Friday, August 14, 2026

Older Humans with a Concentration on Sex and Other Protective Factors

 

Contents

 

  • Requirements
  • Dedication
  • Invitation – UC Irvine – Wednesday, May 14, 2008
  • UCI Study – Lecture Notes (Extended)
  • Sex and QOL, Wellbeing and Satisfaction
  • Betty White’s Position
  • Impotence
  • Role of Fantasy
  • Living Well
  • Protective Factors
  • Performance (Physical) in Older Adults
  • Reprise – Betty White
  • Person of Interest – CH Kawas, MD – Geriatric Neurology
  • Public Lectures
  • CBLM
  • The 90+ Study – UCI MIND
  • Interject COVID related
  • The 90+ Study – Living beyond age 90
  • Laguna Woods Village – Article
  • Confirming Findings
  • Dementia
  • Outreach
  • STEM Fields
  • UCI Neuro Department
  • Scandinavian Longevity Alternating Generations
  • Appendix



Dedicated to Joan “Marie” Nemec-Zhorne

Born 1943 – Most Significant Other Ever (MSOE)

Together 1998-2018

Lived together 2005-2006

Survived & Suffered Congestive Heart Failure (Age 60 in 2003)

Fell prey to dementia




Invitation – UC Irvine – Wednesday, May 14, 2008





Lived Experience - UCI Study

Presentation Notes – In order of presentation
Notes from Lecture (50 minutes)
Principal investigator - Pronunciation Dr. Claudia “K-wass”

Research Questions
What contributes to a 90 year or older individual’s high functionality?
What are some features of 90+ year olds’

 

Life Expectancy (US)

1900 average life expectancy - 48 male and 49 female

1950-68 years old

2003-77.6 years old

2026 added later 79 both sexes combined

 

Year 2000 in China 1.4 million over 90

Year 2008 Leisure World Population now the city of Laguna Woods = 18,442

2020 added later U.S. Census recorded 17,644 residents living in Laguna Woods

2026 added later - Over 2 million people aged 90 and older living in the United States. This "oldest-old" group is one of the fastest-growing parts of the American population, and the total number has more than tripled since 1980.

 

Longevity Expectation (USA)

Added: Average life expectancy at birth in the United States reached an all-time high of 79.0 years, based on final mortality data from the Centers for Disease Control and Prevention. This metric marks an increase of 0.6 years from the prior year, driven by drops in COVID-19 and drug overdose fatalities

 

Impact of Parental Longevity

Added: Parental Longevity boosts a child's chance of living a longer, healthier life. Research shows a person's risk of early death drops by about 17% for every decade that at least one parent lives past age 70. Children of long-lived parents also face lower risks of heart disease, stroke, diabetes, and slow cognitive decline.

 

Fantasy

Added: The psychological role of imagination and play in healthy aging, and the cultural-commercial "fantasy" of escaping biological aging entirely through the booming longevity market.

 

Other Determinants

Vitamin A, C & E = No Affect

Calcium = No Affect

Tea = No Affect

 

Alcohol (EtOH) up to 2 servings per day = decreases Mortality

Caffeine <= 2 cups per day = Decreases in Mortality

 

BMI – Normal and Overweight good

Not wise to drop weight when over 65

 

Activity best 45 minutes per day

More than 45 minutes not beneficial

Activities out and about up to 6 hours per day

Key Word “Moderation”

 

Consider - Living well V Living long V Both

 

Up to 80 years old chance of getting dementia is reasonable

Added: By age 80, roughly 1 in 6 people (about 15% to 18%) will have some form of dementia. The risk of developing the condition is not uniform; it increases significantly as people grow older, doubling roughly every five years past age 65

 

Oxygen

O2 saturation 93-97% OK

< 93% increases chance of dementia

 

FAQs from Audience (2008)

 

  • Effect of WWII activity & greater death of males than females in their 90s
  • Male survivors to and past 90: What did they do during WWII?
  • Effect of smoking tobacco
  • Effect of sex/orgasm

 

Said her team did not assess for sex because it was embarrassing to ask someone as old as your parents about sex.

 


Sex and QOL, Wellbeing and Satisfaction

Sexual health, quality of life (QOL), wellbeing, and satisfaction are deeply connected. Higher sexual satisfaction consistently links to better mental health, lower anxiety, stronger emotional bonds, and a greater overall sense of life satisfaction across all adult age groups.

The Connection to Quality of Life (QOL)

Physical Health Barometer:

Sexual function often reflects general cardiovascular and neurological fitness.

Life Evaluation:

People who report satisfying sexual relationships routinely score higher on standard subjective quality-of-life and health evaluations.

Chronic Illness Impact: Medical conditions like heart disease or chronic pain can lower sexual satisfaction, which in turn impacts overall QOL if emotional or physical symptoms are left untreated.

Wellbeing and Emotional Health

Stress Reduction:

Intimacy and sexual activity release endorphins and oxytocin, which lower daily stress and improve mood.

Lower Distress:

Positive sexual health correlates with lower rates of depression and everyday psychological distress.

Life Balance:

Emotional stability and healthy communication with a partner enhance both general wellbeing and the quality of physical intimacy.

Sexual Satisfaction Factors

More than Frequency:

Satisfaction relies heavily on emotional connection, physical comfort, and mutual pleasure rather than just the frequency of activity.

Partner Communication:

Open dialogue about desires and boundaries directly increases both sexual and relationship satisfaction.

Holistic Self-Care:

Good sleep, a balanced diet, regular exercise, and managing mental health all serve as direct building blocks for a satisfying sex life.


Betty White’s Position on Sex for Older Adults (10-5-2010)

https://www.tvguide.com/news/betty-white-sex-1023975/

Betty White: You're Never Too Old for Sexual Desire

Betty White says sexual desire doesn't melt away with age. In the November/December issue of AARP Magazine, the 88-year-old says that if her third husband, Password host Allen Ludden, were still alive, they'd be spending a lot of time in bed.

 

Medications Associated with Impotence

Many prescription and over-the-counter drugs can cause erectile dysfunction (ED). Common culprits include blood pressure drugs like beta-blockers and diuretics, certain antidepressants (SSRIs), anti-anxiety medications, and 5-alpha reductase inhibitors used for hair loss or enlarged prostates.

Blood Pressure and Heart Medications

Beta-blockers: Propranolol, metoprolol, and atenolol.

Diuretics (water pills): Hydrochlorothiazide and furosemide.

Centrally-acting agents: Clonidine.

Mental Health Medications

SSRIs (Antidepressants): Fluoxetine (Prozac), sertraline (Zoloft), and citalopram (Celexa).

Antipsychotics: Haloperidol, risperidone, and quetiapine.

Anti-anxiety drugs: Diazepam (Valium) and alprazolam (Xanax).

Hormonal and Prostate Medications

5-ARIs: Finasteride (Propecia/Proscar) and dutasteride.

Anti-androgens: Used in prostate cancer care, such as leuprolide.

Hormone treatments: Spironolactone.

Other Common Drugs

Opioids: Morphine, oxycodone, and methadone.

Antihistamines: Diphenhydramine (Benadryl).

Acid reflux drugs: Cimetidine and certain proton pump inhibitors.

 

FYI – AI - If you suspect a medication is causing side effects, would you like to:
Discuss alternative medications in these classes that are neutral or safer for sexual health?
Learn about strategies to manage ED while staying on a necessary prescription?
Please share which specific drug you are curious about if you'd like more tailored details.

 

Role of fantasy in sex

Sexual fantasy plays a vital, healthy role in human sexuality by generating arousal, reducing anxiety, and fulfilling psychological needs like novelty, validation, or stress relief. Fantasies act as an internal safe space where individuals can explore desires without needing to recreate them in real life.

