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The Path Bill Gates Sees to Overcoming Alzheimer’s Biggest Remaining Challenges

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It would be hard to imagine any one person who’s had more of an impact on public health than Bill Gates. Much of the wealth he amassed as founder of Microsoft has gone to charity—according to Fortune, he is one of only five billionaires to have given away more than 20 percent of his wealth. In 2023, the Bill and Melinda Gates Foundation, which he started with his former wife, Melinda Gates, spent more than $8 billion of its more than $70-billion endowment. 

Gates has focused his philanthropy largely on some of the most intractable health problems, such as malaria, HIV/AIDS, and childhood vaccination. In recent years, he has turned to Alzheimer’s disease, starting with diagnostics and more recently expanding to proteomics and healthcare programs related to the disease. Scientific American Custom Media asked him about Alzheimer’s:

SCIENTIFIC AMERICAN CUSTOM MEDIA:
What sparked your interest in Alzheimer’s? How has your personal experience with the disease contributed to your decision to get involved?

Gates: Like many people, I have a personal connection to Alzheimer’s. My dad died from Alzheimer’s, so I understand first-hand what a cruel disease it is, and how difficult it can be to watch a loved one suffer with it. We were fortunate to have the resources to provide my dad with excellent care, and our family is grateful for the wonderful caregivers who helped him in the 13 years he lived with the disease. But for the majority of families battling Alzheimer’s, this is not an option. Caregiving most often falls to a spouse or a child, which can be overwhelming.

The financial burden of the disease is easier to quantify than the emotional cost. The lifetime cost of care for Alzheimer’s and other dementias is rapidly increasing in the U.S., Japan, Europe, and other countries. According to the Institute for Health Metrics and Evaluation, the global cost will exceed $1.6 trillion by 2050 and represent nearly one-third of all healthcare spending. Unlike those with many chronic diseases, people with Alzheimer’s incur long-term care costs as well as direct medical expenses. If you get the disease in your 60s or 70s, you might require expensive care for decades. 

As I spent time learning about Alzheimer’s and the research into it, I came to understand the challenges. The brain can’t be sampled easily or often, for example, and the blood-brain barrier is a double-edged sword—it both protects the brain and makes it harder for treatments to get in.

Even so, as I learned about all the innovation in this field, I grew optimistic about the ability to make progress toward treatment and eventually a cure. This is a frontier where we can dramatically improve human life. It’s a miracle that people are living so much longer today, but longer life expectancies alone are not enough. People should be able to enjoy their later years—and we need a breakthrough in Alzheimer’s to fulfill that. 

As someone who takes a bird’s- eye view of major health issues, how would you describe the current outlook for Alzheimer’s research and clinical practice? 

After decades of negative clinical trials and dozens of failed therapies, researchers are making progress on both diagnostics and therapeutics. 

Blood-based diagnostics are advancing rapidly—the first blood test for Alzheimer’s, PrecivityAD, was launched in late 2020. A few others have followed since, but we are looking forward to the first FDA-cleared blood tests on the horizon. Once this becomes a reality, the next hurdle will be ensuring these tests are used properly, accessible, and available to the patients that need them, and that we understand how these tests work in different patient populations.

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https://static.scientificamerican.com/dam/m/1cd1ceb153224ca6/original/billgates.jpg?w=900Tony Healey

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Click the link below for article:

https://www.scientificamerican.com/custom-media/davos-alzheimers-collaborative/the-path-bill-gates-sees-to-overcoming-alzheimers-biggest-remaining/

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The Common Mistake Parents Make Trying To Control Their Child’s Behavior

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It’s easy for parents to attribute their child’s poor behavior to a friend who they believe is a “bad influence.” Kids often get into trouble in pairs or groups, so there’s generally someone there to take the blame. And criticizing someone else’s child allows parents to hold onto the belief that their own child is fundamentally “good” — that they wouldn’t have engaged in the misbehavior were it not for the influence of their peer.

There are a couple of problems with this line of thinking. By characterizing children as intrinsically good or bad, parents run the risk of leading their children to believe that they are bad people when they do something wrong. Instead, viewing all children as essentially good people who sometimes make poor decisions allows kids room for personal growth.

