`Making' Chances

Thursday, February 16, 2017

Aging In Place - National Institute of Health Initiative

NIH initiative tests in-home technology to help older adults age in place

January 25, 2017

Many older adults want to live at home independently as they age. Sometimes all they need is a little help from their family and friends—and the right technology. A new initiative led by the National Institutes of Health (NIH) aims to help seniors age in place by developing a research platform to study the use of health-related in-home sensors and other technologies.

Older woman using aging-in-place technology

CART—Collaborative Aging (in Place) Research Using Technology—unites NIH, academic, and industry experts to develop and test unobtrusive tools that record and track real-time changes in older adults’ health status and activities. Launched in October 2016, the $7 million, 4-year project will take place in more than 200 homes in rural and urban communities across the United States.

“This project will provide a systematic way of investigating technology that may enable older people to remain independent and avoid hospitalizations and transitions into care facilities,” said Nina Silverberg, Ph.D., of the National Institute on Aging (NIA), which leads the project.

“We want to know if existing and other devices now being developed can identify health issues and other problems—such as depression, risks for falls, or leaving the stove on—that may lead to a loss of independence,” she added.

Collaborative effort for evaluating technology

CART will advance a research platform to develop and test in-home activity sensors and other technologies that detect changes in key health- and independence-related activities, such as sleep, mobility, body composition, and driving. Interaction with computers, phones, and other devices will be used to assess aspects of cognition and socialization.

“The idea is to capture subtle changes that may signal cognitive or other problems that endanger a person’s safety and independence,” said NIA program officer Partha Bhattacharyya, Ph.D.

“CART will test how we might safely and efficiently collect these health data, share it with caregivers and healthcare providers, and possibly speed the delivery of health interventions while maintaining the privacy of volunteers,” he said. “We will not only test products currently available, but also put into place a research infrastructure to advance the development of emerging technologies.”

In the first phase of CART, researchers led by Jeffrey Kaye, M.D., of Oregon Health & Science University (OHSU), Portland, will test technology for collecting data, such as sensors and activity trackers, in more than 200 homes. The ultimate aim is to build an infrastructure that will support research on a large scale, on the order of thousands of homes. If this phase 1 project is successful, investigators could apply, in the future, for funds from multiple sources to continue the infrastructure in a phase 2, which would allow testing of innovative new technologies to help older adults remain independent for longer.

Dr. Kaye, director of OHSU’s Oregon Center for Aging & Technology (ORCATECH), is working with investigators from Intel Corp., Rush University in Chicago, Oregon State University in Corvallis, the University of Pennsylvania in Philadelphia, the University of Miami, and the U.S. Department of Veterans Affairs’ (VA) Northwest Health Network.

Expanding participation to under-represented groups

Leveraging existing infrastructure developed by ORCATECH, the research team plans to start testing its platform in older adults’ homes this year. Participants will include residents in low-income housing in Portland, veterans in the rural Pacific Northwest, African Americans in Chicago, and Latinos in Miami.

“It’s a broad infrastructure designed to be dynamic in response to rapidly changing technology, incorporating new measures and devices as they become available,” said Dr. Silverberg. “We want companies to bring new technology to the market, but with scientific evidence to back up their product claims. By testing the products in larger groups of diverse volunteers, CART data will show what works and for whom it works, and what might merit further study.”

Other NIH funders include the National Cancer Institute, National Institute of Biomedical Imaging and Bioengineering, National Institute of Neurological Disorders and Stroke, National Institute of Nursing Research, National Center for Advancing Translational Sciences, and the NIH Office of Behavioral and Social Sciences Research. The VA Health Services Research & Development Service also plans to support the project.

The wireless CART home

Passive, in-home monitoring technology isn’t new. But barriers to adoption such as cost, little evidence of effectiveness, and concerns about privacy have made its adoption slow to catch on, Dr. Kaye said.

“Ideally, the technology needs to be nonintrusive, tuned to specific living situations to provide highly valued data,” he said. For example, for people living alone, strategically placed motion sensors on the ceiling allow researchers to track participants’ gait speed (a predictor of vitality), cognitive decline, and mortality, without invading their privacy. Contact sensors placed on pill boxes can show medication adherence.

Data will flow wirelessly 24/7, providing a constant flow of objective information about activity, sleep, mobility, walking, social interaction, and general health. “This becomes a terrific window on whether a person is successfully aging in place,” said Dr. Kaye.