Why We Have Sexual Fantasies

Building Arousal:

Mental imagery stimulates the brain and primes the body for sexual response.

Emotional Escape:

Imagining scenarios helps people disconnect from everyday stress or boredom.

Exploring Taboos:

Thoughts allow safe mental exploration of forbidden or unconventional ideas.

Processing Needs:

They often compensate for unfulfilled emotional or physical desires.

Aside – Search - A video detailing the most common sexual fantasies and what they mean:

Common Themes and Types

Intimacy and Romance:

Focusing on deep connection, passion, or being cherished by a partner.

Novelty and Adventure:

Visualizing new locations, changing routines, or adding variety.

Power Dynamics: Exploring roles of dominance, submission, or rougher physical play.

Validation and Attention:

Imagining being watched or deeply desired by others.

Sharing Fantasies with a Partner

Fosters Intimacy:

Open communication about private thoughts can build trust and vulnerability.

Reduces Shame:

Recognizing that normal, private thoughts do not define your real-world intentions brings relief.

Optional Action:

A fantasy does not have to become a blueprint for physical action; keeping it internal is entirely valid.

 


Added - Living Well

Living well means achieving a healthy, balanced, and meaningful quality of life. It goes beyond basic survival or material wealth to include physical health, emotional joy, personal growth, and strong connections with others. Most users on Quora agree that it centers on daily peace, gratitude, and purposeful actions rather than status.

Added - Living Long (USA)

Key Longevity Factors in the U.S.

Lifespan vs. Healthspan:

Americans often spend their final decade managing chronic illnesses rather than living fully active lives.

Lifestyle Choices:

Regular physical movement, plant-rich diets, and strong social ties add healthy years.

Environment and Care:

Access to clean environments, steady income, and early medical screenings strongly boost personal longevity outcomes.

Financial Planning:

Living past 80 requires larger retirement funds and proactive long-term health care strategies.

 

Note: In general women in the USA live longer than men

As physical performance decreases risk for ALZ in older adults increases

 

Protective Factors (Dementia & Longevity) - Summary

 

  • Added: Around 8.5 hours of rejuvenating sleep
  • Alcohol (EtOH) and coffee in moderation
  • Chair Stands without using your hands (x4 times per day)
  • Exercise 45 minutes per day
  • Good Standing Balance
  • Learning new things
  • Nutrition – Focus heart health
  • Rest decreases stress (Time outs)
  • Social Engagement(s)
  • Strong Grip Strength
  • Walking normal V tiny steps is protective

 


Performance in Older Adults

Typical physical performance for a healthy older adult (ages 65+) includes a normal walking gait speed of about 1.0 meter per second, the ability to complete 10 to 19 chair stands in 30 seconds, and the endurance to walk roughly 150 minutes of moderate aerobic activity per week.

Key Performance Benchmarks

Walking Speed:

A normal gait speed is near 1.0 m/s; speeds below 0.8 m/s often signal a higher risk of frailty or mobility issues.

Lower Body Strength:

Completing 14 to 19 chair stands (ages 60s) or 10 to 17 stands (ages 70+) in 30 seconds without using hands.

Balance: Standing unsupported on one leg for 10 to 20 seconds.

Aerobic Capacity:

Accumulating 150 minutes of moderate-intensity activity, like brisk walking, weekly.

Factors Affecting Performance

Muscle Mass:

Natural age-related loss of muscle mass (sarcopenia) changes strength limits.

Joint Health:

Stiffness or past wear-and-tear can lower speed and flexibility.

Activity Level:

Regular training dramatically improves baseline scores compared to a sedentary lifestyle.

 

FYI – AI - If you have a specific test or age group in mind, tell me:

The specific age of the adult

Which skill or test you want to measure (like walking, grip strength, or memory)

I can give you the exact expected range for that category.

 

Feature Betty White

Betty White’s Position on Sex for Older Adults

For Women, Sex Gets Better With Age—Right, Betty White?

 

Betty White and Our Cruel Obsession with…DO Women

Betty White became a beloved cultural icon through her sharp wit and saucy humor, yet cultural critiques—such as a notable essay in The New Republic—argue that reducing an accomplished, decades-long career to an obsession with "dirty old lady" jokes can be a patronizing form of ageism.

 

FYI - New Republic

https://newrepublic.com/article/113296/betty-white-and-our-cruel-obsession-dirty-old-women

Jun 15, 2013 (@ Age 91)

The NBC reality show “Betty White's Off Their Rockers” features senior citizens pranking unsuspecting youths.

 

Betty White

Born January 17, 1922 | Passed Away: December 31, 2021 (aged 99)


Person of Interest - Doctor Claudia H. Kawas MD

University of California, Irvine

https://www.faculty.uci.edu/profile.cfm?faculty_id=4890

Dec 16, 2021

At UCI, she is Co-PI of The 90+ Study and Associate Director of the Institute for Memory Impairments and Neurological Disorders.



Dr. Kawas is looking like she is having a pretty good life.

Public Lectures at the Irvine Barclay Theatre

University of California, Irvine - Outreach

https://cnlm.uci.edu/outreach/barclay-lectures/

Our public lectures are free to the public and are meant to encourage community engagement with science, and promote public understanding of the brain, learning and memory. Lectures are held at the Irvine Barclay Theatre and are free. Attendees are provided with ample opportunity to interact with and ask questions of the speakers. Lectures are generally 45-50 minutes long and are followed by about 20-30 minutes of questions from the audience.

 


Lecture Series – Information

Aside

https://cnlm.uci.edu/distinguished-barclay/

Has past lectures cataloged

 

Legacy Presentation – Joan and Keith Attended
How to Get Old:  Lessons from 90-year-olds
Claudia Kawas, M.D. – Professor of Neurobiology and Behavior
University of California, Irvine
Wednesday, May 14, 2008 – 7:30 p.m.
Irvine Barclay Theatre

 

Claudia Kawas, M.D.

https://cnlm.uci.edu/kawas/

Professor, Neurology School of Medicine. Professor, Neurobiology and Behavior School of Biological Sciences. Phone: (949) 824-2323




The 90+ Study - UCI MIND

FYI - http://www.mind.uci.edu/research-studies/90plus-study/

Co-Principal Investigators: Claudia Kawas, MD; Maria Corrada, ScD

Co-Investigators: Annlia Paganini-Hill, PhD; Dana Greenia, RN, MS

 

The 90+ Study was initiated in 2003 to study the oldest-old, the fastest growing age group in the United States.  The 90+ Study is one of the largest studies of the oldest-old in the world. More than 1,600 people have enrolled.  Because little is known about people who achieve this milestone, the remarkable increase in the number of oldest-old presents a public health priority to promote the quality as well as the quantity of life.

The 90+ Study participants

Initial participants in The 90+ Study were once members of The Leisure World Cohort Study (LWCS), which was started in 1981.  The LWCS mailed surveys to every resident of Leisure World, a large retirement community in Orange County, California (now incorporated as the city of Laguna Woods).  Using the 14,000 subjects from the LWCS, researchers from The 90+ Study were able to ask, What allows people to live to age 90 and beyond?

Studying the oldest-old

Participants of The 90+ Study are visited every six months by researchers who perform neurological and neuropsychological tests. Our researchers at the Clinic for Aging Research and Education (CARE), located in Laguna Woods, obtain information about diet, activities, medical history, medications and numerous other factors. Additionally, participants are given a series of cognitive and physical tests to determine how well people in this age group are functioning.

Goals of the study

Determine factors associated with longevity:  What makes people live to age 90 and beyond? What types of food, activities or lifestyles are associated with living longer?