In addition, parents generally follow up the naming of a friend as a bad influence with a prohibition on spending time with that friend — and new research shows that this approach tends to backfire.

Why banning a friend who is a “bad influence” doesn’t work.

We know that as kids move into middle school, they tend to place increasing value on the opinions of their peers as they try to find their place in the social landscape.

“As children get older, their peers become more and more prominent in their physical lives and their psychological lives,” Cristine Legare, a professor of psychology at the University of Texas at Austin, told HuffPost. The impact of peer influence is very real, and can lead to kids making dangerous choices.

Research has consistently shown, for example, that teen drivers are more likely to get into a car accident when there are other passengers in the car, particularly when those passengers are their peers. In 2022, 56% of teens who died in car crashes were in cars being driven by another teen. This is one of the reasons most states now have graduated license requirements that restrict who else can be in the car when a teen is driving. These changes are credited with a substantial decrease in the number of teen car crashes. Without friends in the car, teen drivers are less likely to speed or take their eyes off the road.

The reasons that teens are more likely to do something “wrong” when they are with their peers, as opposed to alone or with their parents, are both social and biochemical.

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Mistakes

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Click the link below for the article:

https://www.huffpost.com/entry/parents-kids-friend-bad-influence_l_66e3098ee4b02a333c0b3a2f

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The Marathon Journey to the First Alzheimer’s Drugs

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On a spring day in 2011, neuroscientist Cynthia Lemere stood nervously before scientists gathered to appraise the world’s latest research—including hers—at a conference on immune strategies for treating Alzheimer’s disease. Advancing her presentation slides to show stained brain tissue from a recent set of mouse experiments, Lemere circled the pointer around the reddish-brown clumps: protein fragments called amyloid beta that form plaques, a hallmark of the disease. In Lemere’s experiments, mice that received antibody treatment accumulated fewer amyloid plaques than animals receiving placebo.

Some in the audience were skeptical. As Lemere recalls, when she finished her presentation one prominent researcher rose and proclaimed: “It’s not a real thing. It’s a biochemical artifact.”

What that researcher dismissed, others pursued. Lemere and colleagues at Brigham and Women’s Hospital in Boston have studied this form of amyloid beta since the 1990s; so have researchers in Japan and Germany. Now, the rogue protein is center stage: A drug (donanemab) that targets the molecule recently showed clear benefits in a large clinical study of people with mild Alzheimer’s disease.   

Donanemab’s success follows another Alzheimer’s drug, lecanemab (brand name Leqembi), which hit the market in January, and aducanumab (brand name Aduhelm), which got a nod from the U.S. Food and Drug Administration in 2021 after a controversial review. (Aducanumab was withdrawn from the market in 2024.) These are the first new Alzheimer’s treatments since 2003, and the only ones to impede the disease’s progression; earlier drugs only eased symptoms.

The new therapies are revitalizing Alzheimer’s research and renewing hope for millions of families touched by this devastating disease. Yet these treatments carry some risk and a formidable price tag. Translating them from controlled studies to clinical use will require diagnostics that are more scalable and accessible, as well as new training to equip physicians to recognize early-stage disease and decide who is eligible for treatment.

Molecular underpinnings

Alzheimer’s is the most common cause of dementia. It afflicts nearly 7 million people in the United States and more than 30 million worldwide. Older drugs—including donepezil, galantamine, and rivastigmine—work by prolonging the activity of key chemical messengers in the brain. This enhancement of nerve cell communication offers a temporary boost but does not get at the disease’s molecular roots.

The newest drugs do. They are the long-awaited fruit of the amyloid hypothesis, the theory that identifies amyloid buildup as an essential trigger that disrupts neural circuits, causing mental decline and other signs of dementia decades later. This theory has driven much of the Alzheimer’s disease research and drug development since the 1990s.

Creating drugs to slow this progression requires a deep understanding of how the culprit molecules form and how they become a threat. Before amyloid clumps into disease-associated plaques, it floats in the blood as harmless proteins. Day by day, decade after decade, these amyloid beta peptides are churned out and cleared out, like scores of other proteins processed in the brain as part of normal metabolism.