A weekly email survey of participants will address health factors that are difficult to monitor remotely, such as pain level, mood, changes in medications, and hospital visits.

CART’s history and future

CART’s roots go back to 2011, when Dr. Kaye teamed with R. Paul Crawford, Ph.D., then senior research scientist at Intel Labs; the Foundation for the National Institutes of Health; and others to launch the Senior Independent Living Research Network Initiative, which developed a proof-of-concept research environment and infrastructure.

At ORCATECH, Dr. Kaye and researchers continued to develop and implement technologies that unobtrusively collect data. The CART initiative developed out of recommendations from a 2014 National Heart, Lung, and Blood Institute workshop, in which NIA also participated, Technologies for Improving the Independence of Older Adults and Individuals with Disabilities, led by the Computing Community Consortium and funded by the National Science Foundation.

NIA has high hopes for CART. “We think this will be transformative for the whole field,” said Dr. Silverberg. “It may even help clinical trials measure, in real time, things doctors might ask about in a visit every 6 months or every year. We hope it will help detect and prevent important health issues.”

Monday, January 9, 2017

Work At Something: Mental and Physical

From the New York Times, December 31, 2016

By LISA FELDMAN BARRETT

Think about the people in your life who are 65 or older. Some of them are experiencing the usual mental difficulties of old age, like forgetfulness or a dwindling attention span. Yet others somehow manage to remain mentally sharp. My father-in-law, a retired doctor, is 83 and he still edits books and runs several medical websites.

Why do some older people remain mentally nimble while others decline? “Superagers” (a term coined by the neurologist Marsel Mesulam) are those whose memory and attention isn’t merely above average for their age, but is actually on par with healthy, active 25-year-olds. My colleagues and I at Massachusetts General Hospital recently studied superagers to understand what made them tick.

Our lab used functional magnetic resonance imaging to scan and compare the brains of 17 superagers with those of other people of similar age. We succeeded in identifying a set of brain regions that distinguished the two groups. These regions were thinner for regular agers, a result of age-related atrophy, but in superagers they were indistinguishable from those of young adults, seemingly untouched by the ravages of time.

What are these crucial brain regions? If you asked most scientists to guess, they might nominate regions that are thought of as “cognitive” or dedicated to thinking, such as the lateral prefrontal cortex. However, that’s not what we found. Nearly all the action was in “emotional” regions, such as the midcingulate cortex and the anterior insula.

My lab was not surprised by this discovery, because we’ve seen modern neuroscience debunk the notion that there is a distinction between “cognitive” and “emotional” brain regions.

This distinction emerged in the 1940s, when a doctor named Paul MacLean devised a model of the human brain with three layers. An ancient inner layer, inherited from reptiles, was presumed to contain circuits for basic survival. The middle layer, the “limbic system,” supposedly contained emotion circuitry inherited from mammals. And the outermost layer was said to house rational thinking that is uniquely human. Dr. MacLean called this model “the triune brain.”

And now, our research demonstrates that these major hub regions play a meaningful role in superaging. The thicker these regions of cortex are, the better a person’s performance on tests of memory and attention, such as memorizing a list of nouns and recalling it 20 minutes later.The triune brain became (and remains) popular in the media, the business world and certain scientific circles. But experts in brain evolution discredited it decades ago. The human brain didn’t evolve like a piece of sedimentary rock, with layers of increasing cognitive sophistication slowly accruing over time. Rather (in the words of the neuroscientist Georg Striedter), brains evolve like companies do: they reorganize as they expand. Brain areas that Dr. MacLean considered emotional, such as the regions of the “limbic system,” are now known to be major hubs for general communication throughout the brain. They’re important for many functions besides emotion, such as language, stress, regulation of internal organs, and even the coordination of the five senses into a cohesive experience.

Of course, the big question is: How do you become a superager? Which activities, if any, will increase your chances of remaining mentally sharp into old age? We’re still studying this question, but our best answer at the moment is: work hard at something. Many labs have observed that these critical brain regions increase in activity when people perform difficult tasks, whether the effort is physical or mental. You can therefore help keep these regions thick and healthy through vigorous exercise and bouts of strenuous mental effort. My father-in-law, for example, swims every day and plays tournament bridge.

