While our genes can't be changed easily, you can avoid some dementia risk factors. Today we discuss dementia and five drugs that may increase risk.

Memory loss appears to come with age, but we're not talking about forgetfulness. Sometimes losing your car keys isn't an indication of dementia. Dementia impairs the capacity to think, remember, or make judgments. Dementia hinders daily tasks.

Alzheimers is the most common dementia. Dementia is not normal aging, unlike forgetfulness. Aging increases the risk of Alzheimer's and other dementias. A family history of the illness increases your risk, according to the Mayo Clinic (USA).

Given that our genes are difficult to change (I won't get into epigenetics), what are some avoidable dementia risk factors? Certain drugs may cause cognitive deterioration.

Today we look at four drugs that may cause cognitive decline.

Dementia and benzodiazepines

Benzodiazepine sedatives increase brain GABA levels. Example benzodiazepines:

• Diazepam (Valium) (Valium)

• Alprazolam (Xanax) (Xanax)

• Clonazepam (Klonopin) (Klonopin)

Addiction and overdose are benzodiazepine risks. Yes! These medications don't raise dementia risk.

USC study: Benzodiazepines don't increase dementia risk in older adults.

Benzodiazepines can produce short- and long-term amnesia. This memory loss hinders memory formation. Extreme cases can permanently impair learning and memory. Anterograde amnesia is uncommon.

2. Statins and dementia

Statins reduce cholesterol. They prevent a cholesterol-making chemical. Examples:

• Atorvastatin (Lipitor) (Lipitor)

• Fluvastatin (Lescol XL) (Lescol XL)

• Lovastatin (Altoprev) (Altoprev)

• Pitavastatin (Livalo, Zypitamag) (Livalo, Zypitamag)

• Pravastatin (Pravachol) (Pravachol)

• Rosuvastatin (Crestor, Ezallor) (Crestor, Ezallor)

• Simvastatin (Zocor) (Zocor)

This finding is contentious. Harvard's Brigham and Womens Hospital's Dr. Joann Manson says:

“I think that the relationship between statins and cognitive function remains controversial. There’s still not a clear conclusion whether they help to prevent dementia or Alzheimer’s disease, have neutral effects, or increase risk.”

This one's off the dementia list.

3. Dementia and anticholinergic drugs

Anticholinergic drugs treat many conditions, including urine incontinence. Drugs inhibit acetylcholine (a brain chemical that helps send messages between cells). Acetylcholine blockers cause drowsiness, disorientation, and memory loss.

First-generation antihistamines, tricyclic antidepressants, and overactive bladder antimuscarinics are common anticholinergics among the elderly.

Anticholinergic drugs may cause dementia. One study found that taking anticholinergics for three years or more increased the risk of dementia by 1.54 times compared to three months or less. After stopping the medicine, the danger may continue.

4. Drugs for Parkinson's disease and dementia

Cleveland Clinic (USA) on Parkinson's:

Parkinson's disease causes age-related brain degeneration. It causes delayed movements, tremors, and balance issues. Some are inherited, but most are unknown. There are various treatment options, but no cure.

Parkinson's medications can cause memory loss, confusion, delusions, and obsessive behaviors. The drug's effects on dopamine cause these issues.

A 2019 JAMA Internal Medicine study found powerful anticholinergic medications enhance dementia risk.

Those who took anticholinergics had a 1.5 times higher chance of dementia. Individuals taking antidepressants, antipsychotic drugs, anti-Parkinson’s drugs, overactive bladder drugs, and anti-epileptic drugs had the greatest risk of dementia.

Anticholinergic medicines can lessen Parkinson's-related tremors, but they slow cognitive ability. Anticholinergics can cause disorientation and hallucinations in those over 70.

5. Antiepileptic drugs and dementia

The risk of dementia from anti-seizure drugs varies with drugs. Levetiracetam (Keppra) improves Alzheimer's cognition.

One study linked different anti-seizure medications to dementia. Anti-epileptic medicines increased the risk of Alzheimer's disease by 1.15 times in the Finnish sample and 1.3 times in the German population. Depakote, Topamax are drugs.

Understanding your own energy depletion and restoration is how to truly optimize

Hack has meant many bad things for centuries. In the 1800s, a hack was a meager horse used to transport goods.