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Cynthia Lemere overcame scientific skepticism to show that antibodies against rogue forms of amyloid beta could protect mouse brains from damage. Joelle Bolt

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Click the link below for the article:

https://www.scientificamerican.com/custom-media/davos-alzheimers-collaborative/the-marathon-journey-to-the-first-alzheimers-drugs/

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Alzheimer’s Impact on the Brain

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This article relates to several articles about Alzheimer’s that have been and will be posted on, James’ World 2!

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Alzheimer’s disease impairs a patient by destroying neurons, which otherwise live for decades, and by disrupting communication among the remaining brain cells. As neurons die, the areas of the brain they constitute begin to atrophy. A detailed picture of the progression is still under investigation, and the disease follows different tracks in different patients, but researchers have found brains afflicted with Alzheimer’s typically atrophy along the same basic pattern. A better understanding of that pattern may provide the foundation for methods to diagnose the disease earlier, which in turn would give medication and lifestyle changes the best chance of slowing dementia. In broad strokes, here’s how Alzheimer’s tends to change a brain. 

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https://www.scientificamerican.com/custom-media/davos-alzheimers-collaborative/alzheimers-impact-on-the-brain/

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Parents Should Ignore Their Children More Often

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I recently spoke with an anthropologist named Barry Hewlett, who studies child-rearing in hunter-gatherer societies in Central Africa. He explained to me that children in those societies spend lots of time with their parents — they tag along throughout the day and often help with tasks like foraging — but they are rarely the main object of their parents’ attention. Sometimes bored, sometimes engaged, these kids spend much of their time observing adults doing adult things.

Parents in contemporary industrialized societies often take the opposite approach. In the precious time when we’re not working, we place our children at the center of our attention, consciously engaging and entertaining them. We drive them around to sports practice and music lessons, where they are observed and monitored by adults, rather than the other way around. We value “quality time” over quantity of time. We feel guilty when we have to drag our children along with us to take care of boring adult business.

This intensive, often frantic style of parenting requires a lot more effort than the style Professor Hewlett described. I found myself thinking about those hunter-gatherers last month when I read the advisory from the surgeon general, Vivek Murthy, warning that many parents are stressed to their breaking point. There are plenty of reasons for this worrisome state of affairs. One is that we don’t ignore our children often enough.

The modern style of parenting is not just exhausting for adults; it is also based on assumptions about what children need to thrive that are not supported by evidence from our evolutionary past. For most of human history, people had lots of kids, and children hung out in intergenerational social groups in which they were not heavily supervised. Your average benign-neglect day care is probably closer to the historical experience of child care than that of a kid who spends the day alone with a doting parent.

Of course, just because a parenting style is ancient doesn’t make it good. But human beings have spent about 90 percent of our collective time on Earth as hunter-gatherers, and our brains and bodies evolved and adapted to suit that lifestyle. Hunter-gatherer cultures tell us something important about how children are primed to learn.

A parenting style that took its cue from those hunter-gatherers would insist that one of the best things parents can do — for ourselves as well as for our children — is to go about our own lives and tote our children along. You might call it mindful underparenting.

Children learn not only from direct instruction, but also from watching and modeling what other people around them do, whether it’s foraging for berries, changing a tire or unwinding with friends after a long day of work. From a young age, that kind of observation begins to equip children for adulthood.

More important, following adults around gives children the tremendous gift of learning to tolerate boredom, which fosters patience, resourcefulness, and creativity. There is evidence from neuroscience that a resting brain is not an idle one. The research tells us that the mind gets busy when it is left alone to do its own thing — in particular, it tends to think about other people’s minds. If you want to raise empathetic, imaginative children who can figure out how to entertain themselves, don’t keep their brains too occupied.

An excellent way to bore children is to take them to an older relative’s house and force them to listen to a long adult conversation about family members they don’t know. Quotidian excursions to the post office or the bank can create valuable opportunities for boredom, too.