The road to superaging is difficult, though, because these brain regions have another intriguing property: When they increase in activity, you tend to feel pretty bad — tired, stymied, frustrated. Think about the last time you grappled with a math problem or pushed yourself to your physical limits. Hard work makes you feel bad in the moment. The Marine Corps has a motto that embodies this principle: “Pain is weakness leaving the body.” That is, the discomfort of exertion means you’re building muscle and discipline. Superagers are like Marines: They excel at pushing past the temporary unpleasantness of intense effort. Studies suggest that the result is a more youthful brain that helps maintain a sharper memory and a greater ability to pay attention.

This means that pleasant puzzles like Sudoku are not enough to provide the benefits of superaging. Neither are the popular diversions of various “brain game” websites. You must expend enough effort that you feel some “yuck.” Do it till it hurts, and then a bit more.

In the United States, we are obsessed with happiness. But as people get older, research shows, they cultivate happiness by avoiding unpleasant situations. This is sometimes a good idea, as when you avoid a rude neighbor. But if people consistently sidestep the discomfort of mental effort or physical exertion, this restraint can be detrimental to the brain. All brain tissue gets thinner from disuse. If you don’t use it, you lose it.

So, make a New Year’s resolution to take up a challenging activity. Learn a foreign language. Take an online college course. Master a musical instrument. Work that brain. Make it a year to remember.

Wednesday, November 16, 2016

How Exercise Might Keep Depression at Bay

Exercise may be an effective treatment for depression and might even help prevent us from becoming depressed in the first place, according to three timely new studies.

The studies pool outcomes from past research involving more than a million men and women and, taken together, strongly suggest that regular exercise alters our bodies and brains in ways that make us resistant to despair.

Scientists have long questioned whether and how physical activity affects mental health. While we know that exercise alters the body, how physical activity affects moods and emotions is less well understood.

Past studies have sometimes muddied rather than clarified the body and mind connections. Some randomized controlled trials have found that exercise programs, often involving walking, ease symptoms in people with major depression.

But many of these studies have been relatively small in scale or had other scientific deficiencies. A major 2013 review of studies related to exercise and depression concluded that, based on the evidence then available, it was impossible to say whether exercise improved the condition. Other past reviews similarly have questioned whether the evidence was strong enough to say that exercise could stave off depression.

A group of global public-health researchers, however, suspected that newer studies and a more rigorous review of the statistical evidence might bolster the case for exercise as a treatment of and block against depression.

So for the new analyses, they first gathered all of the most recent and best-designed studies about depression and exercise.

Then, for perhaps the most innovative of the new studies, which was published last month in Preventive Medicine, they focused on whether exercise could help to prevent someone from developing depression.

The scientists knew that many past studies of that topic had relied on people providing reports about how much they had exercised. We human beings tend to be notoriously unreliable in our memories of past workouts, though.

So the researchers decided to use only past studies that had objectively measured participants’ aerobic fitness, which will rise or fall depending on whether and how much someone exercises. Participants’ mental health also had to have been determined with standard testing at the start and finish of the studies, and the follow-up time needed to have been at least a year and preferably longer.

Ultimately, the researchers found several large-scale past studies that met their criteria. Together, they contained data on more than 1,140,000 adult men and women.

Among these million-plus people, the links between fitness and mental health turned out to be considerable. When the researchers divided the group into thirds, based on how aerobically fit they were, those men and women with the lowest fitness were about 75 percent more likely to have been given diagnoses of depression than the people with the greatest fitness. The men and women in the middle third were almost 25 percent more likely to develop depression than those who were the most fit.

In a separate study (some of the scientists were involved in each of the reviews), researchers looked at whether exercise might be useful as a treatment for depression. In that analysis, which was published in June in the Journal of Psychiatric Research, they pooled data from 25 past studies in which people with clinically diagnosed depression began some type of exercise program. Each study had to include a control group that did not exercise and be otherwise methodologically sophisticated.

The pooled results persuasively showed that exercise, especially if it is moderately strenuous, such as brisk walking or jogging, and supervised, so that people complete the entire program, has a “large and significant effect” against depression, the authors wrote. People’s mental health tended to demonstrably improve if they were physically active.

The final review offers some hints about why. Published in February in Neuroscience and Biobehavioral Reviews, it took on the difficult issue of what happens within our bodies during and after exercise that might affect and improve our moods. The researchers analyzed 20 past studies in which scientists had obtained blood samples from people with major depression before and after they had exercised. The samples on the whole indicated that exercise significantly reduced various markers of inflammation and increased levels of a number of different hormones and other biochemicals that are thought to contribute to brain health.

