the cancer from returning. If a cancer is localised (limited to a certain part of the body) with no evidence on scans of it spreading to distant sites, local treatments such as surgery or radiotherapy can remove all of the cancer. If, however, cancer is first detected after it has spread to distant parts of the body at diagnosis, clinicians use treatments such as chemotherapy (anti-cancer drugs), hormones or immunotherapy, which circulate <a href="https://www.healthline.com/health/cancer/metastatic-cancer">around the body</a> . The other use for chemotherapy is to add it before or after surgery or radiotherapy, to prevent the primary cancer <a href="https://www.verywellhealth.com/adjuvant-therapy-5198903">coming back</a>. The surgery may have cured the cancer. However, in some cases, undetectable microscopic cells may have spread into the bloodstream to distant sites. This will result in the cancer returning, months or years later. With some cancers, treatment with chemotherapy, given before or after the local surgery or radiotherapy, can kill those cells and prevent the cancer coming back. If we can’t see these cells, how do we know that giving additional chemotherapy to prevent recurrence is effective? We’ve learnt this from clinical trials. Researchers have compared patients who had surgery only with those whose surgery was followed by additional (or often called adjuvant) chemotherapy. The additional therapy resulted in patients not relapsing and surviving longer. <h2>How effective is preventive therapy?</h2> The effectiveness of preventive therapy depends on the type of cancer and the type of chemotherapy. Let’s consider the common example of bowel cancer, which is at high risk of returning after surgery because of its size or spread to local lymph glands. The <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7564362/">first chemotherapy tested</a> improved survival by 15%. With more intense chemotherapy, the chance of surviving six years is approaching 80%. Preventive chemotherapy is usually given for three to six months. <h2>How does chemotherapy work?</h2> Many of the chemotherapy drugs stop cancer cells dividing by disrupting the DNA (genetic material) in the centre of the cells. To improve efficacy, drugs which work at different sites in the cell are given in combinations. Chemotherapy is not selective for cancer cells. It kills any dividing cells. But cancers consist of a higher proportion of dividing cells than the normal body cells. A <a href="https://www.canceraustralia.gov.au/cancer-types/breast-cancer/treatment/chemotherapy/how-does-chemotherapy-work#:%7E:text=Chemotherapy%20works%20by%20killing%20cells%20that%20are%20rapidly,cells%20can%20repair%20the%20damage%20and%20can%20recover.">greater proportion of the cancer is killed</a> with each course of chemotherapy. Normal cells can recover between courses, which are usually given three to four weeks apart. <h2>What are the side effects?</h2> The side effects of chemotherapy are usually reversible and are seen in parts of the body where there is normally a high turnover of cells. The production of blood cells, for example, is temporarily disrupted. When your white blood cell count is low, there is an increased risk of infection. Cell death in the lining of the gut leads to mouth ulcers, nausea and vomiting and bowel disturbance. Certain drugs sometimes given during chemotherapy can attack other organs, such as causing numbness in the hands and feet. There are also generalised symptoms such as <a href="https://www.cancervic.org.au/cancer-information/treatments/treatments-types/chemotherapy/side_effects_of_chemotherapy.html">fatigue</a>. Given that preventive chemotherapy given after surgery starts when there is no evidence of any cancer remaining after local surgery, patients can usually resume normal activities within weeks of completing the courses of chemotherapy.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/226461/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/ian-olver-1047">Ian Olver</a>, Adjunct Professsor, School of Psychology, Faculty of Health and Medical Sciences, <a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/kate-middleton-is-having-preventive-chemotherapy-for-cancer-what-does-this-mean-226461">original article</a>.

Body

"What a legend": Michael J Fox receives emotional standing ovation

Michael J Fox, who has Parkinson's disease, made a surprise appearance at the BAFTA Awards in London. The Back to the Future actor came onstage in a wheelchair, but he insisted on standing up at the podium to present the Best Film award. The star-studded audience all rose to their feet and gave the actor a standing ovation. When presenting the award, Fox described cinema as "magic" which can "change your life". "Five films were nominated in this category tonight and all five have something in common. They are the best of what we do," he said. He added that films can bring people together "no matter who you are or where you're from". "There's a reason why they say movies are magic because movies can change your day. "It can change your outlook. Sometimes it can change your life." Fox, who was diagnosed with Parkinson's in the 1990s, rarely makes public appearances. Many fans were pleasantly surprised at his appearance as he presented the night’s biggest award, Best Film, to Oppenheimer. "I was in tears the moment Michael J Fox came on the stage," one fan wrote on X, formerly known as Twitter. "THE MAN IS A LEGEND" <blockquote class="twitter-tweet"> i was in tears the moment Michael J Fox came on the stage 😥😥😥 THE MAN IS A LEGEND <a href="https://twitter.com/hashtag/BAFTAs?src=hash&ref_src=twsrc%5Etfw">#BAFTAs</a> <a href="https://twitter.com/hashtag/BAFTA2024?src=hash&ref_src=twsrc%5Etfw">#BAFTA2024</a> <a href="https://twitter.com/hashtag/EEBAFTAs?src=hash&ref_src=twsrc%5Etfw">#EEBAFTAs</a> <a href="https://t.co/Uud368S9gb">pic.twitter.com/Uud368S9gb</a> — RanaJi🏹 (@RanaTells) <a href="https://twitter.com/RanaTells/status/1759323180060299726?ref_src=twsrc%5Etfw">February 18, 2024</a></blockquote> "Michael J Fox. Absolute hero. What a legend," wrote another. <blockquote class="twitter-tweet"> Michael J Fox. Absolute hero. What a legend. <a href="https://twitter.com/hashtag/BAFTAs?src=hash&ref_src=twsrc%5Etfw">#BAFTAs</a> <a href="https://t.co/62lxpCy3mn">pic.twitter.com/62lxpCy3mn</a> — Jules 🌼 (@JulesItsjules) <a href="https://twitter.com/JulesItsjules/status/1759320058583568638?ref_src=twsrc%5Etfw">February 18, 2024</a></blockquote> "All those stars in the room, and still the biggest and most affectionate reaction is for Michael J Fox, because the man is a legend," added a third. <blockquote class="twitter-tweet"> All those stars in the room, and still the biggest and most affectionate reaction is for Michael J Fox, because the man is a legend. <a href="https://twitter.com/hashtag/EEBAFTAs?src=hash&ref_src=twsrc%5Etfw">#EEBAFTAs</a> — Declan Cashin (@Tweet_Dec) <a href="https://twitter.com/Tweet_Dec/status/1759319831696855281?ref_src=twsrc%5Etfw">February 18, 2024</a></blockquote> "He's a total legend and wonderful human," wrote a fourth. The actor has spoken <a href="https://www.oversixty.com.au/health/caring/i-m-not-gonna-be-80-michael-j-fox-s-tragic-admission" target="_blank" rel="noopener">candidly</a> about his experience with Parkinson's over the years, and has said that he has made peace with the degenerative nature of the disease. In a previous interview with AARP magazine profile, the actor admitted that he did not fear death. “I am genuinely a happy guy. I don’t have a morbid thought in my head — I don’t fear death. At all," he told the publication. Images: Getty