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https://static01.nyt.com/images/2024/09/15/opinion/15saxbeNEW/15saxbeNEW-superJumbo.jpg?quality=75&auto=webpBrittany Marcoux

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Click the link below for the article:

https://www.nytimes.com

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Vote for Kamala Harris to Support Science, Health and the Environment

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In the November election, the U.S. faces two futures. In one, the new president offers the country better prospects, relying on science, solid evidence and the willingness to learn from experience. She pushes policies that boost good jobs nationwide by embracing technology and clean energy. She supports education, public health and reproductive rights. She treats the climate crisis as the emergency it is and seeks to mitigate its catastrophic storms, fires and droughts.

In the other future, the new president endangers public health and safety and rejects evidence, preferring instead nonsensical conspiracy fantasies. He ignores the climate crisis in favor of more pollution. He requires that federal officials show personal loyalty to him rather than upholding U.S. laws. He fills positions in federal science and other agencies with unqualified ideologues. He goads people into hate and division, and he inspires extremists at state and local levels to pass laws that disrupt education and make it harder to earn a living.

Only one of these futures will improve the fate of this country and the world. That is why, for only the second time in our magazine’s 179-year history, the editors of Scientific American are endorsing a candidate for president. That person is Kamala Harris.

Before making this endorsement, we evaluated Harris’s record as a U.S. senator and as vice president under Joe Biden, as well as policy proposals she’s made as a presidential candidate. Her opponent, Donald Trump, who was president from 2017 to 2021, also has a record—a disastrous one. Let’s compare.

Health Care

The Biden-Harris administration shored up the popular Affordable Care Act (ACA), giving more people access to health insurance through subsidies. During Harris’s September 10 debate with Trump, she said one of her goals as president would be to expand it. Scores of studies have shown that people with insurance stay healthier and live longer because they can afford to see doctors for preventive and acute care. Harris supports expansion of Medicaid, the U.S. health-care program for low-income people. States that have expanded this program have seen health gains in their populations, whereas states that continue to restrict eligibility have not. To pay for Medicare, the health insurance program primarily for older Americans, Harris supports a tax increase on people who earn $400,000 or more a year. And the Biden-Harris administration succeeded in passing the Inflation Reduction Act (IRA), which caps the costs of several expensive drugs, including insulin, for Medicare enrollees. Harris’s vice presidential pick, Tim Walz, signed into law a prohibition against excessive price hikes on generic drugs as governor of Minnesota.

When in office, Trump proposed cuts to Medicare and Medicaid (Congress, to its credit, refused to enact them.) He also pushed for a work requirement as a condition for Medicaid eligibility, making it harder for people to qualify for the program. As a candidate, both in 2016 and this year, he pledged to repeal the ACA, but it’s not clear what he would replace it with. When prodded during the September debate, he said, “I have concepts of a plan” but didn’t elaborate. Like Harris, however, he has voiced concern about drug prices, and in 2020 he signed an executive order designed to lower prices of drugs covered by Medicare.

The COVID pandemic has been the greatest test of the American health-care system in modern history. Harris was vice president of an administration that boosted widespread distribution of COVID vaccines and created a program for free mail-order COVID tests. Wastewater surveillance for viruses has improved, allowing public health officials to respond more quickly when levels are high. Bird flu now poses a new threat, highlighting the importance of the Biden-Harris administration’s Office of Pandemic Preparedness and Response Policy.

Trump touted his pandemic efforts during his first debate with Harris, but in 2020 he encouraged resistance to basic public health measures, spread misinformation about treatments and suggested injections of bleach could cure the disease. By the end of that year about 350,000 people in the U.S. had died of COVID; the current national total is well over a million. Trump and his staff had one great success: Operation Warp Speed, which developed effective COVID vaccines extremely quickly. Remarkably, however, Trump plans billion-dollar budget cuts to the Centers for Disease Control and Prevention and the National Institutes of Health, which started the COVID-vaccine research program. These steps are in line with the guidance of Project 2025, an extreme conservative blueprint for the next presidency drawn up by many former Trump staffers. He’s also talked about ending the Office of Pandemic Preparedness and Response Policy, calling it a pork project.