But the researchers also caution that most of the physiological studies they reviewed were too small and short-term to allow for firm conclusions about how exercise might change the brain to help fight off gloom.

Still, the three reviews together make a sturdy case for exercise as a means to bolster mental as well as physical health, said Felipe Barreto Schuch, an exercise scientist at the Centro Universitário La Salle in Canoas, Brazil, who, with Brendon Stubbs, a professor at King’s College in London, was a primary author on all of the reviews.

Many more experiments are still needed to determine the ideal amounts and types of exercise that might help both to prevent and treat depression, Dr. Schuch said.

But he encouraged anyone feeling overwhelmed by recent events, or just by life, to go for a run or a bike ride. “The main message” of his and his colleagues’ reviews, he said, “is that people need to be active to improve their mental health.”

By GRETCHEN REYNOLDS NOV. 16, 2016

Wednesday, March 30, 2016

Exercise Makes Our Muscles Work Better With Age - by Gretchen Reynolds - NY Times, March 30 2016

To keep our muscles healthy deep into retirement, we may need to start working out more now, according to a new study of world-class octogenarian athletes. The study found substantial differences at a cellular level between the athletes’ muscles and those of less active people.

Muscular health is, of course, essential for successful aging. As young adults, we generally have scads of robust muscle mass. But that situation doesn’t last.

Muscles consist of fibers, each attached to a motor neuron in our spinal column by long, skinny nerve threads called axons. The fiber and its neuron are known as a muscle unit.

When this muscle unit is intact, the neuron sends commands to the muscle fiber to contract. The muscle fiber responds, and your leg, eyelid, pinky finger or other body part moves.

However, motor neurons die as we age, beginning as early as in our 30s, abruptly marooning the attached muscle fiber, leaving it disconnected from the nervous system. In younger people, another neuron can come to the rescue, snaking out a new axon and re-attaching the fiber to the spinal cord.

But with each passing decade, we have fewer motor neurons. So some muscle fibers, bereft of their original neuron, do not get another. These fibers wither and die and we lose muscle mass, becoming more frail. This process speeds up substantially once we reach age 60 or so.

Scientists have not known whether the decline in muscular health with age is inevitable or whether it might be slowed or altered.

There have been encouraging hints that exercise changes the trajectory of muscle aging. A 2010 study of recreational runners in their 60s, for instance, found that their leg muscles contained far more intact muscle units than the muscles of sedentary people of the same age.

But whether exercise would continue to protect muscles in people decades older than 60, for whom healthy muscles might be the difference between independence and institutionalization, had never been examined.

So for the new study, which was published last week in the Journal of Applied Physiology, researchers from McGill University in Canada and other schools contacted 29 world-class track and field athletes in their 80s and invited them to the university’s performance lab. They also recruited a separate group of healthy but relatively inactive people of the same age to act as controls.

At the lab, the scientists measured muscle size and then had the athletes and those in the control group complete a simple test of muscular strength and function in which they pressed their right foot against a movable platform as forcefully as possible. While they pressed, the scientists used sensors to track electrical activity within a leg muscle.

Using mathematical formulas involving muscle size and electrical activity, the scientists then determined precisely how many muscle units were alive and functioning in each volunteer’s leg muscle. They also examined the electrical signal plots to see how effectively each motor neuron was communicating with its attached muscle fiber.

Unsurprisingly, the elite masters athletes’ legs were much stronger than the legs of the other volunteers, by an average of about 25 percent. The athletes had about 14 percent more total muscle mass than the control group.

More interesting to the researchers, the athletes also had almost 30 percent more motor units in their leg muscle tissue, and these units were functioning better than those of people in the sedentary group. In the control group, many of the electrical messages from the motor neuron to the muscle showed signs of “jitter and jiggle,” which are actual scientific terms for signals that stutter and degrade before reaching the muscle fiber. Such weak signaling often indicates a motor neuron that is approaching death.

In essence, the sedentary elderly people had fewer motor units in their muscles, and more of the units that remained seemed to be feeling their age than in the athletes’ legs.

The athletes’ leg muscles were much healthier at the cellular level.

“They resembled the muscles of people decades younger,” said Geoffrey Power, who led the study while a graduate student at McGill and is now an assistant professor at the University of Guelph in Ontario.