What happens to teeth as you age? And how can you extend the life of your smile?

<a href="https://theconversation.com/profiles/arosha-weerakoon-792707">Arosha Weerakoon</a>, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> A healthy smile <a href="https://pubmed.ncbi.nlm.nih.gov/37314011/">helps us</a> live long, well and happy lives. But just <a href="https://pubmed.ncbi.nlm.nih.gov/37436910/">like our bodies</a>, our teeth succumb to age-related changes. So what happens to teeth as you age? And what can you do to ensure your smile lasts the distance? <h2>First, what are teeth made of?</h2> The tooth crown is covered by a hard enamel coat that surrounds softer, brown dentine, which protects a centrally located pulp. Enamel is a complex weave of <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2584618/">brittle</a>, honeycomb-clustered strands that interact with light to make teeth appear opalescent (a pearly, milky iridescence). <a href="https://onlinelibrary.wiley.com/doi/10.1111/j.1601-1546.2012.00269.x">Dentine under enamel</a> forms most of the tooth crown and root, and is made of collagen, mineral, water and proteins. Collagen strands are <a href="https://www.sciencedirect.com/science/article/pii/S0003996922002102?via%3Dihub#bib12">woven</a> to stretch and spring back, to <a href="https://www.sciencedirect.com/science/article/pii/S0003996922002102?via%3Dihub#bib12">prevent teeth</a> from cracking and breaking when we grind and chew. The pulp has blood vessels and nerves that communicate with the rest of your body. Enmeshed in the dentine mineral and collagen are small, <a href="https://pubmed.ncbi.nlm.nih.gov/8809302/">interconnected tubules</a> formed by specialised cells called <a href="https://www.sciencedirect.com/science/article/abs/pii/S1047847799940960">odontoblasts</a> that settle around the pulp, once our teeth completely form. Each tooth contains a <a href="https://pubmed.ncbi.nlm.nih.gov/23803461/">finite number of odontoblasts</a>, unlike the constantly replenished special bone cells that renew. <h2>How do our teeth change as we age?</h2> Unable to renew, our teeth <a href="https://www.sciencedirect.com/science/article/pii/S0003996922002102?via%3Dihub#bib19">become brittle</a>, and prone to fracture as dentine loses its spring. This is <a href="https://www.sciencedirect.com/science/article/pii/S0002817714613532?casa_token=1K9Y6CJXmsAAAAAA:t6y_b_Iy02AWpUGaiz4H8Fk0Kdfx6z1ypHiGOEjFqFNlU1jvSRCVjfYOyysgIErJvgCzh33c2hfX">more common</a> in teeth with existing crack lines, large fillings or root canal treatments. With time, the outer surface of enamel <a href="https://www.sciencedirect.com/science/article/abs/pii/S0022391305004348?casa_token=xXfdecXrLaoAAAAA:YE_0swAFtT3RyCUeJmPwciixQ0hwL-foLyC2RGtnlyUSJ9O-pPLQz0B8XNd4Gq1AMtCN2BgnCrqo">thins</a> to reveal the relatively opaque dentine that darkens as we age. The dentine darkens because the collagen weave <a href="https://www.sciencedirect.com/science/article/abs/pii/S1047847722000697">stiffens and shrinks</a>, and the fluid in the tubules <a href="https://www.sciencedirect.com/science/article/pii/S2590152422000010?via%3Dihub">fills with mineral</a>. The odontoblasts continue to form dentine inside the tooth to reduce the translucent pulp space. The increase in dentine makes our teeth appear <a href="https://www.sciencedirect.com/science/article/abs/pii/S0003996913003294">opaque</a> and insulates from hot and cold sensations. This is why <a href="https://www.sciencedirect.com/science/article/pii/S0300571215000494?casa_token=iiLtoxOZOYQAAAAA:RfaGR7lrq9dgWuO_nh6hLETzVUiIWdu-mB-Ev019vZH5t6meVyAHs3YpZzcu9FNrDBYQL6OExu6j">X-rays</a> are useful to detect cavities we may not feel. Food and drink particles fill micro-gaps and age-related fine crack lines that run up and down enamel to <a href="https://www.researchgate.net/profile/Yash-Kapadia/publication/322509199_Tooth_staining_A_review_of_etiology_and_treatment_modalities/links/5b4cd922a6fdcc8dae245b7d/Tooth-staining-A-review-of-etiology-and-treatment-modalities.pdf">discolour and stain</a>. These stains are easily managed by <a href="https://www.sciencedirect.com/science/article/pii/S2772559622000207">tooth whitening</a>. How else can you extend the life of your teeth and brighten your smile? Here are seven tips to avoid dental decline: <h2>1. Avoid unnecessary forces</h2> Avoid <a href="https://www.nature.com/articles/sj.bdj.2012.722">using</a> your teeth to hold things such as working tools or to open packaging. Take measures to avoid forces such as <a href="https://www.sciencedirect.com/science/article/pii/S1882761622000059">grinding or clenching</a> by wearing a night guard. If you have <a href="https://www.sciencedirect.com/science/article/pii/S0109564122002421">large fillings</a> or <a href="https://www.sciencedirect.com/science/article/pii/S0109564122001579?casa_token=kQPjGNgU2iQAAAAA:ytMnT5MLV8aRehNyyWD7qC7FXSBE5xpPCxnzZ2ryKsuyJePq1jHisue1udtN0Cs6NDYJ37xYHy_5">root canal-treated</a> teeth, speak