Reproductive Rights

Harris is a staunch supporter of reproductive rights. During the September debate, she spoke plainly about her desire to reinstate “the protections of Roe v. Wade” and added, “I think the American people believe that certain freedoms, in particular the freedom to make decisions about one’s own body, should not be made by the government.” She has vowed to improve access to abortion. She has defended the right to order the abortion pill mifepristone through the mail under authorization by the U.S. Food and Drug Administration, even as MAGA Republican state officials have tried—so far unsuccessfully—to revoke those rights. As a U.S. senator, she co-sponsored a package of bills to reduce rising rates of maternal mortality. In August, Trump said he would vote against a ballot measure expanding access to abortions in Florida, where he lives. The current Florida “heartbeat” law makes most abortions illegal after six weeks of pregnancy, before many people even know they are pregnant.

Trump appointed the conservative U.S. Supreme Court justices who overturned Roe v. Wade, removing the constitutional right to a basic health-care procedure. He spreads misinformation about abortion—during the September debate, he said some states support abortion into the ninth month and beyond, calling it “execution after birth.” No state allows this. He also refused to answer the question of whether he would veto a federal abortion ban, saying Congress would never approve such a ban in the first place. He made no mention of an executive order and praised the Supreme Court, three justices of which he placed, for sending abortion back to states to decide. This ruling led to a patchwork of laws and entire sections of the country where abortion is dangerously limited.

Gun Safety

The Biden-Harris administration closed the gun-show loophole, which had allowed people to buy guns without a license. The evidence is clear that easy access to guns in the U.S. has increased the risk of suicides, murder and firearm accidents. Harris supports a program that temporarily removes guns from people deemed dangerous by a court.

Trump promised the National Rifle Association that he would get rid of all Biden-Harris gun measures. Even after Trump was injured and a supporter was killed in an attempted assassination, the former president remained silent on gun safety. His running mate, J. D. Vance, said the increased number of school shootings was an unhappy “fact of life” and the solution was stronger school security.

Environment and Climate

Harris said pointedly during the September debate that climate change was real. She would continue the responsible leadership shown by Biden, who has undertaken the most substantial climate action of any president. The Biden-Harris administration restored U.S. membership in the Paris Agreement on coping with climate change. Harris’s election would continue IRA tax credits for clean energy, as well as regulations to reduce power-plant emissions and coal use. This approach puts the country on course to spend the authorized billions of dollars for renewable energy that should cut U.S. carbon emissions in half by 2030. The IRA also includes a commitment to broadening electric vehicle technology.

Trump has said climate change is a hoax, and he dodged the question “What would you do to fight climate change?” during the September debate. He pulled the U.S. out of the Paris Agreement. Under his direction the Environmental Protection Agency and other federal agencies abandoned more than 100 environmental policies and rules, many designed to ensure clean air and water, restrict the dangers of toxic chemicals and protect wildlife. He has also tried to revoke funding for satellite-based climate-research projects.

Technology

The Biden-Harris administration’s 2023 Executive Order on Safe, Secure and Trustworthy Development and Use of Artificial Intelligence requires that AI-based products be safe for consumers and national security. The CHIPS and Science Act invigorates the chipmaking industry and semiconductor research while growing the workforce. A new Trump administration would undo all of this work and quickly. Under the devious and divisive Project 2025 framework, technology safeguards on AI would be overturned. AI influences our criminal justice, labor and health-care systems. As is the rightful complaint now, there would be no knowing how these programs are developed, how they are tested or whether they even work.

The 2024 U.S. ballots are also about Congress and local officials—people who make decisions that affect our communities and families. Extremist state legislators in Ohio, for instance, have given politicians the right to revoke any rule from the state health department designed to limit the spread of contagious disease. Other states have passed similar measures. In education, many states now forbid lessons about racial bias. But research has shown such lessons reduce stereotypes and do not prompt schoolchildren to view one another negatively, regardless of their race. This is the kind of science MAGA politicians ignore, and such people do not deserve our votes.

At the top of the ballot, Harris does deserve our vote. She offers us a way forward lit by rationality and respect for all. Economically, the renewable-energy projects she supports will create new jobs in rural America. Her platform also increases tax deductions for new small businesses from $5,000 to $50,000, making it easier for them to turn a profit. Trump, a convicted felon who was also found liable of sexual abuse in a civil trial, offers a return to his dark fantasies and demagoguery, whether it’s denying the reality of climate change or the election results of 2020 that were confirmed by more than 60 court cases, including some that were overseen by judges whom he appointed.

