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be avoided or delayed by tackling 14 risk factors An early diagnosis also allows people to be eligible for clinical trials, receive specialized treatment and care, and improve their quality of life, said Lycia Neumann, senior director of health services research for the When You’re Licking Her Pussy & ear Her Big Toe Crack T-Shirts besides I will buy this Alzheimer’s Association. She was not involved in the new study. “Everyone has exactly the same right to receive a diagnosis of this nature — that’s the first step for them to understand why they are noticing signs and symptoms and to change how they manage their daily lives and even their relationships with their family,” Neumann said. “Knowing where disparities exist is the first step for us to be able to address them,” she added. “We need to do better. We need to ensure that these differences don’t exist.” Move across the country, get a different diagnosis Traditionally, research has shown the largest percentage of Alzheimer’s and dementia cases occur in the Southeast, known as the “stroke belt” because deaths from stroke are two to four times higher in those states than in other regions, according to the US Centers for Disease Control and Prevention. “However, obesity is widespread across the US, as is high blood pressure, type 2 diabetes, heart disease and other conditions that contribute to dementia,” Bynum said. “So why would the majority of diagnoses be in the South?” Alzheimer’s diagnoses are traditionally higher in the Southeast, known as the “stroke belt.” The darkest color indicates the most cases and the lightest color the fewest. To find out, she and her team spent years analyzing Medicare claims data from each of 306 hospital referral regions in the United States. A hospital referral region is a collection of ZIP codes where the hospitals, physicians and specialists in that area provide most of the health care for residents. The team compared 2019 Medicare dementia diagnoses in people 66 and older in each region with the number of expected new cases in that geographical area based on potentially modifiable risk factors for dementia. Those risk factors include alcohol

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consumption, lower levels of education, depression, diabetes, high blood pressure, obesity, smoking and low social contact. Known demographic and health risk factors were then removed, leaving the When You’re Licking Her Pussy & ear Her Big Toe Crack T-Shirts besides I will buy this team with a measure of diagnosis intensity that looked different than the traditional view. No longer was all the emphasis on the Southeast; instead, the map showed a picture of diagnosis discrepancies across the nation. Alaska, Connecticut and the Texas Panhandle, for example, had excellent matches between dementia diagnoses and what might be expected for their areas, according to the study published recently in the journal Alzheimer’s & Dementia. Surprisingly, Florida did not. RELATED ARTICLE Cut your risk of dementia by 20% with this dietary change “Estimates are anywhere from 30% to 40% of people 80 and older have a form of dementia, so you’d assume that Florida, which has a really old Medicare population, would have a higher rate of diagnosis than other areas,” Bynum said. “That’s not what we found.” Hospital regions also differed widely in the number of newly diagnosed cases of Alzheimer’s or another dementia. One region only diagnosed 1.7% of its older population, the lowest the study found, while another diagnosed the highest number of cases at 5.4%. The largest disparities were found in people in the youngest age category of 66 to 74 — when lifestyle changes and early-stage Alzheimer’s medications might have the most benefit — and in Black and Hispanic people, who are at much higher risk than White people for Alzheimer’s and other dementias. “Even within the Black community, you see twofold differences in an individual’s likelihood of getting diagnosed depending on their ZIP code,” Bynum said. “So, it’s not just those group characteristics. There’s something going on.” Differences

between ZIP codes affect all races and social groups, according to the When You’re Licking Her Pussy & ear Her Big Toe Crack T-Shirts besides I will buy this study. Drazen Zigic/iStockphoto/Getty Images Insurance coverage, stigma and overworked physicians Even though all patients in the study were on the same insurance plan — Medicare — differences exist between health systems concerning how many hospitals and specialists accept the government’s fee-for-service health insurance program. “If you live in a city where nearby hospitals do not accept Medicare versus living in a different city where hospitals do accept Medicare, that could explain some of the disparity,” Ighodaro said. “Both patients have Medicare, but they’re getting different access and treatment.” RELATED ARTICLE A simple tool may be able to predict your risk for both dementia and depression, study finds Even if your local health system does accept Medicare, it doesn’t mean the program will cover the tests necessary to confirm a suspected diagnosis, she added. “Biomarkers, neuropsychological testing, MRI or PET scans are not always covered by Medicare or even other insurance,” Ighodaro said. “If I, as a neurologist, cannot do these exams and order these tests, it’s going to be difficult for me to make the diagnosis of dementia. Yet without that diagnosis, patients are not eligible for these disease-modifying medications that could add to their quality of life.” Cognitive decline also carries