to your dentist about <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/aej.12002?casa_token=RwMhhwmgjwwAAAAA%3AGCWVA9vjFX68S2DdKbCFl4jwTAjMeqVDoT3GtXTSjA7SMEc3ksktOMCUSz9ArikD4XhBM5v08nGCvmVF0g">specific filling materials or crowns</a> that can protect your teeth from cracking or breaking. <h2>2. Share the load</h2> If you are missing molars or premolars, distribute chewing forces evenly to prevent overloading your remaining teeth. Replace missing teeth with <a href="https://www.sciencedirect.com/science/article/pii/S010956411100858X?casa_token=4vrj3ssj0PEAAAAA:UODaFxNDCKmQ_lQs1faL6lh0xIeIfSFrRQBq-s0KF1ZvUJd6ytbXX37TVaiHLRzJPJaSDF_2aVmL">bridges</a>, <a href="https://aap.onlinelibrary.wiley.com/doi/full/10.1902/jop.2008.080188?casa_token=uA0r7imcRbUAAAAA%3AeXGszI5-Dcu4oKi33FCrRRviiAj0uyoP7V5wApIRQD1-1Zu-rkLAcoLhKMAJYVnC9tEnxj33UdNJIndEBA">implants</a> or well-fitted <a href="https://www.mdpi.com/1660-4601/18/13/6776">dentures</a> to support your bite. Get your dentures <a href="https://www.sciencedirect.com/science/article/pii/S0022391320301554">checked regularly</a> to ensure they fit and support adequately, and replace them at least every ten years. <h2>3. Preserve your enamel</h2> Reduce <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/jcpe.12330?casa_token=W2Ib34A77-QAAAAA%3AnLZtwwqZuueyHf1CMX0K9MERSW_Pvc3w0KlpArFT1KNusuopjEUcWmGd8pDUA7fQcj6DMkcS-JnXISFV1w">further enamel and dentine loss</a> by selecting soft-bristled <a href="https://www.tandfonline.com/doi/full/10.1080/00016350802195041?casa_token=E-ErdP543QUAAAAA%3A0Wz5AWwQxntBIc3UndFX_5nVbAYoPDx-PX1tg7Umxjr_QepX3CSIFVXYcrrxWV9iTx99Afk8c_zff-o">tooth brushes and non-abrasive toothpastes</a>. Certain whitening toothpastes can be abrasive, which can <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8874033/">roughen and wear</a> the tooth surfaces. If you are unsure, stick with toothpastes that are labelled “sensitive”. Reduce your exposure to <a href="https://www.nature.com/articles/sj.bdj.2012.722">acid</a> in food (think lemons or apple cider vinegar) or illness (reflux or vomiting) where possible to maintain enamel and prevent erosion. <h2>4. Enhance your saliva</h2> <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/jtxs.12356?casa_token=1moXbwnrDQIAAAAA%3AHz3Im9lmR3h75TmG8FSUQH-8_0UGnQ9TNkgaPL79LlrCmwC3kzZZJaAB2mSZHf4X7PX5y3GKaVoY5cm5JA">Saliva</a> protects against acid attacks, flushes our teeth, and has antibacterial properties to reduce erosion and decay (holes forming). Saliva is also important to help us chew, swallow and speak. But our saliva quality and quantity reduces because of age-related changes to our salivary glands as well as certain medications prescribed to <a href="https://pubmed.ncbi.nlm.nih.gov/19392837/">manage chronic illnesses</a> such as depression and high blood pressure. Speak to your doctor about other medication options to improve your saliva or manage reflux disease to prevent erosion. <h2>5. Treat gum disease</h2> Aesthetically, <a href="https://pubmed.ncbi.nlm.nih.gov/37358230/">treating gum disease (periodontitis)</a> reduces gum shrinkage (recession) that typically exposes the relatively darker tooth roots that are more <a href="https://journals.sagepub.com/doi/abs/10.1177/00220345231166294">prone to developing holes</a>. <h2>6. Manage and prevent senescence</h2> <a href="https://pubmed.ncbi.nlm.nih.gov/36908187/">Cellular senescence</a> is the process that changes DNA in our cells to reduce our ability to withstand physical, chemical or biological damage. Cellular senescence enhances new cancer formation, the spread of existing cancers and the onset of chronic illnesses such as Alzheimer’s disease, diabetes, osteoporosis and heart disease. You can prevent cell damage by managing lifestyle factors such as smoking, uncontrolled diabetes and chronic infections such as gum disease. <h2>7. Adapt and ask for help</h2> <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/jan.15769?casa_token=SC-LouFQThsAAAAA%3A4jcvLRuJ56dGEm7ttvMad65hvUoZ7V5nvILg5sLFVZo8jxyQGR6YFeTcfM8sByTbdVrCWR1O5ytI3Z_crA">Ageing</a> can affect our cognition, hand dexterity and eyesight to prevent us from cleaning our teeth and gums as effectively as we once could. If this describes you, talk to your dental care team. They can help clean your teeth, and <a href="https://www.magonlinelibrary.com/doi/full/10.12968/bjon.2020.29.9.520?casa_token=_rol0NXx9c8AAAAA%3Aq8zgxiMSASwF1MRQZnZzfzmttn2x7FfGwsiIv71C_s_PTTmGD9JOIbqqtLNXa0oF9ogOjOCZwwpwB94">recommend products and tools</a> to fit your situation and abilities.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/215786/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/arosha-weerakoon-792707">Arosha Weerakoon</a>, Senior Lecturer, School of Dentistry, The University of Queensland and General Dentist., <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/what-happens-to-teeth-as-you-age-and-how-can-you-extend-the-life-of-your-smile-215786">original article</a>.