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https://static.scientificamerican.com/dam/m/18342a38d6a31cf9/original/Kam2.jpg?w=900Luca D’Urbino

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Click the link below for the article:

https://www.scientificamerican.com/article/vote-for-kamala-harris-to-support-science-health-and-the-environment/

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Is It a Red Flag That I Don’t Have Any Childhood Friends?

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One thing I remember about childhood is how easy it was to make friends. “Do you want to play with me?” you’d ask another child in a deadpan tone, and they’d reply with either “yes” or “no.” (If I said that to someone today, they’d likely call the police.) Making friends as a teenager wasn’t too difficult, either. I remember sitting next to people in class, and the next thing I knew I was sharing snacks with them at lunchtime, or passing scrunched-up notes about who in our year we found attractive. In fact, as a young person, I always had at least one best mate, if not a whole group of them. Maybe it would’ve been more on-brand for me to have been a social outcast, but I can’t claim that was ever the case.

When I look around me now, though, I have very few close friends that remember me from before my frontal lobe had fully developed. There are a few, yes—a much beloved friend from primary school, a few mates from my teen job (working at a vintage shop in Shoreditch that still haunts my nightmares to this day)—but other than that, it’s as though those earlier friend-making years were wiped clean from my personal history. I’m surprised my partner doesn’t suspect that I committed some grisly crime in my youth and had to take on a new identity.

It’s a commonly held belief that, if a person has no childhood friends, they’re probably not to be trusted. There must be a reason, people claim. They’ve probably done some deranged thing. They’re probably, like, evil or something. Except I—and, of course, I may be biased here—don’t think that’s true. I went to three different primary schools and three different secondary schools—not for any sinister reason, but because my mum and I just moved a lot during those years. As a result, I became adept at forming friendships that didn’t tend to last. I tried to keep in touch with people, but before iPhones, that wasn’t the easiest task. Besides, when you’re a kid, you tend to just become friends with whoever’s in front of you. And for me, that often changed.

Growing up, I was also notoriously flaky. My friends were regularly annoyed about my bowing out of parties. Looking back, this was probably the result of social anxiety, or introversion, but it used to piss people off. As an adult, this is a behavioral trait I’ve definitely managed to curb. I very rarely bail on plans unless I’ve got a good reason, which means that my platonic relationships don’t fizzle out in the way they used to. Friendships, I realized around the age of 21, are like gardens. If you don’t water them on a regular basis, they tend to dry up quickl

I also went to university in London, just down the road from where I already lived. So I didn’t bother going to freshman-year events, and only secured a place in the dorms when someone later dropped out. More than that, I very often felt disconnected, as if everyone had left their hometowns to start an exciting new life, while I was just where I’d always been. I made some friends—and ended up in a long-term relationship—but nothing at uni seemed to stick. This time, it wasn’t because I was constantly moving. Or didn’t have a phone. I just didn’t make the effort. (Looking back, I was probably depressed.) By the time I graduated, I wanted a fresh start—again. Another situation in which I hadn’t retained close friends.

Thankfully, I have lots of mates I love these days, mates who’ve seen me through various break-ups, job changes, weird tattoos, and flop eras. But do I sometimes feel sad that I don’t have many close friends from childhood? Definitely. I think you are, in some ways, your truest self when you’re 12 years old, and anyone you meet at that age will simply understand you on a different level than someone you meet later in life. But that doesn’t mean I’m an evil or untrustworthy person. Or, at least, I don’t think so. Maybe you’d be better off asking around.

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Click the link below for the article:

https://www.vogue.com/article/red-flag-no-childhood-friends?utm_source=pocket_discover_parenting

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Former NIH Director Elias Zerhouni says beating Alzheimer’s requires studying diverse cohorts

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When Elias Zerhouni took over as director of the National Institutes of Health in 2002, the only way doctors could know for certain whether a dementia patient had Alzheimer’s disease was to perform an autopsy. 

A few years later, new technologies that could deliver a definitive diagnosis revealed an embarrassing truth: many of the ongoing clinical trials for Alzheimer’s treatments included a significant number of subjects who had been misdiagnosed. “We didn’t know who had the disease and who didn’t have it,” Zerhouni recalls. 

