Exceptionalism

Exceptionalism

I am writing a book about disruptive science. This is science that overturns how we think about the world. Such scientists as Galileo, Newton, Einstein, Freud, Tesla, and many others. I am researching this to understand why there is a lack of disruptive science nowadays. We seem to have career scientists who do not disrupt science but affirm it. This is not how science progresses. Science progresses through ‘revolutions’ that turn what we believe upside down. The book focuses on similarities between these scientists. As a psychologist, I am interested not just in their personality but also in the conditions that allowed them to be disruptive. Interestingly, for example, most of these scientists were accused of plagiarism early on. Most had influential friends, and most spent time in obscurity and isolation. With this frame of thought, I was trying to explain what is happening politically here in the US and, it seems, across Europe, too. We are going through disruptive politics. But unlike science, which only seems to move forward, politics is more of a pendulum confined by human desires. The pendulum swings right and, after some time, returns to center and swings left. Right now, we have swung out to the right as much as we have ever done. I speak with a lot of this administration’s supporters, as most are older adults. They want things to be more stable and more consistent They are afraid of ambiguity: transgender, gay, foreigners, disabled, poor, homeless. Their view of the world, where the US is the paramount of virtue, does not fit with having these “types” of people. There is also a strong belief in exceptionalism. That we are uniquely different. I find exceptionalism in every country. I was brought up on a small island of Malta. We had no resources, could hardly feed ourselves throughout history, and it was one of the poorest places on earth. We had a coin, a ‘habba,’ that was the lowest denomination in the world (‘Habba’ a third of a farthing-farthing a quarter of a penny-penny one-twelfth of a shilling, shilling one-twentieth of a pound). Despite this poverty, I was brought up to believe we are special. Everyone believes this about their country growing up. The difference is when you impose this view on others, either by enslaving them or declaring war on them, then you create an injustice. In the US, we are now again imposing war on ‘others.’ It seems we exported this to other countries and waged war on the poor. However, there is another angle to this conflict, both at home and abroad. The inequity also affects those who are doing well. There is a feeling that they do not deserve their condition, they have not earned it. This feeling makes them more protective of what they have, an unsettling feeling that it can all be taken away. This is the new conservatism we are seeing. People are so unsettled that they feel they must protect themselves from others, even if they are doing well.

Money and Science

Galileo sold telescopes; Einstein sold patents for a refrigerator (among other patents), Edison commercialized many of his 1,000 patents, Tesla sold many appliances and inventions to the public, while Watt improved and sold steam engines. In fact, science is expensive, but science is not only about money, but it seems like it is. 

Science as it relates to old people is all about geriatrics, about their health. The biggest worry is, of course, dementia. In the United States, dementia receives the third most funding money, after heart problems and cancer. After more than five decades of this funding, there are the traditional medications that were supposed to slow the disease. These Acetylcholinesterase Inhibitors are ineffective. Although they seem to reduce death, they do not improve behavior. In the last few years, a new class of anti-amyloid drugs was introduced that clean the disease (amyloid) from the brain. Two main drugs are now approved by the Food and Drug Administration (FDA) for dementia: donanemab (Kisunla) and lecanemab-irmb (Leqembi). A third anti-amyloid drug, aducanumab (Aduhelm), was fast-tracked for approval in 2021, but Biogen, the drugmaker, took it off the market in early 2024, possibly to reduce the risk of liability. In all these injectable drugs, there is a serious risk of brain bleeds that have caused death in the past. Statistically, these drugs make little positive changes, but money has a way of interfering with science. What is surprising is that non-drug therapies have much better improvement and yet receive little research funding. These non-drug alternatives also have the advantage of not causing your brain to bleed.

Brainfitness, from Posit Science, is the oldest and most established of such programs in the US. However, Japan has its own homegrown and established programs. One of these is a computer-based program developed by Namco Bandai and tested by Dr. Kawashima, known for his Nintendo DS games Brain Age: Train Your Brain in Minutes a Day! and Brain Age 2: More Training in Minutes a Day! Japan sold 3.3 million already. The other with more than 20 years of legacy, is NeU Corporation. They fused the science of Tohoku University’s Institute of Development, Aging and Cancer, with the “portable brain measurement technology” of Hitachi’s High Technology Division. All of these are effective, and although they cost a little bit of money, it is an investment in the future. Science does not have to be free, only affordable.

Sarcopenia

There is an “Obesity paradox” among older Americans. This describes the unexpected finding that slightly overweight older people with a particular disease have better outcomes than their normal-weight or underweight peers.  Overweight is measured by a formula called the Body Mass Index (BMI), which measures height, weight, and age. A recent review in 2023 by Moustapha Dramé confirmed this observation that being a little overweight for older adults is beneficial. Even though obese people are more vulnerable to diseases, including an increased risk of infections, cancer, and heart disease. However, once you get a disease, having greater functional reserves might come in use. But there is a more interesting story to tell rather than simply weight.

BMI is not a good way to measure healthy body weight, especially for older adults. Once you reach 30 years of age, muscle begins to reduce. By the time we reach 70, we may have only half the muscle we had in our 20s. This is not only a function of age but a function of poor nutrition, inactivity, and a general difficulty in building muscle. Women’s menopause might also make things worse. Physicians call this Sarcopenia, the common tendency to lose muscle mass due to aging, but it does not have to be like this.

Loss of muscle mass is a serious threat to health.  It contributes to disability and frailty. In addition, studies show that there may be an association between sarcopenia and rheumatoid arthritis, falls, and even dementia. Building muscle in older age is difficult but possible. A person can only build muscle through resistance training, not just walking. We can use our own body weight (e.g., by doing push-ups and squats) and lifting household items such as soup cans. One of the few areas that is easy to change is diet. Older adults don't eat enough protein. 

Rei Otsuka and his colleagues have shown that greater protein intake improved muscle mass for men but not for women, which might have to do with menopause and the role of estrogen (especially estradiol). Women have it worse, since the loss of estradiol increases fat, decreases bone density, as well as muscle mass and muscle strength. All of these factors significantly contribute to the development of a condition termed “sarcopenic obesity.” It is that much harder for women to retain their muscles. But diet and exercise still seem to help, and increasing protein intake seems to help.

Keisuke Sakurai and his team compared a high-carbohydrate (HC) diet mainly composed of cereal against a protein-balanced (PB) diet with high intake of legumes, vegetables, seafood, meat, and eggs. Cognitive function was significantly higher in the PB group than in the HC group in a Japanese group. 

What is good for muscles is also good for the brain. A healthy body means a balanced diet and staying as active as you can.  Addressing sarcopenia might also prevent falling. Improving balance and flexibility by strengthening core muscles (chest, back, belly, hips, glutes, and thighs) and careful stretching can help prevent falls, a major cause of disability and death. Avoiding falls can be as simple as wearing stable shoes and having well-lit paths, to maintaining strength and flexibility. However active you are, don’t use ladders and perform other risky actions.