stigma in some communities and cultures and may have an impact on a person’s work or family relationships, Bynum said. That may leave some doctors — and patients — uneasy about pursuing a diagnosis. Then there’s the When You’re Licking Her Pussy & ear Her Big Toe Crack T-Shirts besides I will buy this issue of teasing out signs of cognitive decline, which can be difficult at times. “If you think about the older adult who comes in, they have three, four, five chronic conditions and multiple bodily complaints, all of which may impact their cognition,” Bynum said. “I’m a geriatrician in practice, and I can tell you diagnosing cognitive decline is not always straightforward.” RELATED ARTICLE Eating these foods lowers dementia risk, even with type 2 diabetes and heart disease, study says How can people make sure they are given the cognitive tests they require during yearly wellness visits? Be your own advocate, Ighodaro said. Call in advance to find out if a doctor or hospital provides such assessments as part of the visit and keep looking for one that does, she said. Another tip: Call an insurer in advance to determine which types of additional cognitive tests are covered if indeed they are required. “If one has the slightest concern about their cognition or that of a family member, go get checked out,” Ighodaro said. “It’s better to be reassured by a physician there’s nothing to worry about than wait and not be eligible for these new medications. “Remember, it’s not the patient’s job to determine ‘Is this dementia or not?’ It’s our job.”

Editor’s note: Dana Santas, known as the When You’re Licking Her Pussy & ear Her Big Toe Crack T-Shirts besides I will buy this “Mobility Maker,” is a certified strength and conditioning specialist and mind-body coach in professional sports, and is the author of the book “Practical Solutions for Back Pain Relief.” — The importance of sleep for overall health cannot be overstated — it improves mood, boosts energy and lowers disease risk, to name just a few benefits. Yet many people struggle to achieve restful nights. In the United States, 39% of adults ages 45 to 64 report not getting enough sleep, according to a 2022 survey by the US Centers for Disease Control and Prevention. Now, a small efficacy study published July 16 in the journal BMJ Open Sport & Exercise Medicine suggests a simple yet effective strategy to improve sleep duration: incorporating short resistance, or strength training, exercise breaks in the evening. Based on the findings, this novel approach could transform the way people think about pre-bedtime routines and offer a practical solution for those needing more sleep. Mini strength-training breaks in the p.m. Conducted by researchers from the University of Otago in New Zealand, the small study investigated the impact

of regular three-minute bouts of resistance exercise every 30 minutes over a four-hour period in the When You’re Licking Her Pussy & ear Her Big Toe Crack T-Shirts besides I will buy this evening. Wearing activity monitors, 28 healthy female nonsmokers ages 18 to 40 years old, who typically experienced prolonged sitting during the workday and in the evening, either engaged in activity breaks or remained seated for the duration in a supervised lab setting. The findings were compelling: The participants slept an average of 27.7 minutes longer when they took regular exercise breaks compared with when they sat uninterrupted. Additionally, there were no significant differences in sleep efficiency or the number of awakenings, indicating that the short exercise sessions did not disrupt other aspects of sleep quality. Participants in a small study slept an average of 27.7 minutes longer when they took regular exercise breaks in the evening over a four-hour period compared with when they sat uninterrupted. Aaron Lockwood Even the researchers said the results were unexpected. “Given the current sleep hygiene guidelines, we were surprised to see such a positive impact on sleep,” said lead study author Jennifer Gale, doctoral student of human nutrition at the University of Otago. According to Gale, most traditional sleep hygiene advice

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