Examine the epidemiology of dementia in the oldest-old: How many people aged 90 and older have dementia?  How many become demented each year?  What are ways to remain dementia-free into your 90s?

Examine rates of cognitive and functional decline in the oldest-old: How do memory loss and disability affect those in their 90s?  How can people prevent memory loss and disability at this age?

Examine clinical pathological correlations in the oldest-old:  Do the brains of people in their 90s show evidence of memory loss and dementia?  Do people with dementia have differences in their brains that can be detected and treated?  Determining Modifiable Risk Factors for Mortality and Dementia: What kinds of things can people change in their lives to live longer? Can people change their risk of dementia through diet, exercise or supplements?

Major findings

Researchers from The 90+ Study have published many scientific papers in premier journals.

 

Some of the major findings are:

People who drank moderate amounts of alcohol or coffee lived longer than those who abstained.

People who were overweight in their 70s lived longer than normal or underweight people did.

Over 40% of people aged 90 and older suffer from dementia while almost 80% are disabled. Both are more common in women than men.

About half of people with dementia over age 90 do not have sufficient neuropathology in their brain to explain their cognitive loss.

People aged 90 and older with an APOE2 gene are less likely to have clinical Alzheimer’s dementia, but are much more likely to have Alzheimer’s neuropathology in their brains.

 

Promotion – Not Certain if this is Current

The 90+ Study is seeking new participants. If you are at least 90 years old and are willing to participate in twice annual visits and donate your brain to research after death, you may be eligible to enroll in The 90+ Study. Please contact 949.824.2323 or study90@uci.edu  or 1517 Hewitt Hall, Irvine, CA 92637-1400 (mailing address) for more information.

 

COVID Pause

“Given the current and rapidly evolving situation with COVID-19, The 90+ Study is taking measures to keep our participants and researchers safe from exposure. Until further notice, all in-person visits and brain scans are suspended. We will be conducting telephone visits for those with biannual appointments until the situation is over. We want to make sure that our participants are staying healthy, safe and have everything they need so please contact us at (949) 768-3635 if there is anything we can do to help. We will be checking our messages almost daily.”

 

Brain Donations

Please also know that we are doing everything possible to continue with the brain donation program during this time. If you have any specific questions or concerns, please contact us and we will get back to you as soon as possible.  We are confident in our study’s ability to navigate this unprecedented set of challenges together with our participants and their families. In the meantime, we extend our profound thanks for your dedication, patience and compassion.

 

Aside - For additional resources, please contact:

 

  • Alzheimer’s Orange County 24/7 Helpline at (844) 435-7259
  • Council of Aging at (714) 479-0107
  • Heartland Hospice care at (888) 327-6590

 

 

The 90+ Study - Living beyond age 90 | UCI Health | Orange County, CA

https://www.ucihealth.org/blog/2015/02/living-beyond-age-90

Feb 26, 2015 90+ Study

Alcohol and coffee longevity role

According to UC Irvine’s trailblazing 90+ Study, people who drink moderate amounts of alcohol or coffee live longer than those who abstain. Co-directed by UCI Health geriatric neurologist Dr. Claudia Kawas, the 90+ Study is the longest continuing research effort focused exclusively on the distinctive health and lifestyle issues of Americans in their 90s or older.

 

The UCI 90+ Study at Laguna Woods Village - Baby Boomer

https://www.baby-boomer-retirement.com/2014/05/the-uci-90-study-at-laguna-woods-village.html

May 8, 2014 - The study is being conducted by Dr. Claudia Kawas, a medical ... UCI researchers sent surveys to the residents of Laguna Woods ... They were able to find nearly 1900 of them who were still alive and in their 90's or older.

 

Key Words

Geriatric Neurologist
Drinking Coffee
Laguna Woods
Dementia
Claudia Kawas, MD
Lived Experience

 

The UCI 90+ Study at Laguna Woods Village

https://www.baby-boomer-retirement.com/2014/05/the-uci-90-study-at-laguna-woods-village.html#google_vignette




On May 4, 2014, the CBS television show, "60 Minutes" featured a study that is taking place in the retirement community where I live, Laguna Woods Village in Southern California.

The study is being conducted by Dr. Claudia Kawas, a medical doctor and professor of neurology at the University of California in Irvine.  However, the study actually started about 30 years ago ... long before Dr. Kawas was in Irvine.



Between the years of 1981 and 1984, UCI researchers sent surveys to the residents of Laguna Woods Village (then called Leisure World).  Nearly 14,000 residents completed them.  The surveys asked a wide range of questions over topics such as health, marital status, the activities in which they participated, foods they ate, vitamins they took, alcohol consumption, etc.

The average participant was 73 years old at the time of that first survey.  Two-thirds of them were women.  Most were white and about 40% were college graduates.   During the following years, the original group of participants were asked to update their information in 1982, 1985, 1992, and 1998.  Gradually, of course, the group got smaller.


Then, in 2003, UCI researchers took these dusty old folders off the shelf and decided to see how these people were doing.  They were able to find nearly 1900 of them who were still alive and in their 90's or older.  Approximately 1600 of them enrolled in Dr. Kawas' current study and agreed to submit to extensive testing. 


In addition, 306 people in this group agreed to donate their brains to the researchers after death.  So far, they have done autopsies on approximately 210 of those brains.

 

The research has been fascinating and I have summarized it below after watching both the "60 Minutes" episode as well as a YouTube video by Dr. Kawas.



UCI Research on Longevity: [Confirming Findings]


Vitamin consumption did not seem to help people live longer, although it may help in other areas, such as preventing fractures, etc.


Drinking a glass or two of alcohol of any type (not just red wine) occasionally (not necessarily daily) seemed to help people live longer.


Caffeine from all sources, including soft drinks, chocolate, tea and coffee did make a difference.  People who consumed about 200 mg. of caffeine a day (2-3 cups of coffee) seemed to live longer.  People who consumed too much or too little did not live as long.


Being of average weight or heavier seemed to be protective; being too thin was associated with an increased risk of early death.  People who were underweight in their 70's had a 50% increase in their mortality rate.  People who were of normal weight or overweight in their 70's had a 3% lower mortality rate for each year they lived.


While having low blood pressure was healthier for younger seniors, having high blood pressure seemed to benefit those who are over the age of 90.


It was beneficial to stay mentally, physically and socially active as long as possible.  About 45 minutes a day of physical activity seemed to help people live until their 90's.  More time spent in exercise did not make a difference.  In addition, the activity did not need to be intense in order to benefit this age group.  It did not have to be jogging and it did not have to be all at once.  It could be broken up into two or three periods of activity a day. As for leisure/social activities, those were also associated with a longer lifespan.



UCI Research on Dementia: (Confirming Findings]

 

Risk

There are more than 100 pathologies that can lead to dementia.  Alzheimer's is only one form of dementia, although it is one of the most common.  The more different pathologies you have, the higher your risk of developing dementia.

 

Researchers have long believed that plaques and Amyloid tangles in the brain are related to Alzheimer's Disease and other forms of dementia.  However, the brain autopsies that have been completed to date are bringing this into question.  So far, half of the people with dementia had plaques and tangles, while half did not.  In addition, the reverse has also been true.  Half of the people without dementia had plaques and half did not.  Dr. Kawas is now concluding that plaques and Amyloid tangles may not be as closely related to Alzheimers and other forms of dementia as we first thought, although there is still some reason to believe that it does matter.  Researchers are concluding that dementia is more complicated than they first thought.

 

Three or more micro-infarcts or mini-strokes in the brain can multiply your chances of having dementia by five times.