Modern usage describes a butcher or ax murderer's cleaver chop. The 1980s programming boom distinguished elegant code from "hacks". Both got you to your goal, but the latter made any programmer cringe and mutter about changing the code. From this emerged the hacker trope, the friendless anti-villain living in a murky hovel lit by the computer monitor, eating junk food and breaking into databases to highlight security system failures or steal hotdog money.

Now, start-a-billion-dollar-business-from-your-garage types have shifted their sights from app development to DIY biology, coining the term "bio-hack". This is a required keyword and meta tag for every fitness-related podcast, book, conference, app, or device.

Bio-hacking involves bypassing your body and mind's security systems to achieve a goal. Many biohackers' initial goals were reasonable, like lowering blood pressure and weight. Encouraged by their own progress, self-determination, and seemingly exquisite control of their biology, they aimed to outsmart aging and death to live 180 to 1000 years (summarized well in this vox.com article).

With this grandiose north star, the hunt for novel supplements and genetic engineering began.

Companies selling do-it-yourself biological manipulations cite lab studies in mice as proof of their safety and success in reversing age-related diseases or promoting longevity in humans (the goal changes depending on whether a company is talking to the federal government or private donors).

The FDA is slower than science, they say. Why not alter your biochemistry by buying pills online, editing your DNA with a CRISPR kit, or using a sauna delivered to your home? How about a microchip or electrical stimulator?

What could go wrong?

I'm not the neo-police, making citizen's arrests every time someone introduces a new plumbing gadget or extrapolates from animal research on resveratrol or catechins that we should drink more red wine or eat more chocolate. As a scientist who's spent her career asking, "Can we get better?" I've come to view bio-hacking as misguided, profit-driven, and counterproductive to its followers' goals.

We're creatures of nature. Despite all the new gadgets and bio-hacks, we still use Roman plumbing technology, and the best way to stay fit, sharp, and happy is to follow a recipe passed down since the beginning of time. Bacteria, plants, and all natural beings are rhythmic, with alternating periods of high activity and dormancy, whether measured in seconds, hours, days, or seasons. Nature repeats successful patterns.

During the Upstate, every cell in your body is naturally primed and pumped full of glycogen and ATP (your cells' energy currencies), as well as cortisol, which supports your muscles, heart, metabolism, cognitive prowess, emotional regulation, and general "get 'er done" attitude. This big energy release depletes your batteries and requires the Downstate, when your subsystems recharge at the cellular level.

Downstates are when you give your heart a break from pumping nutrient-rich blood through your body; when you give your metabolism a break from inflammation, oxidative stress, and sympathetic arousal caused by eating fast food — or just eating too fast; or when you give your mind a chance to wander, think bigger thoughts, and come up with new creative solutions. When you're responding to notifications, emails, and fires, you can't relax.

Downstates aren't just for consistently recharging your battery. By spending time in the Downstate, your body and brain get extra energy and nutrients, allowing you to grow smarter, faster, stronger, and more self-regulated. This state supports half-marathon training, exam prep, and mediation. As we age, spending more time in the Downstate is key to mental and physical health, well-being, and longevity.

When you prioritize energy-demanding activities during Upstate periods and energy-replenishing activities during Downstate periods, all your subsystems, including cardiovascular, metabolic, muscular, cognitive, and emotional, hum along at their optimal settings. When you synchronize the Upstates and Downstates of these individual rhythms, their functioning improves. A hard workout causes autonomic stress, which triggers Downstate recovery.

By choosing the right timing and type of exercise during the day, you can ensure a deeper recovery and greater readiness for the next workout by working with your natural rhythms and strengthening your autonomic and sleep Downstates.

Morning cardio workouts increase deep sleep compared to afternoon workouts. Timing and type of meals determine when your sleep hormone melatonin is released, ushering in sleep.

Rhythm isn't a hack. It's not a way to cheat the system or the boss. Nature has honed its optimization wisdom over trillions of days and nights. Stop looking for quick fixes. You're a whole system made of smaller subsystems that must work together to function well. No one pill or subsystem will make it all work. Understanding and coordinating your rhythms is free, easy, and only benefits you.

Dr. Sara C. Mednick is a cognitive neuroscientist at UC Irvine and author of The Power of the Downstate (HachetteGO)

Sometimes doing everything correctly isn't enough.

In 2020, I could fix my life.