Body

"I’m not going to be cured". How breast cancer awareness and support sidelines people with metastatic disease

<a href="https://theconversation.com/profiles/sophie-lewis-111177">Sophie Lewis</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/andrea-smith-15431">Andrea Smith</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>, and <a href="https://theconversation.com/profiles/katherine-kenny-318175">Katherine Kenny</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> There have been incredible <a href="https://www.cancer.gov/types/breast/research">advances</a> in breast cancer diagnosis and treatment in recent years. And stories about celebrities who have “beaten” breast cancer continue to be a source of inspiration for many people. However, this emphasis on fighting, beating and surviving cancer shuts out the voices of those who will not survive. That is, the many people diagnosed with incurable, life-limiting metastatic breast cancer, <a href="https://www.aihw.gov.au/reports/cancer/cancer-data-in-australia">which kills nine Australians every day</a> or nearly <a href="https://www.aihw.gov.au/reports/cancer/cancer-data-in-australia">3,300 people</a> a year. Yet an <a href="https://www.bcna.org.au/latest-news/bcna-news/making-metastatic-breast-cancer-count/">estimated 10,000</a> Australians are living with the diagnosis. Being diagnosed with metastatic breast cancer, as one of the authors has been, means ongoing treatment to live as long, and as well, as possible. It also means an ongoing need for emotional and practical support. However, society, health-care professionals, cancer advocacy organisations, even a patient’s closest family and friends, can struggle to understand what it is like to live with an incurable and life-limiting cancer and how best to provide support. <h2>Why is there so little awareness?</h2> <a href="https://www.breastcancer.org/types/metastatic">Metastatic breast cancer</a>, also called stage four breast cancer, is the most serious form of breast cancer. Unlike early breast cancer that is contained within the breast or nearby lymph nodes, metastatic breast cancer has spread to other parts of the body, most often the bones, lungs, liver, or brain. There is no cure for metastatic breast cancer despite decades of advocacy, funding and research. Treatment continues for as long as it helps to control the cancer and is tolerated by the patient. Median survival is <a href="https://onlinelibrary.wiley.com/doi/10.5694/mja2.51687">two to three years</a>, although newer, novel treatments mean some patients are living much longer. As a society, we can be uncomfortable <a href="https://theconversation.com/before-you-go-are-you-in-denial-about-death-34056">talking about and facing death</a>. When it comes to cancer, we usually prefer focusing on good news stories. These narratives are often perceived to be better for fundraising and are reassuring for people newly diagnosed. But they fail to <a href="https://onlinelibrary.wiley.com/doi/10.1111/1467-9566.13704">represent</a> the diversity and reality of cancer experiences. Despite considerable research into people with non-metastatic breast cancer, <a href="https://www.bcna.org.au/latest-news/bcna-news/making-metastatic-breast-cancer-count/">relatively little</a> is known about Australians with metastatic breast cancer. <h2>Feeling silenced and unsupported</h2> Through our <a href="https://onlinelibrary.wiley.com/doi/10.1111/1467-9566.13704">research</a> we wanted to better understand people’s experiences of metastatic breast cancer. We interviewed 38 participants from around Australia with diverse experiences of metastatic breast cancer. Participants were recruited through breast cancer and community organisations. We found messages and public campaigns about cancer survivorship, which emphasise hope and positivity, drowned out the voices of those with metastatic breast cancer. The focus on “success stories” about surviving breast cancer made some people feel like it was their responsibility to “beat” cancer. If they didn’t, it was their own fault. As one interviewee told us: "I react quite badly to all the, ‘we’ve had breast cancer and we beat it and we’ve survived. Aren’t we fantastic.’ There’s almost a feeling if you haven’t beaten your breast cancer you haven’t tried hard enough." Silence around metastatic breast cancer was common in research participants’ experiences. It prevented many from connecting with others and to the support they needed. It even affected relationships with those closest to them leaving them feeling misunderstood: "They don’t realise I’ve got to be on treatment forever. I’m not going to be cured. I think society thinks everything can be fixed; metastatic breast cancer actually can’t be fixed." Sharing deep fears and worries about their life expectancy can leave people with metastatic breast cancer feeling drained rather than supported. Many participants reported having to support and shield family, friends, acquaintances and work colleagues from the reality of their terminal diagnosis. "You hide how you feel because you don’t want to be avoided […] You put on that big, happy face. But like an onion if you peeled the layers away, you’d find out what’s going on." While many participants wanted to join a community of people with metastatic breast cancer, they struggled to know how to find one. Those who did, emphasised how invaluable it had been: "Being able to identify with and know that these people really get me is a huge relief and it reduces the isolation." These findings echo <a href="https://www.bcna.org.au/media/alcjjmm2/bcna_member-survey-report_2017.pdf">previous research</a> demonstrating people with metastatic breast cancer have higher support needs than those with non-metastatic breast cancer. And these needs are <a href="https://www.bcna.org.au/media/alcjjmm2/bcna_member-survey-report_2017.pdf">less likely to be met</a> by <a href="https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-022-08269-8">health care, support services</a>, family or friends. <h2>A new path</h2> Being diagnosed with metastatic breast cancer can be terrifying, lonely and create significant support needs. It is essential people with metastatic breast cancer have their <a href="https://ascopubs.org/doi/10.1200/OP.20.00183">voices listened to</a> and their needs met. Next steps should include: <ul> <li> <a href="https://bcna-dxp.azureedge.net/media/d32bhdzf/bcna_making-metastatic-breast-cancer-count_2022.pdf">improving data collection by cancer registries</a> so we know exactly how many people in Australia have metastatic breast cancer </li> <li> increasing representation of people with metastatic breast cancer in advocacy, support organisations and research </li> <li> nationwide access to peer-to-peer programs and professionally led metastatic breast cancer support groups. </li> </ul> We must ensure people with metastatic breast cancer are the ones to speak to their experience and needs. As a colleague with metastatic breast cancer said: "I read an article written by an early-stage breast cancer ‘survivor’. It felt like someone describing winter when they had only ever experienced autumn." If you or someone you know has metastatic breast cancer, these organisations may be able to support you or connect you with others with the same diagnosis: <ul> <li> <a href="https://www.bcna.org.au">Breast Cancer Network Australia</a> for information and support </li> <li> <a href="https://www.mcgrathfoundation.com.au/">McGrath Foundation</a> for information about access to metastatic breast care nurses. </li> </ul> <hr /> The authors would like to thank the members of Breast Cancer Network Australia’s Metastatic Breast Cancer Lived Experience Reference Group for their review of this article.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/215458/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/sophie-lewis-111177">Sophie Lewis</a>, Senior Lecturer, University of Sydney, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/andrea-smith-15431">Andrea Smith</a>, Research fellow, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>, and <a href="https://theconversation.com/profiles/katherine-kenny-318175">Katherine Kenny</a>, ARC DECRA Senior Research Fellow, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/im-not-going-to-be-cured-how-breast-cancer-awareness-and-support-sidelines-people-with-metastatic-disease-215458">original article</a>.