It fell to Zerhouni and his colleagues at NIH to fashion a research program that could exploit the power of the new diagnostic technologies—which now include imaging, biomarker tests, and digital cognitive tests, among others—to learn about what has turned about to be a hugely complex disease. 

Since leaving NIH in 2008, Zerhouni has carried on that work in various roles—as head of research at Sanofi from 2011 to 2018 and, currently, as a founding board member of the Davos Alzheimer’s Collaborative (DAC). He is helping DAC assemble a cohort of Alzheimer’s patients that reflect the world’s genetic, environmental, social, and economic diversity, which he believes is crucial to understanding and treating the disease. DAC’s Global Cohorts program has so far engaged 26 different countries, with the goal of drawing up to one million people from rich and poor nations alike in North America, South America, Africa, Europe, Asia, and the Middle East. 

Expanding research to include a diverse cohort is essential to treating Alzheimer’s disease, he believes. Still, new drugs that can slow the progress of Alzheimer’s, despite their limitations, are a turning point, and bode well for the future. “Progress in medicine tends to occur like a swarm around a fortress,” he says. “When there is a crack in one place, you have a lot of people going through that crack, not knowing if it’s a dead end or if it’s the beginning of redemption.” 

Scientific American Custom Media talked with Zerhouni about the last two decades of Alzheimer’s research and his vision for what needs to happen going forward. 

SCIENTIFIC AMERICAN CUSTOM MEDIA:
You’ve had a bird’s-eye view of many different human diseases. How is Alzheimer’s unique?

ZERHOUNI: A perfect life is: you are born, you’re healthy, you remain healthy, and you die.

However, that’s not what you see. What you see is that you have a healthy beginning after childhood illnesses, you’re pretty healthy until about 50, when there are some cancers. For many people who live longer and remain physically healthy, cognitive impairment because of neuronal degeneration leads to a more profound loss of quality of life. 

Alzheimer’s is a slow pandemic. It’s growing along with the prevalence of obesity and diabetes and with aging populations almost worldwide. It has a huge economic impact—a permanent impact, because you have a population of patients that could have been healthy and self-sufficient but no longer are.

We found that if you delayed the onset of Alzheimer’s disease by five years, it would reduce its burden on society by 50 percent. We also found that the mortality of caregivers—the wife who takes care of the husband and vice versa—is extremely high. 

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https://static.scientificamerican.com/dam/m/7e77632f26dad877/original/zerhouni.jpg?w=900Oboh Moses

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Click the link below for the article:

https://www.scientificamerican.com/custom-media/davos-alzheimers-collaborative/former-nih-director-elias-zerhouni-says-beating-alzheimers-requires-studying/

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Athlete vs. grandmaster: The psychology of decision-making

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In thinking about the economy, two heads are almost always better than one. Great ideas tend to emerge from teamwork. Even so, the partnership between the psychologists Daniel Kahneman and Amos Tversky was exceptional. First, it endured, lasting for more than 25 years and only ending with Tversky’s death in 1996. Secondly, it was immensely productive in establishing modern behavioral economics. Their work won Kahneman the Nobel Memorial Prize in 2002. Had Tversky lived, he would undoubtedly have shared the award. The working relationship had been so close that, rather like Lennon and McCartney, it was not always clear who had done what.

In behavioral economics, information is a resource, and decision making is costly. Its explanation of decision making has much in common with Herbert Simon’s understanding that behavior is rational when it follows a standardized process and economizes on the use of information. But behavioral economics has diverged from Simon’s thinking by arguing that people systematically fail to apply mental processes correctly because of the short-cuts which they take when they process information.

As psychologists, Tversky and Kahneman knew that while our brains are wonderful in many ways, they are still imperfect. We might think of them as having evolved to be very effective in engaging with the environment which our ancestors faced, but much less effective when we start dealing with the typical problems of a modern society. The weaknesses in decision making which psychologists and behavioral economists have identified result from people over-estimating the importance of whatever they can recall or recognize immediately.