After failing to start a business, I owed $40,000 and had no work.

A $1.2 billion startup on the cusp of going public pulled me up.

Ironically, it was getting ready for an epic fall — with the world watching.

Life sometimes helps. Without a base, even the strongest fall. A corporation that did everything right failed 3 months after going public.

First-row view.

Apple is the creator of Adore.

Out of respect, I've altered the company and employees' names in this account, despite their failure.

Although being a publicly traded company, it may become obvious.

We’ll call it “Adore” — a revolutionary concept in retail shopping.

Two Apple execs established Adore in 2014 with a focus on people-first purchasing.

Jon and Tim:

• The concept for the stylish Apple retail locations you see today was developed by retail expert Jon Swanson, who collaborated closely with Steve Jobs.

• Tim Cruiter is a graphic designer who produced the recognizable bouncing lamp video that appears at the start of every Pixar film.

The dynamic duo realized their vision.

“What if you could combine the convenience of online shopping with the confidence of the conventional brick-and-mortar store experience.”

Adore's mobile store concept combined traditional retail with online shopping.

Adore brought joy to 70+ cities and 4 countries over 7 years, including the US, Canada, and the UK.

Being employed on the ground floor, with world dominance and IPO on the horizon, was exciting.

I started as an Adore Expert.

I delivered cell phones, helped consumers set them up, and sold add-ons.

As the company grew, I became a Virtual Learning Facilitator and trained new employees across North America using Zoom.

In this capacity, I gained corporate insider knowledge. I worked with the creative team and Jon and Tim.

It's where I saw company foundation fissures. Despite appearances, investors were concerned.

The business strategy was ground-breaking.

Even after seeing my employee stocks fall from a home down payment to $0 (when Adore filed for bankruptcy), it's hard to pinpoint what went wrong.

Solid business model, well-executed.

Jon and Tim's chase for public funding ended in glory.

Here’s the business model in a nutshell:

Buying cell phones is cumbersome. You have two choices:

1. Online purchase: not knowing what plan you require or how to operate your device.

2. Enter a store, which can be troublesome and stressful.

Apple, AT&T, and Rogers offered Adore as a free delivery add-on. Customers could:

• Have their phone delivered by UPS or Canada Post in 1-2 weeks.

• Alternately, arrange for a person to visit them the same day (or sometimes even the same hour) to assist them set up their phone and demonstrate how to use it (transferring contacts, switching the SIM card, etc.).

Each Adore Expert brought a van with extra devices and accessories to customers.

Happy customers.

Here’s how Adore and its partners made money:

Adores partners appreciated sending Experts to consumers' homes since they improved customer satisfaction, average sale, and gadget returns.

**Telecom enterprises have low customer satisfaction. The average NPS is 30/100. Adore's global NPS was 80.

Adore made money by:

• a set cost for each delivery

• commission on sold warranties and extras

Consumer product applications seemed infinite.

A proprietary scheduling system (“The Adore App”), allowed for same-day, even same-hour deliveries.

It differentiates Adore.

They treated staff generously by:

• Options on stock

• health advantages

• sales enticements

• high rates per hour

Four-day workweeks were set by experts.

Being hired early felt like joining Uber, Netflix, or Tesla. We hoped the company's stocks would rise.

Exciting times.

I smiled as I greeted more than 1,000 new staff.

I spent a decade in retail before joining Adore. I needed a change.

After a leap of faith, I needed a lifeline. So, I applied for retail sales jobs in the spring of 2019.

The universe typically offers you what you want after you accept what you need. I needed a job to settle my debt and reach $0 again.

And the universe listened.

After being hired as an Adore Expert, I became a Virtual Learning Facilitator. Enough said.

After weeks of economic damage from the pandemic.

This employment let me work from home during the pandemic. It taught me excellent business skills.

I was active in brainstorming, onboarding new personnel, and expanding communication as we grew.

This job gave me vital skills and a regular paycheck during the pandemic.

It wasn’t until January of 2022 that I left on my own accord to try to work for myself again — this time, it’s going much better.

Adore was perfect. We valued:

• Connection

• Discovery

• Empathy

Everything we did centered on compassion, and we held frequent Justice Calls to discuss diversity and work culture.

The last day of onboarding typically ended in tears as employees felt like they'd found a home, as I had.