Age seems to matter the most in regard to dementia.  By age 85 about 5% have dementia; at 90, 10% of all seniors have dementia; by age 95, 20% have dementia; by 100, 40% have dementia.

Low oxygen levels in the blood, especially below 93%, doubled your chances of developing dementia.

Low walking speed resulted in an eleven times great risk of dementia.

People with a weak hand grip had a five times greater risk of dementia


High blood pressure and high cholesterol apparently REDUCES your chances of dementia (although these are still related to a higher incidence of heart disease and strokes).  Researchers are now studying whether it is the blood pressure and cholesterol themselves, or if it is the drugs that are given for these illnesses, that provide the protection.

This report was fascinating ... and they are not finished, yet.  They intend to continue studying this group of people until they have all died.  Who knows what other incredible facts are still to be discovered?

Aside - If you want to watch the entire "60 Minutes" episode for yourself, which also includes an update on the BP oil spill in the Gulf of Mexico, you can find it here:

http://www.cbsnews.com/videos/over-a-barrel-90/

 

If want to see an even more in-depth lecture by Dr. Kawas, here is a YouTube video of her giving a guest lecture at the University of California in Davis:

https://www.youtube.com/watch?v=bXWhCniCWck

 

FYI – AI - Aside - If you are looking for more interesting information to assist you with aging and retirement, use the tabs at the top of this blog.  They contain links to hundreds of articles to help you.

You are reading from the blog: 

http://www.baby-boomer-retirement.com

Photo Held Back - Photo credit:  Photo of a clubhouse at Laguna Woods Village was taken by Author, Deborah-Diane.  All rights reserved.

Demographics

Posted by Deborah-Diane at 7:51 PM   (Wednesday, August 5, 2026)

Labels: alzheimers research, alzheimers risk factors, Dr. Claudia Kawas research, how to live to be 90, research on 90+ population, UCI study of Laguna Woods Village residents, UCI study of the elderly

 

Outreach

Center for the Neurobiology of Learning and Memory | UCI CNLM

https://cnlm.uci.edu/outreach/ (2025)

Connecting Neuroscience and Society

The Center for the Neurobiology of Learning and Memory (CNLM) at UC Irvine is committed to serving students and the community through our outreach programs directed by the Outreach Team of Dr. Manuella Oliveira Yassa, Director of Outreach and Education; Dr. Morgan Coburn, Assistant Director of Outreach and Education, and Dr. Erin Purvis Conway, Civic Science Fellow. Our public lectures foster community engagement and understanding of the brain, learning, and memory. Our K-12 programs facilitate a new passion for neuroscience in the next generation of brain scholars. The CNLM Ambassador Program is a trainee-led neuroscience outreach, education, and training group run and founded by Dr. Oliveira Yassa. The Program not only serves the community, but also enriches its trainees by offering pedagogy, project management, and leadership training, teaching and scientific communication opportunities. Through their participation, Ambassadors broaden their connections in the field of neuroscience, foster community and identify outlets for engagement outside of the lab.

 

Mission and Vision:

 

  • To advance public understanding of brain science
  • To bridge the gap between neuroscience and society
  • To inspire youth to pursue education and careers in STEM fields
  • To broaden participation in neuroscience
  • To foster an inclusive and supportive environment for CNLM scientists

 

 

STEM Fields

STEM is an acronym for Science, Technology, Engineering, and Mathematics. It groups these four closely related academic and professional disciplines together. These fields focus on innovation, scientific inquiry, logical reasoning, and solving real-world problems.

The Four Core Pillars of STEM

Science:

Studies the natural and physical world through observation and experiments (includes biology, chemistry, and physics).

Technology:

Focuses on computers, software systems, networks, and data management to build digital tools.

Engineering:

Applies scientific and mathematical principles to design and build physical structures, devices, and systems.

Mathematics:

Uses numbers, formulas, and logic to analyze data, model systems, and solve abstract problems.

Popular Disciplines and Majors

Computer Science:

Software development, artificial intelligence, and cybersecurity.

Life and Physical Sciences:

Biology, biochemistry, chemistry, and physics.

Traditional Engineering:

Mechanical, civil, electrical, and aerospace engineering.

Math and Data:

Statistics, data science, and actuarial science.

 

FYI – AI - If you'd like, let me know:
Are you looking for a specific career path or college major?
Do you want to know about job growth or salary estimates?
I can provide more tailored information for your goals.

 

Aside - The 9th Annual Arnold Starr Lecture and Exhibition

http://www.neurology.uci.edu/starr-lecture/

Admission: Free (No RSVP Required)

Arnold Starr Lecture was established in 2010 at the University of California, Irvine to honor Dr. Arnold Starr, the founding chair of the UC Irvine Department of Neurology, and to celebrate advancements in neurophysiology, cognitive neuroscience, and the study of the auditory system.

 

FYI – UCI Department of Neurology (August 12, 2026)

https://www.ucihealth.org/medical-services/programs/neurology

 

Our approach to neurology

Our goal is to provide you with patient-centered, individualized and compassionate care. We offer you evidence-based medicine with a holistic, integrated approach.

 

How we work together

Neurology is an intricate and complex field. Your brain, spinal cord and nervous system are responsible for managing:

Your senses – what you see, hear, feel, touch and taste

How you move

Your cognitive ability, thoughts and feelings

Involuntary activities like breathing, heart pumping and metabolic processes

 

Body activities like temperature control, blood pressure, thirst, hunger and digestion

Your case is unique, but you can expect to work with a highly specialized team based on your diagnosis. We are naturally collaborative and work across multiple departments to provide the most accurate diagnosis and the best treatment options. Our team will coordinate your access to care across our subspecialties.

 

The advantages of an academic hospital

The benefits to you include:

  • Highly integrated network of generalist and specialist providers
  • Access to the most sophisticated diagnostic testing and the latest treatments
  • Leading-edge research on the future of medicine and neurological advances
  • Includes access to clinical trials that offer hope for complex neurological issues

 

In fact, we have over a hundred clinical trials taking place in neurology. At UCI Health, the gold standard in medicine, the latest treatments and integrative add-ons such as acupuncture and Tai-Chi are all available.

 

We offer telemedicine

We love to see you in person, but many of our specialties work well via telemedicine, saving you the drive. However, sometimes there's no substitute for coming in for hands-on exams and testing. We'll always find time for you if you need to visit us in person at our clinic.

 

Why choose UCI Health for neurology care?

 

We're meeting the needs of our patients across all ages

Neurological diseases can hit at any age, but as we age, there’s an increased risk of getting disorders such as Alzheimer's, Parkinson’s, stroke, and epilepsy. To keep pace, it's our responsibility to make sure we keep delivering the most advanced treatments.

 

We’re growing the movement toward precision medicine

Because many neurological disorders are complex and mimic other illnesses, getting a precise diagnosis is vital. For example, we not only want to understand an Alzheimer's diagnosis but everything else that could possibly play into it. If there are vascular or any other risks, we’ll spot them with ultra sophisticated testing and imaging.  High level, precision diagnostics allow us to get you the right treatment at the right time while minimizing side effect risks. We’re currently expanding our precision neurology and precision Parkinson’s programs.

 

We have a rare offering, a women’s epilepsy program

Neurological disorders and symptoms sometimes affect men and women differently. Dr. Mona Sazgar is one of the world’s foremost experts and leads our women’s epilepsy services. If you’re an epileptic woman, you may benefit from seizure treatments that take your hormones and reproductive health into account.

 

We treat the most difficult-to-control conditions

We will help you manage complex and challenging neurological disorders that may resist standard treatment methods. That includes rare diseases, advanced stages of common neurological conditions, or cases with multiple, interacting symptoms needing a highly specialized approach.