Caring

Do stress and depression increase the risk of Alzheimer’s disease? Here’s why there might be a link

<a href="https://theconversation.com/profiles/yen-ying-lim-355185">Yen Ying Lim</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> and <a href="https://theconversation.com/profiles/ivana-chan-1477100">Ivana Chan</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> Dementia affects more than <a href="https://www.who.int/news-room/fact-sheets/detail/dementia">55 million people</a> around the world. A number of factors can increase a person’s risk of developing dementia, <a href="https://link.springer.com/article/10.14283/jpad.2023.119">including</a> high blood pressure, poor sleep, and physical inactivity. Meanwhile, keeping cognitively, physically, and socially active, and limiting alcohol consumption, can <a href="https://www.thelancet.com/article/S0140-6736(20)30367-6/fulltext">reduce the risk</a>. Recently, a <a href="https://alzres.biomedcentral.com/articles/10.1186/s13195-023-01308-4">large Swedish study</a> observed that chronic stress and depression were linked to a higher risk of developing <a href="https://alz-journals.onlinelibrary.wiley.com/doi/10.1002/alz.12638">Alzheimer’s disease</a>, the most common form of dementia. The researchers found people with a history of both chronic stress and depression had an even greater risk of the disease. Globally, around <a href="https://www.who.int/news-room/fact-sheets/detail/depression">280 million people</a> have depression, while roughly <a href="https://www.who.int/news-room/fact-sheets/detail/anxiety-disorders">300 million people</a> experience anxiety. With so many people facing mental health challenges at some stage in their lives, what can we make of this apparent link? <h2>What the study did and found</h2> This study examined the health-care records of more than 1.3 million people in Sweden aged between 18 and 65. Researchers looked at people diagnosed with chronic stress (technically chronic stress-induced exhaustion disorder), depression, or both, between 2012 and 2013. They compared them with people not diagnosed with chronic stress or depression in the same period. Participants were then followed between 2014 and 2022 to determine whether they received a diagnosis of mild cognitive impairment or dementia, in particular Alzheimer’s disease. <a href="https://alz-journals.onlinelibrary.wiley.com/doi/10.1016/j.jalz.2016.07.151">Mild cognitive impairment</a> is often seen as the precursor to dementia, although not everyone who has mild cognitive impairment will progress to dementia. During the study period, people with a history of either chronic stress or depression were around twice as likely to be diagnosed with mild cognitive impairment or Alzheimer’s disease. Notably, people with both chronic stress and depression were up to four times more likely to be diagnosed with mild cognitive impairment or Alzheimer’s disease. <h2>Important considerations</h2> In interpreting the results of this study, there are some key things to consider. First, the diagnosis of <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9438479/">chronic stress-induced exhaustion disorder</a> is unique to the Swedish medical system. It is characterised by at least six months of intensive stress without adequate recovery. Symptoms include exhaustion, sleep disturbance and concentration difficulties, with a considerable reduction in ability to function. Mild stress may not have the same effect on dementia risk. Second, the number of people diagnosed with dementia in this study (the absolute risk) was very low. Of the 1.3 million people studied, 4,346 were diagnosed with chronic stress, 40,101 with depression, and 1,898 with both. Of these, the number who went on to develop Alzheimer’s disease was 14 (0.32%), 148 (0.37%) and 9 (0.47%) respectively. These small numbers may be due to a relatively young age profile. When the study began in 2012–2013, the average age of participants was around 40. This means the average age in 2022 was around 50. Dementia is typically diagnosed in <a href="https://www.health.gov.au/topics/dementia/about-dementia">people aged over 65</a> and diagnosis <a href="https://karger.com/dem/article-abstract/34/5-6/292/99009/Overdiagnosis-of-Dementia-in-Young-Patients-A?redirectedFrom=fulltext">in younger ages</a> may be less reliable. Finally, it’s possible that in some cases stress and depressive symptoms may reflect an awareness of an already declining memory ability, rather than these symptoms constituting a risk factor in themselves. This last consideration speaks to a broader point: the study is observational. This means it can’t tell us one thing caused the other – only that there is an association. <h2>What does other evidence say?</h2> <a href="https://link.springer.com/article/10.14283/jpad.2023.119">Many studies</a> indicate that significant symptoms of depression, anxiety and stress are related to higher dementia risk. However, the nature of this relationship is unclear. For example, are depressive and anxiety symptoms a risk factor for dementia, or are they consequences of a declining cognition? It’s likely to be a bit of both. High <a href="https://pubmed.ncbi.nlm.nih.gov/32082139/">depressive and anxiety symptoms</a> are commonly reported in people with mild cognitive impairment. However, studies in middle-aged or younger adults suggest they’re important dementia risk factors too. For example, similar to the Swedish study, other <a href="https://www.sciencedirect.com/science/article/pii/S0165032719323031">studies</a> have suggested people with a history of depression are twice as likely to develop dementia than those without this history. In addition, in middle-aged adults, high anxiety symptoms are associated with <a href="https://pubmed.ncbi.nlm.nih.gov/34648818/">poorer cognitive function</a> and <a href="https://bmjopen.bmj.com/content/8/4/e019399">greater dementia risk</a> in later life. <h2>Why the link?</h2> There are several potential pathways through which stress, anxiety and depression could increase the risk of dementia. Animal studies suggest cortisol (a hormone produced when we’re stressed) can increase risk of Alzheimer’s disease by causing the accumulation of key proteins, <a href="https://pubmed.ncbi.nlm.nih.gov/34159699/">amyloid and tau</a>, in the brain. The accumulation of these proteins can result in increased <a href="https://www.mdpi.com/1422-0067/23/18/10572">brain inflammation</a>, which affects the brain’s nerves and supporting cells, and can ultimately lead to brain volume loss and memory decline. Another potential pathway is through <a href="https://www.sciencedirect.com/science/article/pii/S1087079217300114?via%3Dihub">impaired sleep</a>. Sleep disturbances are common in people with chronic stress and depression. Similarly, people with Alzheimer’s disease commonly report sleep disturbances. Even in people with <a href="https://pubmed.ncbi.nlm.nih.gov/34668959/">early Alzheimer’s disease</a>, disturbed sleep is related to poorer memory performance. Animal studies suggest poor sleep can also enhance accumulation of <a href="https://pubmed.ncbi.nlm.nih.gov/31408876/">amyloid and tau</a>. We still have a lot to learn about why this link might exist. But evidence-based strategies which target chronic stress, anxiety and depression may also play a role in reducing the risk of dementia.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/215065/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/yen-ying-lim-355185">Yen Ying Lim</a>, Associate Professor, Turner Institute for Brain and Mental Health, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> and <a href="https://theconversation.com/profiles/ivana-chan-1477100">Ivana Chan</a>, PhD candidate, clinical psychology, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/do-stress-and-depression-increase-the-risk-of-alzheimers-disease-heres-why-there-might-be-a-link-215065">original article</a>.