Like all nice things, the wonderful vibes ended.

First indication of distress

My first day at the workplace was great.

Fun, intuitive, and they wanted creative individuals, not salesman.

While sales were important, the company's vision was more important.

“To deliver joy through life-changing mobile retail experiences.”

Thorough, forward-thinking training. We had a module on intuition. It gave us role ownership.

We were flown cross-country for training, gave feedback, and felt like we made a difference. Multiple contacts responded immediately and enthusiastically.

The atmosphere was genuine.

Making money was secondary, though. Incredible service was a priority.

Jon and Tim answered new hires' questions during Zoom calls during onboarding. CEOs seldom meet new hires this way, but they seemed to enjoy it.

All appeared well.

But in late 2021, things started changing.

Adore's leadership changed after its IPO. From basic values to sales maximization. We lost communication and were forced to fend for ourselves.

Removed the training wheels.

It got tougher to gain instructions from those above me, and new employees told me their roles weren't as advertised.

External money-focused managers were hired.

Instead of creative types, we hired salespeople.

With a new focus on numbers, Adore's uniqueness began to crumble.

Via Zoom, hundreds of workers were let go.

So.

Early in 2022, mass Zoom firings were trending. A CEO firing 900 workers over Zoom went viral.

Adore was special to me, but it became a headline.

30 June 2022, Vice Motherboard published Watch as Adore's CEO Fires Hundreds.

It described a leaked video of Jon Swanson laying off all staff in Canada and the UK.

They called it a “notice of redundancy”.

The corporation couldn't pay its employees.

I loved Adore's underlying ideals, among other things. We called clients Adorers and sold solutions, not add-ons.

But, like anything, a company is only as strong as its weakest link. And obviously, the people-first focus wasn’t making enough money.

There were signs. The expansion was presumably a race against time and money.

Adore finally declared bankruptcy.

Adore declared bankruptcy 3 months after going public. It happened in waves, like any large-scale fall.

• Initial key players to leave were

• Then, communication deteriorated.

• Lastly, the corporate culture disintegrated.

6 months after leaving Adore, I received a letter in the mail from a Law firm — it was about my stocks.

Adore filed Chapter 11. I had to sue to collect my worthless investments.

I hoped those stocks will be valuable someday. Nope. Nope.

Sad, I sighed.

$1.2 billion firm gone.

I left the workplace 3 months before starting a writing business. Despite being mediocre, I'm doing fine.

I got up as Adore fell.

Finally, can we scale kindness?

I trust my gut. Changes at Adore made me leave before it sank.

Adores' unceremonious slide from a top startup to bankruptcy is astonishing to me.

The company did everything perfectly, in my opinion.

• first to market,

• provided excellent service

• paid their staff handsomely.

• was responsible and attentive to criticism

The company wasn't led by an egotistical eccentric. The crew had centuries of cumulative space experience.

I'm optimistic about the future of work culture, but is compassion scalable?

Are MVPs outdated and have no place in modern product culture?

Frank Robinson coined "MVP" in 2001. In the same year as the Agile Manifesto, the first Scrum experiment began. MVPs are old.

The concept was created to solve the waterfall problem at the time.

The market was still sour from the .com bubble. The tech industry needed a new approach. Product and Agile gained popularity because they weren't waterfall.

More than 20 years later, waterfall is dead as dead can be, but we are still talking about MVPs. Does that make sense?

What is an MVP?

Minimum viable product. You probably know that, so I'll be brief:

[…] The MVP fits your company and customer. It's big enough to cause adoption, satisfaction, and sales, but not bloated and risky. It's the product with the highest ROI/risk. […] — Frank Robinson, SyncDev

MVP is a complete product. It's not a prototype. It's your product's first iteration, which you'll improve. It must drive sales and be user-friendly.

At the MVP stage, you should know your product's core value, audience, and price. We are way deep into early adoption territory.

What about all the things that come before?

Modern product discovery

Eric Ries popularized the term with The Lean Startup in 2011. (Ries would work with the concept since 2008, but wide adoption came after the book was released).

Ries' definition of MVP was similar to Robinson's: "Test the market" before releasing anything. Ries never mentioned money, unlike Jobs. His MVP's goal was learning.