 

For example, if you have drug-resistant epilepsy, our highly skilled team performs complex electroencephalogram (EEG) studies. This helps us find the “origin of the storm” of electrical activity. You may then benefit from advanced surgical procedures and neuromodulation device implants.

 

Aside - The UCI Health neurology program has one of the only specialized brain monitoring units in Southern California

We can handle as many as six patients at once. This monitoring unit allows our specialists to track and locate seizure origins in the folds of your brain. If epilepsy medication isn’t a good fit and surgery is the better option, we can map your brain with pinpoint accuracy.

 

FYI - Distinguished Lecture on the Brain - UCI MIND

http://www.mind.uci.edu/events/lecture-series/

Illustrious speakers from across the country are invited to deliver community lectures on their research in the area of brain, learning, and memory.  This series is held at the Irvine Barclay Theatre on UCI Campus and is free to the public. Check back soon for updates and tickets for our upcoming lecture:

 

FYI - What Can We Learn from the Sleeping Brain? (About 1 hour long on You Tube)

Ruth Benca, MD, PhD, UC Irvine - February 7, 2017

https://youtu.be/5lrhdFq4vew

 

Scandinavian Longevity Alternating Generations

Primary Reference: https://www.nature.com/articles/5201832

Historical Scandinavian demographic and epidemiological studies (particularly using Swedish and-overlapping historical cohort records) have identified sex-specific, alternating-generation (transgenerational) responses in human longevity and metabolism linked to ancestral food supply during the slow growth period (SGP).

Transgenerational Responses

Grandparent-to-Grandchild Link:

Research using historical Scandinavian parish databases (such as those from northern Sweden) showed that a grandfather’s nutrition during his slow growth period specifically impacts the longevity and metabolic health of his male grandchildren, bypassing the intervening father.

Sex-Specific Paths:

Dietary abundance or severe famine shocks experienced by a paternal grandfather during pre-adolescence route directly to the grandson's lifespan outcomes, mirroring a separate maternal grandmother-to-granddaughter transmission line.

Father-to-Son Effects:

Direct linear responses from father to son also occur, but the multi-generational "skipped" generation effect operates explicitly along the same-sex lineage (grandfather to grandson).

Underlying Factors

Epigenetic Imprinting:

Environmental stressors like food scarcity modify chemical tags on sex chromosomes or autosomal DNA during gametogenesis in the growing child.

Resilience Transmission:

Surviving early-life nutritional adversity builds an inherited physiological or metabolic resilience that manifests in later male descendants.

 

FYI – AI - If you'd like, I can provide more details on:
The exact age range defined as the slow growth period (SGP)
How historical Scandinavian famine data was mapped in these studies
The biological mechanisms proposed for sex-specific chromosome imprinting


 

Appendix – MSOE Health Records






Friday, August 7, 2026

Making the most of a Neurology Consult by Keith Torkelson, MS, BS

 


Contents

 

  • Specifications
  • Goal(s)
  • Presenting Problems
  • List of Medications
  • Notes & Time Line
  • Comprehensive Consultation with a Neurologist
  • Treatment Plan/Summary of Visit
  • Baselines
  • Medication in the ER
  • Routine Meds in the ER
  • Tremors
  • When to see a Neurologist
  • Imaging and EEG
  • Early onset of dementia
  • Treating dementia
  • Tremors and Weakness
  • Practical Lithium
  • Practical Abilify
  • Practical Wellbutrin
  • Combination Therapy
  • Lithium Fix
  • Avoiding the Psych Ward I & II




Goals

Address checklist
Address presenting problems
Describe how your issues impact work, sleep, or daily routines
Get a clear diagnosis
Have EEG performed
Have scanning performed
Make the most of our appointment
Medication PRN
Guarded changes to existing treatment plan
Note specific triggers or patterns you noticed
Not have Neurology problems
Share family medical history related to the brain or nerves
Share list of current medications
Understand how your symptoms affect your daily life
Walk away with a concrete testing or treatment plan

 

Preparing for Neurology Consultation

Presenting Problems – Elimination List

 

  • Abilify Toxicity
  • Dementia
  • Epilepsy
  • Lithium Toxicity
  • Risk of Falling
  • Sleep
  • Stroke
  • Tremors
  • Walking
  • Wellbutrin Toxicity

 

List of Medications [Stayed]




Notes & Time Line

20260702-TH-PCP ruling out need for a neurologic exam.  2pm with Dr. Nguyen.  Presenting problem – Balance, Unsteadiness, Tremors, Risk of Falling & Gate.  Have been using a walker a bit.  Appointment located at Garden Grove Central City, Passed dementia screening with a score of 4/5 with high scores being favorable.  Would not give referral to a neurologist.  Says our medial quadriceps (Vastus) is atrophied.  Committed to more exercise (walking). 

 

Get a second opinion: You can always ask another PCP for their take on your symptoms.

 

20260714-TU-Morning medication gap > Informed staff I will call the pharmacy > Pharmacy says all meds to be delivered tonight.  Make note of favorable impact.  Meds arrive.  Note that our nursing staff maintained gap-free delivery since June 20, 2024.

 

20260715-W-Resume morning meds.  Med management with Dr. Bera.  When I said side effects (ARs) he said we will do them at the end.  We didn’t get around to ARs.  We did discuss a referral to a neurologist. He said see the PCP for a referral.

 

20260716-TH-Adverse Reactions (ARs) resume.

 

20260717-F-Begin Neurology research.

 

20260719-SU-Hope for appointment with Nurse Practitioner N Bim (Second opinion)

 

20260720-M-Called Central City. Decided to keep appointment with Dr. Nguyen

 

20260721-TU-Dr. Nguyen

Appointment originally scheduled for Dr. Nguyen to sign our DNR and POLST.  He did so.  After reviewing our notes (assessment) he approved a referral to a neurologist.

 

20260723-TH-Prospective Medications associated with ARs

Abilify, Wellbutrin, and Lithium.  Shared walking and weakness situation with sister CMF.  She wasn’t very helpful.  Didn’t discuss issue with oldest sister because she is focused on herself rather than us.

 

20260724-F-Telepsychiatry

NP Ogbonna - I have debilitating side effects.  Need to adjust morning meds.  Said he couldn’t do it because he doesn’t know my baseline.  In context of falling he says go to ER or see Dr. Bera (RBB).  Made appointment for Bera July 29 (W) at 1pm.

 

20260729-W-Psychiatry Appointment – Major Milestone - Dr. RBB discontinued Lithium. 

 

20260731-F-Build Confidence Walking without Walker

Walked in the park without walker.  Total distance for day with and without walker just over 1.6 miles.  Received Neurology Approval in the mail.

 

20260803-M-First drink tea. Made me giddy.

 

20260805-W-Confidence Building

Walked to storage without walker.  Could work storages key pad without tremor.  Drank tea. Less fatigue @ 5pm.    

 

20260806-TH-Goal to not use walker at all today.  Not met.

 

20260807-F-Car trip driving Dave P. to the bank.  Make rough draft of graph of Fatigue, Tremors, and Walking Confidence.  Publish this study on Google Blogger.

 

Comprehensive Consultation with a Neurologist

A comprehensive neurological consultation is an in-depth medical evaluation lasting 45 to 90 minutes. It involves reviewing your detailed medical history, conducting a physical nervous system exam, and planning diagnostic tests or treatments for brain, spine, or nerve conditions.

What Happens During the Visit

Medical History:

The doctor asks about your current symptoms, past health, family background, and medications.

Physical Exam: The doctor tests your balance, coordination, reflexes, strength, and senses using simple, painless tools.