Mind

Is it okay to kiss your pet? The risk of animal-borne diseases is small, but real

<a href="https://theconversation.com/profiles/sarah-mclean-1351935">Sarah McLean</a>, <a href="https://theconversation.com/institutions/swinburne-university-of-technology-767">Swinburne University of Technology</a> and <a href="https://theconversation.com/profiles/enzo-palombo-249510">Enzo Palombo</a>, <a href="https://theconversation.com/institutions/swinburne-university-of-technology-767">Swinburne University of Technology</a> Our relationship with pets has changed drastically in recent decades. Pet ownership is at an all-time high, with <a href="https://animalmedicinesaustralia.org.au/media-release/more-than-two-thirds-of-australian-households-now-own-a-pet/">a recent survey</a> finding 69% of Australian households have at least one pet. We spend an estimated A$33 billion every year on caring for our fur babies. While owning a pet is linked to numerous <a href="https://www.onehealth.org/blog/10-mental-physical-health-benefits-of-having-pets">mental and physical health benefits</a>, our pets can also harbour infectious diseases that can sometimes be passed on to us. For most people, the risk is low. But some, such as pregnant people and those with weakened immune systems, are at <a href="https://www.cdc.gov/healthypets/specific-groups/high-risk/index.html">greater risk</a> of getting sick from animals. So, it’s important to know the risks and take necessary precautions to prevent infections. <h2>What diseases can pets carry?</h2> Infectious diseases that move from animals to humans are called zoonotic diseases or <a href="https://www.cdc.gov/onehealth/basics/zoonotic-diseases.html">zoonoses</a>. More than <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3668296/#B18">70 pathogens</a> of companion animals are known to be transmissible to people. Sometimes, a pet that has a zoonotic pathogen may look sick. But often there may be no visible symptoms, making it easier for you to catch it, because you don’t suspect your pet of harbouring germs. Zoonoses can be transmitted directly from pets to humans, such as through contact with saliva, bodily fluids and faeces, or indirectly, such as through contact with contaminated bedding, soil, food or water. Studies suggest <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4500695/">the prevalence of pet-associated zoonoses is low</a>. However, the true number of infections is likely <a href="https://www.mdpi.com/1660-4601/17/11/3789">underestimated</a> since many zoonoses are not “<a href="https://www.healthdirect.gov.au/notification-of-illness-and-disease">notifiable</a>”, or may have multiple exposure pathways or generic symptoms. Dogs and cats are major reservoirs of zoonotic infections (meaning the pathogens naturally live in their population) caused by viruses, bacteria, fungi and parasites. <a href="https://www.who.int/data/gho/data/themes/topics/rabies">In endemic regions in Africa and Asia</a>, dogs are the main source of rabies which is transmitted through saliva. Dogs also commonly carry Capnocytophaga bacteria <a href="https://www.cdc.gov/capnocytophaga/index.html">in their mouths and saliva</a>, which can be transmitted to people through close contact or bites. The vast majority of people won’t get sick, but these bacteria can occasionally cause infections in people with weakened immune systems, <a href="https://www.cdc.gov/capnocytophaga/signs-symptoms/index.html">resulting</a> in severe illness and sometimes death. Just last week, such a death <a href="https://thewest.com.au/news/wa/tracy-ridout-perth-mum-dies-11-days-after-rare-bacterial-infection-from-minor-dog-bite-c-11748887">was reported in Western Australia</a>. Cat-associated zoonoses include a number of illnesses spread by the faecal-oral route, such as giardiasis, campylobacteriosis, salmonellosis and toxoplasmosis. This means it’s especially important to wash your hands or use gloves whenever handling your cat’s litter tray. Cats can also sometimes transmit infections through bites and scratches, including the aptly named <a href="https://www.cdc.gov/healthypets/diseases/cat-scratch.html#:%7E:text=Cat%20scratch%20disease%20(CSD)%20is,the%20surface%20of%20the%20skin.">cat scratch disease</a>, which is caused by the bacterium Bartonella henselae. Both dogs and cats are also reservoirs for <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10122942/">methicillin-resistant bacterium Staphylococcus aureus</a> (MRSA), with close contact with pets identified as an important