“Remove any feature, process, or effort that doesn't directly contribute to learning” — Eric Ries, The Lean Startup

Product has since become more about "what" to build than building it. What started as a learning tool is now a discovery discipline: fake doors, prototyping, lean inception, value proposition canvas, continuous interview, opportunity tree... These are cheap, effective learning tools.

Over time, companies realized that "maximum ROI divided by risk" started with discovery, not the MVP. MVPs are still considered discovery tools. What is the problem with that?

Time to Market vs Product Market Fit

Waterfall's Time to Market is its biggest flaw. Since projects are sliced horizontally rather than vertically, when there is nothing else to be done, it’s not because the product is ready, it’s because no one cares to buy it anymore.

MVPs were originally conceived as a way to cut corners and speed Time to Market by delivering more customer requests after they paid.

Original product development was waterfall-like.

Time to Market defines an optimal, specific window in which value should be delivered. It's impossible to predict how long or how often this window will be open.

Product Market Fit makes this window a "state." You don’t achieve Product Market Fit, you have it… and you may lose it.

Take, for example, Snapchat. They had a great time to market, but lost product-market fit later. They regained product-market fit in 2018 and have grown since.

An MVP couldn't handle this. What should Snapchat do? Launch Snapchat 2 and see what the market was expecting differently from the last time? MVPs are a snapshot in time that may be wrong in two weeks.

MVPs are mini-projects. Instead of spending a lot of time and money on waterfall, you spend less but are still unsure of the results.

MVPs aren't always wrong. When releasing your first product version, consider an MVP.

Minimum viable product became less of a thing on its own and more interchangeable with Alpha Release or V.1 release over time.

Modern discovery technics are more assertive and predictable than the MVP, but clarity comes only when you reach the market.

MVPs aren't the starting point, but they're the best way to validate your product concept.

Failures inspire young developers

Jason citron created many products.

These products flopped.

Microsoft offered $10 billion for one of these products.

He rejected the offer since he was so confident in his success.

Let’s find out how he built a product that is currently valued at $15 billion.

Early in his youth, Jason began learning to code.

Jason's father taught him programming and IT.

His father wanted to help him earn money when he needed it.

Jason created video games and websites in high school.

Jason realized early on that his IT and programming skills could make him money.

Jason's parents misjudged his aptitude for programming.

Jason frequented online programming communities.

He looked for web developers. He created websites for those people.

His parents suspected Jason sold drugs online. When he said he used programming to make money, they were shocked.

They helped him set up a PayPal account.

Florida higher education to study video game creation

Jason never attended an expensive university.

He studied game design in Florida.

“Higher Education is an interesting part of society… When I work with people, the school they went to never comes up… only thing that matters is what can you do…At the end of the day, the beauty of silicon valley is that if you have a great idea and you can bring it to the life, you can convince a total stranger to give you money and join your project… This notion that you have to go to a great school didn’t end up being a thing for me.”

Jason's life was altered by Steve Jobs' keynote address.

After graduating, Jason joined an incubator.

Jason created a video-dating site first.

Bad idea.

Nobody wanted to use it when it was released, so they shut it down.

He made a multiplayer game.

It was released on Bebo. 10,000 people played it.

When Steve Jobs unveiled the Apple app store, he stopped playing.

The introduction of the app store resembled that of a new gaming console.

Jason's life altered after Steve Jobs' 2008 address.

“Whenever a new video game console is launched, that’s the opportunity for a new video game studio to get started, it’s because there aren’t too many games available…When a new PlayStation comes out, since it’s a new system, there’s only a handful of titles available… If you can be a launch title you can get a lot of distribution.”

Apple's app store provided a chance to start a video game company.

They released an app after 5 months of work.

Aurora Feint is the game.

Jason believed 1000 players in a week would be wonderful. A thousand players joined in the first hour.

Over time, Aurora Feints' game didn't gain traction. They don't make enough money to keep playing.

They could only make enough for one month.

Instead of buying video games, buy technology

Jason saw that they established a leaderboard, chat rooms, and multiplayer capabilities and believed other developers would want to use these.

They opted to sell the prior game's technology.

OpenFeint.

Assisting other game developers

They had no money in the bank to create everything needed to make the technology user-friendly.

Jason and Daniel designed a website saying:

“If you’re making a video game and want to have a drop in multiplayer support, you can use our system”

TechCrunch covered their website launch, and they gained a few hundred mailing list subscribers.