Mental Check:

The doctor evaluates your memory, speech, and thinking skills.

Common Tests Ordered Next

Imaging:

Scans like an MRI or CT scan to view pictures of your brain or spine.

Electrical Tests:

An EEG to check brain waves or an EMG to check nerve and muscle function.

Blood Work:

Lab tests to rule out other medical issues.

How to Prepare

Bring a list of all your current medicines and doses.

Write down a timeline of when your symptoms start and how often they happen.

Bring copies of past test results, scans, or notes from other doctors.

FYI – AI - If you'd like, please share:

What main symptoms or concerns you have

What tests or past records you already have ready

I can help you list specific questions to ask your doctor.

 

Scan Treatment Plan – Summary of Visit

2026 Sample – Possible Held Back [Stayed]


FYI - Ogbonna Iwuamadi Olelewe - Nurse Practitioner with Central City

 

In psychiatry what is a baseline?

In psychiatry, a baseline is a person's normal, stable state of emotional, mental, and behavioral functioning. It serves as a starting point to compare future changes, measure how severe symptoms are, and see if a treatment is working.

Why a Baseline Matters

Spotting changes:

Doctors look at a baseline to see if a patient gets worse or shifts away from how they usually act.

Guiding care:

It helps providers choose the right medicine or therapy goals.

Measuring progress:

Doctors compare new check-ups against the starting baseline to see if healing happens.

What Makes Up a Baseline

Mood:

How a person generally feels day-to-day (such as calm or even-tempered).

Thinking:

How well a person focuses, remembers, and makes choices.

Daily habits:

How a person sleeps, eats, works, and talks with others.


 

What to expect in terms of medication in the ER?

In the emergency room (ER), medication management focuses on rapid stabilization, symptom relief, and diagnostic work. Expect a nurse to start an IV line for fast delivery, receive common treatments like anti-nausea drugs or fluids, and experience a tiered approach to pain management where oral options are often tried before intravenous ones.

Administration and Safety

IV Access:

An intravenous line is frequently placed to deliver fluids or medications quickly.

Reconciliation:

Nurses and doctors will repeatedly ask for your allergy history and a list of current home medications.

Monitoring:

Vital signs and heart monitors may be attached to track how your body responds to powerful treatments.

Common Types of ER Medications

Symptom Relief:

Frequent treatments include anti-nausea medications (like ondansetron) and basic intravenous fluids or anti-inflammatory drugs.

Pain Management:

Non-opioid or oral pain medications are generally offered first. Stronger intravenous options are reserved for severe pain.

Acute Interventions:

Depending on your emergency, targeted drugs like asthma inhalers, blood pressure adjusters, or antibiotics may be given.

 

If you have a specific symptom or medical concern in mind, let me know and I can share what targeted treatments or medications doctors usually consider.

 


Will they give you your routine medications while in the ER?

Generally, the emergency room (ER) will not automatically give you your routine daily medications unless they are critical for your immediate condition or acute care while you are there.

Why the ER Handles Routine Meds Differently

Focus on Emergencies:

The ER is designed to diagnose and stabilize acute, life-threatening issues, not manage chronic, long-term care routines.

Safety and Verification:

ER doctors must verify every drug, dose, and timing through your medical records or pharmacy before giving it, which takes time.

NPO Status:

If you need tests, procedures, or surgery, doctors may keep your stomach empty (NPO), meaning no oral medications are allowed.

Hospital Supply Rules:

Hospitals rarely let you take your own loose pills from home due to safety and contamination risks; they must stock and dispense their own supply if a doctor orders it.

What You Should Do

Bring a List:

Bring an accurate, up-to-date list of all your medications, doses, and schedules.

Speak Up:

Tell your nurse or doctor right away if a critical medication (like for seizures, blood pressure, or insulin) is due soon or if you are feeling symptoms from missing a dose.

Expect a Delay:

If your routine medication is missed during a short ER visit, it can usually be resumed safely once you go home or if you are admitted to an inpatient hospital room.

FYI – AI - If you'd like, let me know:

What specific medication you are due to take

How many hours it has been since your last dose


Should you see a neurologist if you have tremors?

Yes, you should see a neurologist for tremors. A neurologist is a doctor who specializes in brain and nerve problems. Tremors can be signs of nervous system issues like Parkinson's disease, multiple sclerosis, or other movement disorders. Tremors are often a symptom of underlying brain activity errors. You can often start by visiting your primary care doctor. They will do a basic checkup and may refer you to a neurologist if the tremors are persistent.

A neurologist will perform a physical exam to test your:

Coordination

Coordination refers to the act of organizing people, groups, or activities to work together harmoniously, efficiently, and with unity of action. It also denotes the ability to synchronize different elements smoothly, whether referring to human teamwork, physical bodily movements, or specialized concepts in chemistry and grammar.

Balance

Balance refers to an even distribution of weight, steadiness, or the harmony between opposing elements. The term applies across multiple disciplines, from a physical ability and artistic principle to accounting and physiology.

Muscle strength

Muscular strength is the maximum amount of force a muscle or muscle group can generate in a single, maximal effort. It is measured by how much weight you can lift or how much resistance you can push against for a short period of time.

 

They may also order tests or imaging to rule out other causes and confirm exactly what is causing your shaking.

 

When to See a Neurologist?

https://www.rush.edu/news/when-see-neurologist

Part of Presenting Problems – Neurology Assessment






ND = Not Diagnosed | RT = Real Time | LSF = Low Scores are Favorable

Scale

0.0      = No | 0.50 = SoSo | 1.00 = Yes

20260729-W-Dr RBB discontinues Lithium

Grounds to see a neurologist

See a neurologist if you have unexplained numbness, sudden muscle weakness, or severe dizziness. You should also book an appointment if you experience chronic migraines, persistent memory loss, or sudden seizures. Ditto: Neurologists are medical doctors who treat the nervous system, which includes the brain, spinal cord, and nerves. Neurologists diagnose and manage conditions like stroke, multiple sclerosis, and Parkinson's disease. They act much like a master electrician for your body. If the wiring (nerves) is damaged, the power fails to reach your lights (muscles). A neurologist finds exactly where the short-circuit is.

Here are specific red flags to watch for:

Nerve Pain:

Sharp, burning, or tingling pain (like pins and needles) in your hands or feet.

Balance Issues:

Feeling unsteady, clumsy, or experiencing ongoing vertigo (the sensation that the room is spinning).

Cognitive Decline:

Noticeable changes in short-term memory, sudden confusion, or trouble finding the right words.

Vision Changes:

Sudden double vision, blurry vision, or vision loss.

For more detailed information, you can review the Rush guide on neurological symptoms or explore the Cleveland Clinic overview of what neurologists do.

To help narrow down your situation, could you tell me:

What specific symptoms are you or your loved one experiencing?

How long have these symptoms been happening?

I can provide more targeted information or help you prepare for a doctor's visit.

 

Neurological Imaging and EEG

Neurological imaging and electroencephalography (EEG) are vital tools used to evaluate brain health. An EEG measures electrical signals from the brain via scalp electrodes, offering millisecond-level timing of activity, while imaging like MRI or CT provides detailed structural maps. Together, they map both brain structure and function.