risk factor for zoonotic transmission. <h2>Birds, turtles and fish can also transmit disease</h2> But it’s not just dogs and cats that can spread diseases to humans. Pet birds can occasionally transmit <a href="https://www.cdc.gov/pneumonia/atypical/psittacosis/">psittacosis</a>, a bacterial infection which causes pneumonia. Contact with <a href="https://www.fda.gov/animal-veterinary/animal-health-literacy/pet-turtles-source-germs">pet turtles</a> has been linked to Salmonella infections in humans, particularly in young children. Even pet fish have been linked to a <a href="https://www.cdc.gov/healthypets/pets/fish.html">range of bacterial infections</a> in humans, including vibriosis, mycobacteriosis and salmonellosis. Close contact with animals – and some behaviours in particular – increase the risk of zoonotic transmission. <a href="https://pubmed.ncbi.nlm.nih.gov/19398275/">A study from the Netherlands</a> found half of owners allowed pets to lick their faces, and 18% allowed dogs to share their bed. (Sharing a bed increases the duration of exposure to pathogens carried by pets.) The same study found 45% of cat owners allowed their cat to jump onto the kitchen sink. Kissing pets has also been linked to occasional zoonotic infections in pet owners. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3298380/">In one case</a>, a woman in Japan developed meningitis due to Pasteurella multicoda infection, after regularly kissing her dog’s face. These bacteria are often found in the oral cavities of dogs and cats. Young children are also more likely to engage in behaviours which increase their risk of <a href="https://www.cdc.gov/healthypets/specific-groups/high-risk/children.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fhealthypets%2Fspecific-groups%2Fchildren.html">getting sick</a> from animal-borne diseases – such as putting their hands in their mouth after touching pets. Children are also less likely to wash their hands properly after handling pets. Although anybody who comes into contact with a zoonotic pathogen via their pet can become sick, certain people are more likely to suffer from serious illness. These people include the young, old, pregnant and immunosuppressed. For example, while most people infected with the toxoplasmosis parasite will experience only mild illness, it can be life-threatening or <a href="https://www.nhs.uk/common-health-questions/pregnancy/what-are-the-risks-of-toxoplasmosis-during-pregnancy/">cause birth defects in foetuses</a>. <h2>What should I do if I’m worried about catching a disease from my pet?</h2> There are a number of good hygiene and pet husbandry practices that can reduce your risk of becoming sick. These include: <ul> <li>washing your hands after playing with your pet and after handling their bedding, toys, or cleaning up faeces</li> <li>not allowing your pets to lick your face or open wounds</li> <li>supervising young children when they are playing with pets and when washing their hands after playing with pets</li> <li>wearing gloves when changing litter trays or cleaning aquariums</li> <li>wetting bird cage surfaces when cleaning to minimise aerosols</li> <li>keeping pets out of the kitchen (especially cats who can jump onto food preparation surfaces)</li> <li>keeping up to date with preventative veterinary care, including vaccinations and worm and tick treatments</li> <li>seeking veterinary care if you think your pet is unwell.</li> </ul> It is especially important for those who are at a higher risk of illness to take precautions to reduce their exposure to zoonotic pathogens. And if you’re thinking about getting a pet, ask your vet which type of animal would best suit your personal circumstances.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/210898/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/sarah-mclean-1351935">Sarah McLean</a>, Lecturer in environmental health, <a href="https://theconversation.com/institutions/swinburne-university-of-technology-767">Swinburne University of Technology</a> and <a href="https://theconversation.com/profiles/enzo-palombo-249510">Enzo Palombo</a>, Professor of Microbiology, <a href="https://theconversation.com/institutions/swinburne-university-of-technology-767">Swinburne University of Technology</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/is-it-okay-to-kiss-your-pet-the-risk-of-animal-borne-diseases-is-small-but-real-210898">original article</a>.

Family & Pets

Taking more than 5 pills a day? ‘Deprescribing’ can prevent harm – especially for older people