They raised seed funding with the mailing list.

Nearly all iPhone game developers started adopting the Open Feint logo.

“It was pretty wild… It was really like a whole social platform for people to play with their friends.”

What kind of a business model was it?

OpenFeint originally planned to make the software free for all games. As the game gained popularity, they demanded payment.

They later concluded it wasn't a good business concept.

It became free eventually.

Acquired for $104 million

Open Feint's users and employees grew tremendously.

GREE bought OpenFeint for $104 million in April 2011.

GREE initially committed to helping Jason and his team build a fantastic company.

Three or four months after the acquisition, Jason recognized they had a different vision.

He quit.

Jason's Original Vision for the iPad

Jason focused on distribution in 2012 to help businesses stand out.

The iPad market and user base were growing tremendously.

Jason said the iPad may replace mobile gadgets.

iPad gamers behaved differently than mobile gamers.

People sat longer and experienced more using an iPad.

“The idea I had was what if we built a gaming business that was more like traditional video games but played on tablets as opposed to some kind of mobile game that I’ve been doing before.”

Unexpected insight after researching the video game industry

Jason learned from studying the gaming industry that long-standing companies had advantages beyond a single release.

Previously, long-standing video game firms had their own distribution system. This distribution strategy could buffer time between successful titles.

Sony, Microsoft, and Valve all have gaming consoles and online stores.

So he built a distribution system.

He created a group chat app for gamers.

He envisioned a team-based multiplayer game with text and voice interaction.

His objective was to develop a communication network, release more games, and start a game distribution business.

Remaking the video game League of Legends

Jason and his crew reimagined a League of Legends game mode for 12-inch glass.

They adapted the game for tablets.

League of Legends was PC-only.

So they rebuilt it.

They overhauled the game and included native mobile experiences to stand out.

Hammer and Chisel was the company's name.

18 people worked on the game.

The game was funded. The game took 2.5 years to make.

Was the game a success?

July 2014 marked the game's release. The team's hopes were dashed.

Critics initially praised the game.

Initial installation was widespread.

The game failed.

As time passed, the team realized iPad gaming wouldn't increase much and mobile would win.

Jason was given a fresh idea by Stan Vishnevskiy.

Stan Vishnevskiy was a corporate engineer.

He told Jason about his plan to design a communication app without a game.

This concept seeded modern strife.

“The insight that he really had was to put a couple of dots together… we’re seeing our customers communicating around our own game with all these different apps and also ourselves when we’re playing on PC… We should solve that problem directly rather than needing to build a new game…we should start making it on PC.”

So began Discord.

Online socializing with pals was the newest trend.

Jason grew up playing video games with his friends.

He never played outside.

Jason had many great moments playing video games with his closest buddy, wife, and brother.

Discord was about providing a location for you and your group to speak and hang out.

Like a private cafe, bedroom, or living room.

Discord was developed for you and your friends on computers and phones.

You can quickly call your buddies during a game to conduct a conference call. Put the call on speaker and talk while playing.

Discord wanted to give every player a unique experience. Because coordinating across apps was a headache.

The entire team started concentrating on Discord.

Jason decided Hammer and Chisel would focus on their chat app.

Jason didn't want to make a video game.

How Discord attracted the appropriate attention

During the first five months, the entire team worked on the game and got feedback from friends.

This ensures product improvement. As a result, some teammates' buddies started utilizing Discord.

The team knew it would become something, but the result was buggy. App occasionally crashed.

Jason persuaded a gamer friend to write on Reddit about the software.

New people would find Discord. Why not?

Reddit users discovered Discord and 50 started using it frequently.

Discord was launched.

Rejecting the $10 billion acquisition proposal

Discord has increased in recent years.

It sends billions of messages.

Discord's users aren't tracked. They're privacy-focused.

Purchase offer

Covid boosted Discord's user base.

Weekly, billions of messages were transmitted.

Microsoft offered $10 billion for Discord in 2021.

Jason sold Open Feint for $104m in 2011.

This time, he believed in the product so much that he rejected Microsoft's offer.

“I was talking to some people in the team about which way we could go… The good thing was that most of the team wanted to continue building.”

Last time, Discord was valued at $15 billion.

Discord raised money on March 12, 2022.

The $15 billion corporation raised $500 million in 2021.