When Kahneman and Tversky found evidence that the presentation of information affected decisions, they did not claim to have found evidence that we are irrational. They simply concluded that they had found still more evidence of widespread information-processing biases. Kahneman explained how these biases could arise in his intellectual autobiography, Thinking, Fast and Slow. He suggested that we make most decisions using System 1 processes, which are ‘always on’, and so used by default, but make some using an alternative System 2, in which decision making involves conscious thought.

System 1 thinking is fast, intuitive, and uses very little information. It means going with our instincts. This system manages unconscious responses to our environment, like spitting out very hot food which is scalding our mouths, and routine activities such as parking a car. For elite sports players, letting System 2 get involved in their decision making can damage their performance badly. It is too slow, and too demanding of mental resources to be effective in a highly competitive context where speed of decision making is critical. System 2 is much better for a grandmaster playing chess or an engineer calculating the load which a beam will need to bear. That makes System 2 an important part of what it means to be human. But usually, it sits in reserve, and we decide to switch it on when we are alerted to something novel in the decision which we are trying to make which makes us think that it will outperform System 1.

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https://bigthink.com/wp-content/uploads/2024/09/think_like_economist_compressed.jpg?resize=480,270Unsplash / WikiCommons / Big Think

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Click the link below for the article:

https://bigthink.com/business/athlete-vs-grandmaster-the-psychology-of-decision-making/?utm_source=pocket_discover_career

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The Ten Trillion Dollar Disease

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Tremendous advancements in science, public health, and material standards of living in recent decades means that people are living longer than ever before. In 1950, when the world’s population was 2.5 billion, life expectancy at birth was 46.5 years. In 2022, those figures rose to 8 billion and 71.2 years, respectively. By 2050, global life expectancy is projected to rise to 77.3 years.

This good news, however, presents a challenge: keeping many more older people healthy than ever before. By 2050, the number of people aged 65 and above is expected to reach 1.6 billion, up from 761 million in 2021, according to the U.N.’s World Social Report 2023.

Alzheimer’s disease is one of the gravest threats to this growing population: as more and more people live longer and longer, the total number of people with Alzheimer’s disease worldwide is expected to increase by more than 150 percent in the next 30 years. These people have progressively greater challenges in carrying out their day-to-day activities, are more likely to become injured from falls, and face major challenges managing otherwise straightforward medical problems. Many people with Alzheimer’s disease suffer from hallucinations, confusion, and depression. It is also an ultimately fatal disease.

Alzheimer’s disease can cause horrible suffering among patients and their caregivers. This suffering is part of the large burden Alzheimer’s imposes on people and their families, public-health systems, and nations. The economic cost of this burden is difficult to assess. It involves not only easily quantifiable effects such as treatment and long-term care costs and loss of work productivity and lifespan, but also myriad others that are not easy to measure, such as its effects on the mental health and livelihoods of caregivers and other indirect medical costs.

Quantifying the broad economic cost of Alzheimer’s disease is important, not least because it is needed to assess the soundness of the expense to bring tests and, eventually, treatments to so many people through health systems. To this end, we have undertaken a comprehensive analysis, drawing on data from the Institute for Health Metrics and Evaluation (IHME), a leading research organization specializing in analyzing the global burden of diseases, as well as from other organizations and prior studies. We used a methodological approach that estimates the economic burden of Alzheimer’s disease based on people’s willingness to pay to avoid the risk of death. We also developed a macroeconomic model of the productive capacity of a country’s economy that allows for a reduction in labor and capital formation resulting from the disease burden. These methods take into account a wide array of direct and indirect costs of Alzheimer’s disease for individual patients, caregivers, and the aggregate economy.

Based on our willingness-to-pay approach, we estimate that the global economic burden of the disease in 2019 was roughly $2 trillion. By 2050, that burden will rise sharply to about $10 trillion and perhaps as high as $13.5 trillion. For comparison, world GDP is projected to be $228 trillion (inflation adjusted) in 2050. 

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https://static.scientificamerican.com/dam/m/5ad93af4d6762b20/original/atlasbrain.jpg?w=900

Dementia poses a global economic challenge, affecting rich, middle-income and poor nations. Davide Bonazzi

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Click the link below for the article:

https://www.scientificamerican.com/custom-media/davos-alzheimers-collaborative/the-ten-trillion-dollar-disease/

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