<a href="https://theconversation.com/profiles/emily-reeve-1461339">Emily Reeve</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a>; <a href="https://theconversation.com/profiles/jacinta-l-johnson-1441348">Jacinta L Johnson</a>, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a>; <a href="https://theconversation.com/profiles/janet-sluggett-146318">Janet Sluggett</a>, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a>, and <a href="https://theconversation.com/profiles/kate-ohara-1462183">Kate O'Hara</a>, <a href="https://theconversation.com/institutions/university-of-newcastle-1060">University of Newcastle</a> People are living longer and with more <a href="https://www.aihw.gov.au/reports/older-people/older-australia-at-a-glance/contents/health-functioning/health-disability-status">chronic health conditions</a> – including heart disease, diabetes, arthritis and dementia – than ever before. As societies continue to grow older, one pressing concern is the use of multiple medications, a phenomenon known as <a href="https://www.who.int/docs/default-source/patient-safety/who-uhc-sds-2019-11-eng.pdf">polypharmacy</a>. About <a href="https://onlinelibrary.wiley.com/doi/full/10.5694/mja2.50244">1 million older Australians</a> experience polypharmacy and this group is increasing. They may wake up in the morning and pop a pill for their heart, then another one or two to control blood pressure, a couple more if they have diabetes, a vitamin pill and maybe one for joint pain. Polypharmacy is usually <a href="https://www.safetyandquality.gov.au/sites/default/files/2021-04/fourth_atlas_2021_-_6.1_polypharmacy_75_years_and_over.pdf">defined</a> as taking five or more different medications daily. In aged care homes, <a href="https://doi.org/10.1016/j.archger.2022.104849">90% of residents</a> take at least five regular medications every single day. That can put their health at risk with increased costs for them and the health system. <h2>Adding up over time</h2> As people age, the effects of medications can change. Some medications, which were once beneficial, might start to do more harm than good or might not be needed anymore. About <a href="https://www.psa.org.au/wp-content/uploads/2020/02/Medicine-Safety-Aged-Care-WEB-RES1.pdf">half of older Australians</a> are taking a medication where the likely harms outweigh the potential benefits. While polypharmacy is sometimes necessary and helpful in managing multiple health conditions, it can lead to unintended consequences. <a href="https://www.nps.org.au/living-with-multiple-medicines/costs">Prescription costs</a> can quickly add up. Taking multiple medications can be difficult to manage particularly when there are specific instructions to crush them or take them with food, or when extra monitoring is needed. There is also a risk of <a href="https://www.nps.org.au/consumers/understanding-drug-interactions">drug interactions</a>. Medications bought “over the counter” without a prescription, such as vitamins, herbal medications or pain relievers, can also cause <a href="https://onlinelibrary.wiley.com/doi/abs/10.5694/mja11.10698">problems</a>. Some people might take an over-the-counter medication each day due to previous advice, but they might not need it anymore. Just like prescription medications, over-the-counter medications add to the overall burden and cost of polypharmacy as well as drug interactions and side effects. Unfortunately, the more medications you take, the more likely you are to have <a href="https://www.nps.org.au/consumers/managing-your-medicines#risks-of-taking-multiple-medicines">problems with your medications</a>, a reduced quality of life and increased risk of falls, hospitalisation and death. Each year, <a href="https://www.psa.org.au/wp-content/uploads/2019/01/PSA-Medicine-Safety-Report.pdf">250,000 Australians</a> are admitted to hospital due to medication-related harms, many of which are preventable. For example, use of multiple medications like sleeping pills, strong pain relievers and some blood pressure medications can cause drowsiness and dizziness, potentially resulting in a <a href="https://betterhealthwhileaging.net/preventing-falls-10-types-of-medications-to-review/">fall</a> and broken bones. <h2>Prescribing and deprescribing are both important</h2> Ensuring safe and effective use of medications involves both prescribing, and <a href="https://www.racgp.org.au/clinical-resources/clinical-guidelines/key-racgp-guidelines/view-all-racgp-guidelines/silver-book/part-a/deprescribing">deprescribing</a> them. <a href="https://www.australiandeprescribingnetwork.com.au/474-2/">Deprescribing</a> is a process of stopping (or reducing the dose of) medications that are no longer required, or for which the risk of harm outweighs the benefits for the person taking them. The process involves reviewing all the medications a person takes with a health-care professional to identify medications that should be stopped. Think of deprescribing as spring cleaning your medicine cabinet. Just like how you tidy up your house and get rid of objects that are causing clutter without being useful, deprescribing tidies up your medication list to keep only the ones truly required. <h2>But care is needed</h2> The process of deprescribing requires close monitoring and, for many medications, slow reductions in dose (tapering). This helps the body adjust gradually and can prevent sudden, unpleasant changes. Deprescribing is often done on a trial basis and medication can be restarted if symptoms come back. Alternatively, a safer medication, or non-drug treatment may be started in its place. Studies show deprescribing is a safe process when managed by a health-care professional, both for people living at <a href="https://link.springer.com/article/10.1007/s11606-020-06089-2">home</a> and those in <a href="https://doi.org/10.1016/j.jamda.2018.10.026">residential aged care</a>. You should always talk with your care team before stopping any medications. Deprescribing needs to be a team effort involving the person, their health-care team and possibly family or other carers. Shared decision-making throughout the process empowers the person taking medications to have a say in their health care. The team can work together to clarify treatment goals and decide which medications are still serving the person well and which can be safely discontinued. If you or a loved one take multiple medications you might be eligible for a free visit from a pharmacist (<a href="https://www.nps.org.au/assets/NPS/pdf/NPSMW2390_Anticholinergics_HMR_Factsheet.pdf">a Home Medicines Review</a>) to help you get the best out of your medications. <h2>What’s next?</h2> Health care has traditionally focused on prescribing medications, with little focus on when to stop them. Deprescribing is not happening as often as it should. <a href="https://www.australiandeprescribingnetwork.com.au/">Researchers</a> are working hard to develop tools, resources and service models to support deprescribing in the community. Health-care professionals may think older adults are not open to deprescribing, but about <a href="https://academic.oup.com/biomedgerontology/article/77/5/1020/6352400">eight out of ten people</a> are willing to stop one or more of their medications. That said, of course some people may have concerns. If you have been taking a medication for a long time, you might wonder why you should stop or whether your health could get worse if you do. These are important questions to ask a doctor or pharmacist. We need more <a href="https://shpa.org.au/news-advocacy/MedsAware">public awareness</a> about polypharmacy and deprescribing to turn the tide of increasing medication use and related harms. <img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/211424/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/emily-reeve-1461339">Emily Reeve</a>, Senior Research Fellow in the Centre for Medicine Use and Safety , <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a>; <a href="https://theconversation.com/profiles/jacinta-l-johnson-1441348">Jacinta L Johnson</a>, Senior Lecturer in Pharmacy Practice, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a>; <a href="https://theconversation.com/profiles/janet-sluggett-146318">Janet Sluggett</a>, Enterprise Fellow, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a>, and <a href="https://theconversation.com/profiles/kate-ohara-1462183">Kate O'Hara</a>, PhD student, Clinical Pharmacology and Toxicology, <a href="https://theconversation.com/institutions/university-of-newcastle-1060">University of Newcastle</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/taking-more-than-5-pills-a-day-deprescribing-can-prevent-harm-especially-for-older-people-211424">original article</a>.

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Taking more than 5 pills a day? ‘Deprescribing’ can prevent harm – especially for older people