How EEG Works

Uses small metal discs (electrodes) placed on the scalp

Records tiny electrical impulses from active brain cells

Displays brain wave patterns (like alpha or delta waves) on a screen

Excels at real-time tracking and timing (millisecond precision)

Limited in pinpointing the exact deep location of brain signals (spatial resolution)

How Neurological Imaging Works

Includes structural scans like MRI (Magnetic Resonance Imaging) and CT (Computed Tomography)

Includes functional scans like fMRI (functional MRI) and PET (Positron Emission Tomography)

Provides clear, detailed pictures of brain anatomy, blood flow, or metabolic activity

Shows physical damage, tumors, strokes, or structural defects clearly

Slower at tracking rapid split-second changes in brain activity compared to EEG

Common Uses in Medicine

Diagnosing and monitoring epilepsy and seizure disorders

Evaluating sleep disorders

Assessing recovery after traumatic brain injury

Investigating cognitive decline, memory issues, or unexplained confusion

FYI – AI - If you are looking for specific information, tell me:

Are you preparing for a test or procedure?

Are you trying to understand a specific diagnosis like seizures or sleep issues?

 

How do you know if you have early onset of dementia?

Early-onset dementia (symptoms appearing before age 65) often starts subtly. Key early indicators include short-term memory loss (e.g., repeatedly asking the same question), difficulty completing routine tasks like balancing a checkbook, spatial disorientation, language struggles, and uncharacteristic personality changes or social withdrawal.

Specific early signs often vary based on the underlying disease:

Alzheimer’s Disease:

Short-term memory issues, difficulty concentrating, and misplacing items in bizarre locations.

Vascular Dementia:

Challenges with planning, organization, decision-making, and focus.

Frontotemporal Dementia:

Changes in behavior, loss of inhibition, reduced empathy, and language problems.

Lewy Body Dementia:

Visual hallucinations, sleep disturbances, and fluctuating alertness.

If you notice these changes disrupting daily life, consult a healthcare provider for a thorough evaluation. Early intervention can help manage symptoms, access support services, and slow progression. You can find resources and diagnostic centers through the Alzheimer's Association or Dementia UK.

 

Conditions: Your symptoms—including tingling, disequilibrium, and memory changes—could point to several different underlying issues, such as Vitamin B12 deficiency, Peripheral Neuropathy, or progressive neurological conditions. Because many of these overlap with your family history of strokes, they require a professional evaluation.

A few main possibilities for these combined symptoms include:

Vitamin B-12 Deficiency:

Often overlooked, low B-12 causes 'pins and needles' sensations alongside significant cognitive symptoms like memory loss, confusion, and trouble finding words.

Peripheral Neuropathy:

Nerve damage typically originating in the feet and hands that causes tingling, numbness, balance issues, and unsteadiness.

Vascular Conditions:

Given the family history of strokes, conditions affecting blood flow to the brain can cause a rapid decline in cognition, speech difficulty, and coordination.

Dementia / Alzheimer’s Disease:

While dementia primarily affects memory, orientation, and speech, some variants (like Lewy Body) are strongly associated with sleep disturbances and movement/tremor issues.

To help identify the exact cause, you can explore the Mayo Clinic Dementia Overview or learn about nerve issues via the Foundation for Peripheral Neuropathy.

 

How do you treat Dementia?

While there is currently no cure for most progressive dementias, treatments focus on managing symptoms, slowing disease progression, and improving quality of life. A personalized care plan typically combines medications with lifestyle changes and non-drug therapies.

1. Medications

Symptomatic Medications:

Cholinesterase inhibitors (like donepezil, rivastigmine, and galantamine) and NMDA receptor antagonists (memantine) help manage memory and cognitive symptoms.

Disease-Modifying Therapies:

Anti-amyloid therapies (such as lecanemab) are available for early-stage Alzheimer's disease to help slow cognitive and functional decline by clearing harmful plaques in the brain.

Behavioral Treatments:

Doctors may also prescribe antidepressants, anti-anxiety medications, or newer FDA-approved treatments for specific symptoms like agitation.

2. Lifestyle & Home Strategies

Brain Health:

Staying mentally active with puzzles, games, and new hobbies can help challenge thinking skills.

Physical Activity:

Regular light exercise like walking is encouraged to maintain mobility and improve mood.

Diet:

Consuming heart-healthy, balanced meals (such as a Mediterranean-style diet) is recommended to support brain function.

Social Engagement:

Participating in community activities or support groups is vital for emotional and mental well-being.

3. Non-Pharmacological Therapies

To improve daily functioning and reduce anxiety without the use of drugs, specialists may incorporate therapies such as:

Music or pet therapy, Cognitive stimulation activities, Art therapy

How to access local resources in Buena Park, CA

Alzheimer's Orange County: Provides caregiver resources, education, and support groups. Visit the Alzheimer's Orange County website for local events and assistance.

Buena Park Community Center:

Offers older adult programs and social activities. Check the City of Buena Park Community Services for current schedules.

Orange County Office on Aging:

Can connect you with case management, adult day care, and caregiver respite programs. Explore the Orange County Aging & Disability Resource Center for official county resources.

 

Aside - Can you treat tremors and weakness with Zyprexa?

No, Zyprexa (olanzapine) is not used to treat tremors and weakness. In fact, Zyprexa can actually cause tremors, shakiness, and muscle weakness or fatigue as side effects.

 

What do you treat tremors and weakness with?

Tremors and weakness are treated based on their underlying cause using medications like beta-blockers, anti-seizure drugs, or therapies, though combining both shaking and weakness can signal specific neurological conditions requiring an exact medical evaluation.

Common Treatments for Tremors

Beta-blockers:

Medications like propranolol help slow down shaking.

Anti-seizure drugs:

Options like primidone calm active nerve signals in the brain.

Advanced care: Procedures like deep brain stimulation or focused ultrasound are used for severe cases.

Addressing Muscle Weakness

Physical therapy:

Helps build strength and improve daily movement control.

Targeted diagnosis:

Weakness paired with tremors requires a doctor to check for conditions like Parkinson's disease, nerve damage, or medication side effects.

 

What is cogentin used to treat?

Cogentin (benztropine) is primarily used alongside other medications to treat Parkinson’s disease symptoms (such as tremors and muscle stiffness). It is also frequently prescribed to control acute drug-induced movement disorders, such as dystonia and akathisia, caused by psychiatric and nervous system medications.

 

Practical – July 29, 2026 (W)

Lithium, tremors and weakness

Tremors and muscle weakness while taking lithium can be early signs of lithium toxicity, a serious condition that happens when lithium levels in your blood become too high. You should contact your doctor or seek emergency medical care right away.

Warning Signs of Toxicity

Shaking or twitching:

Worsening hand tremors or muscle twitches.

Body changes:

Growing muscle weakness, lack of balance, or trouble walking.

Stomach issues:

Severe nausea, vomiting, or diarrhea.

Mind and senses:

Confusion, extreme sleepiness, dizziness, or slurred speech.

What You Should Do

Call your doctor or go to the nearest emergency room immediately.

Do not take your next dose of lithium until a medical professional tells you it is safe.

Drink water only if you are fully awake and alert, but do not try to treat toxicity at home.

 

Typical Dose of Lithium

https://www.mayoclinic.org/drugs-supplements/lithium-oral-route/description/drg-20064603

For long-term treatment of mania: Adults and children 7 years of age and older weighing more than 30 kilograms (kg)—300 mg to 600 mg or 5 mL to 10 mL 2 to 3 times a day. Your doctor may adjust your dose as needed.  Call your doctor right away if you have diarrhea, vomiting, drowsiness, muscle weakness, tremors, unsteadiness, or other problems with muscle control or coordination. These may be symptoms of lithium toxicity.

 

Practical

Abilify, tremors and weakness

Abilify (aripiprazole) can cause movement side effects like tremors and muscle stiffness, which are known as extrapyramidal symptoms. General weakness, fatigue, or difficulty moving as usual are also recognized side effects of the medication.

Understanding Movement and Strength Changes

Tremors and Shaking:

Affect hands, fingers, or limbs due to how the drug impacts dopamine pathways in the brain.

Muscle Stiffness:

Can make limbs feel rigid, tight, or jerky.

Weakness and Fatigue:

General lack of physical strength, heavy limbs, or profound tiredness.

Balance and Coordination:

Risk of reduced motor control or feeling lightheaded, which can lead to accidental falls.

Important Safety Steps

Contact Your Doctor:

Inform your prescribing physician immediately about new or worsening tremors and weakness so they can safely evaluate your dosage or consider alternative options.

Do Not Stop Suddenly:

Never alter or stop taking your medication without medical supervision, as abrupt discontinuation can lead to returning mental health symptoms or withdrawal effects.

Seek Emergency Care:

Go to an emergency room right away if you experience severe muscle rigidity accompanied by a high fever, confusion, or sweating, which can be signs of a rare, serious condition called Neuroleptic Malignant Syndrome (NMS).


Practical

Wellbutrin, tremors and weakness

Wellbutrin (bupropion) can cause tremors and unusual tiredness or weakness as your nervous system adjusts to increased brain activity. These side effects are often dose-related or most noticeable during the first few weeks.

Understanding the Symptoms

Tremors:

Shakiness in the hands or fingers happens because the medication affects brain chemicals like norepinephrine and dopamine.

Weakness:

General body fatigue or a heavy feeling in the limbs can occur, sometimes linked to poor sleep or changes in energy levels early in treatment.

What You Should Do

Contact your doctor:

Let your prescriber know right away about these physical changes. Do not stop taking Wellbutrin suddenly, as this can cause unwanted withdrawal effects or a return of your original symptoms.

Review your dose:

Your doctor may evaluate if your current dose is too high or if an adjustment is needed.

Seek urgent care:

Seek immediate medical help if you experience severe symptoms like confusion, a fast or irregular heartbeat, or signs of a seizure.

 

Aside - Signs of a seizure? [Stayed]


Practical

Combined side effects of Abilify, Lithium and Wellbutrin

Combining Abilify (aripiprazole), lithium, and Wellbutrin (bupropion) can increase nervous system side effects like dizziness, drowsiness, confusion, hand tremors, and a higher risk of lowered seizure thresholds.

Overlapping Nervous System Effects

Dizziness and Drowsiness:

Abilify and lithium together can impair thinking, judgment, and motor coordination.

Tremors:

Both lithium and Abilify (at higher doses) can cause or worsen hand shaking.

Sleep Changes:

Both Abilify and Wellbutrin can cause insomnia or restlessness.

Major Risk Interactions

Seizure Risk:

Wellbutrin lowers the seizure threshold, and combining it with other drugs that affect the brain (like lithium or high doses of Abilify) can rarely increase seizure risk.

Increased Drug Levels:

Wellbutrin can increase the amount of Abilify in your blood, making side effects more likely.

 

Practical

Combined side effects of Abilify, Lithium and Wellbutrin weakness and unsteadiness

Combining Abilify, lithium, and Wellbutrin can increase the risk of overlapping nervous system side effects like muscle weakness, unsteadiness, dizziness, and tremors. These symptoms may also point to lithium toxicity or an additive sedative effect requiring urgent medical evaluation.

Overlapping Side Effects and Risks

Central Nervous System Depression:

Both Abilify (aripiprazole) and lithium can cause dizziness, drowsiness, and impaired motor coordination.

Tremors and Weakness:

Lithium and Wellbutrin (bupropion) can both cause fine hand tremors and muscle weakness. When combined, these tremors or weakness can become pronounced.

Lithium Toxicity Warning:

Unsteadiness, lack of coordination, severe muscle weakness, confusion, and dizziness are hallmark signs of high lithium levels (toxicity).

When to Seek Help

Contact your prescribing doctor or seek emergency medical care immediately if your weakness and unsteadiness are sudden, severe, or accompanied by confusion, slurred speech, persistent vomiting, or severe shaking. Do not stop taking your medications without speaking to your doctor first.


Lithium Fix

We listed our goals surrounding our Neurology appointment previously.  Our target is to address as many of our signs and symptoms as possible.  On July 29, 2026 (W) our psychiatrist discontinued Lithium.  The results have been remarkable when it comes to tremors and fatigue and less so with our issues walking.  Therefore we call the change in Lithium a fix.  We want to push ahead to a solution.  We entertain the notion that it may be a promising practice to discontinue Abilify and or Wellbutrin.  Our objectives are to score less than 25% on the Neurology Assessment

 

How to Avoid the Psych Ward I?

To avoid a psychiatric hospitalization, create a formal safety plan, utilize intensive outpatient alternatives, and engage early with community mental health resources. If you are experiencing overwhelming distress, reach out immediately to the Suicide & Crisis Lifeline by calling or texting 988.

Proactive Crisis Management

Build a Safety Plan:

Write down specific coping strategies, personal triggers, and contact details for a therapist or trusted support person.

Remove Access to Means:

Securely lock away or hand over potential items of self-harm to a trusted family member or friend.

Use Outpatient Levels of Care:

Step up treatment before a crisis peaks by enrolling in an Intensive Outpatient Program (IOP) or Partial Hospitalization Program (PHP).

Communication and Support

Utilize Crisis Text and Warmlines:

Text HOME to 741741 for the Crisis Text Line, or call a local peer warmline for non-emergency emotional support.

Be Clear with Professionals:

Communicate your safety strategies clearly to doctors or mental health workers, demonstrating that you have a reliable plan and environment to keep yourself safe. If you or someone you know is in immediate danger, please call 911 or go to the nearest emergency room..


How to avoid the psychiatric ward II

How to Avoid Being Admitted to a Psychiatric Ward

If you want to reduce the risk of being admitted to a psychiatric ward, the key is proactive mental health management rather than reacting to crises.

 

1. Maintain a Stable Daily Routine

Your circadian rhythm (internal body clock) plays a big role in mental stability. Going to bed and waking up at the same time every day, ideally with the same person, helps regulate hormones like cortisol and melatonin. Avoid travel across time zones, and during seasonal lows, get extra sunlight or bright light therapy to prevent mood dips.

2. Avoid Gradual Escalation of Stress

The “cooking frog” metaphor applies: small, gradual increases in stress can make you less aware of danger until it’s too late. If you notice stress or emotional changes creeping in, take action early—get support, adjust your schedule, or seek help before symptoms worsen.

3. Build Accountability and Support

A buddy system or trusted accountability partner can help you stay on track. Knowing someone will check in on you reduces the chance of neglecting self-care, which can be a trigger for hospitalization.

4. Develop Healthy Coping Strategies

Instead of harmful coping mechanisms like substance use or avoidance, build skills for managing stress. Activities such as exercise, journaling, art, meditation, and talking with trusted friends or family can help regulate emotions. Therapy can also teach you tools to handle difficult situations constructively.

5. Seek Professional Help Early

If you feel overwhelmed by anxiety, depression, intrusive thoughts, or other emotional struggles, early intervention with a licensed therapist or psychologist can prevent crises. Early treatment can stabilize your condition and reduce the likelihood of needing inpatient care.

6. Nurture a Strong Support Network

Strong relationships with people who understand and support you create a safety net during tough times. This can include friends, family, or community groups, and provides a space to share experiences without judgment.

7. Be Mindful of Triggers

If you have a history of hospitalization, identify and address triggers—such as sleep disruption, isolation, or unmet needs—before they escalate. Small, consistent changes in behavior and environment can prevent crises.

Bottom line:

Avoiding a psychiatric ward is about preventing crises through stability, self-awareness, and early help-seeking. By keeping your routine steady, managing stress early, and building a support system, you can significantly reduce the risk of needing inpatient care.