Of course, this type of single-snapshot-in-time study can’t tell us whether the athletes’ training actually changed their muscle health over the years or if the athletes were somehow blessed from birth with better muscles, allowing them to become superb masters athletes.

But Dr. Power, who also led the 2010 study, said that he believes exercise does add to the numbers and improve the function of our muscle units as we grow older.

Whether we have to work out like a world-class 80-year-old athlete to benefit, however, remains in question. Most of these competitors train intensely for several hours every week, Dr. Power said. But on the plus side, some of them did not start their competitive regimens until they had reached their 50s, providing hope for the dilatory among us.

Saturday, March 26, 2016

How I Rationalize My Athletic Failures

As I age (and age and age) I have a new ally in my many shortcomings: rationalization.

"I'd do better but I'm an `older athlete,' so that's o.k."

And then a patient, Cheshire smile. (Now slowly blink your eyes and pat your belly).

Greying hair turning silvery white adds a sort of distinction to getting worse and worse and worse. Isn't that a dirty trick!

While wishing I were in the Olympics but searching for a way to let myself off the hook I came upon this interesting essay:
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Against Athletic Pride

Brian Jay Stanley

Watching Olympic swimmers paddling through the water with gangly legs and arms, heaving their heads up for air, unequipped with fins or gills, I question the pride of the champions.

Goldfish in an aquarium move more gracefully.

Is not a contest of humans swimming like a contest of fish running?

If animals competed in the Olympics, few humans would win medals.

An elephant or rhinoceros would hurl our strongest wrestlers from the mat like plastic dolls.
Our fastest sprinters would lose the 50-meter dash to their cats.
Schools of sardines would dominate synchronized swimming.

Feats of intellect should be accorded more honor than feats of athleticism.

To be an Einstein is to comprehend more of physics than any other mind in the known universe. But to win a gold medal in the Olympics is merely to stand atop one's narrow class of competitors, human beings, who share the same evolutionary handicaps.

The Olympics are really the Special Olympics.

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Being old enough to find one's own history filed away in a folder in the National Archives (true) puts a new spin on cycling event records. When I turned 60 I was elated. Now I could be at the back of the pack and still be `first' in my age-category. "(F)or his age category" always followed "And a new record was set by Dan Fallon."

Like I have said many times in the past: I'm special. (Given my age).

`Getting old' vs. Aging

The community in which I live has a `common house' that we jointly fund and use for many good purposes. When we moved here last year I brought all my indoor training equipment and set it up in a designated room in the `common house.' My motives were self-interest and communitarian. That is, I didn't want to take up space in my own house with this armamentarium of equipment but wanted it to be nearby and free to use.

The community neighbors were delighted to have the equipment: Concept2 indoor rower, Solex Elliptical, indoor bicycle on a wind-resistance trainer, a set of free weights, and a bunch of mats, etc.

They wanted assistance in learning how best to use the equipment.

We have a lot of kids and their working parents here. The kids don't use the stuff. Their parents use it irregularly when time permits. But the older, often semi- or fully retired folks have a real interest in the equipment.

None of the community users are athletes. They use the equipment for 30 minutes every other day or so. They asked me for an `orientation' to the equipment and if I'd be the community person available for instruction, etc....

As folks age their `parts' start to give them trouble. Unless there is deliberate and disciplined attention to working to stay fit we will all just seize up and become sedentary.

And that is the very definition of `getting old' to 99% of us: seizing up and becoming sedentary.

That is, an increasingly submissive giving-in to predictable physical impediments.

The `getting old' spiral cycle is as follows:

Ouch! that hurts!
I won't do THAT again.
Next time I have to get up to do something I won't do it because it hurts.
I sit more.
I move less.
I become known to myself as `not able.'
I eat more.
I drink more.
I shuffle around more.
I lose fitness (muscle mass, flexibility, cardiovascular capacity, stamina).
My body decides on it's own that I want to slowly `die' down.
I get sick.
I take `fake it' pills (that trick my organs into not dieing so fast).
I get fat.
Now that I'm fat it's even harder to move!

And so the descent into the spiraling cycle of decrepitude continues.

It's a `psychology' of voluntary withdrawal from life. And the emotional anxiety it generates within us requires effort to deal with.

In otherwords, `getting old' and decrepit is hard work and we earn every debility we accomplish! It is NOT a simple function of the passage of time. We `choose' decrepitude.

Aging is not for sissies. It requires clear-headed vigilance and a more mature commitment than just coasting along on the inertia that youth gives us.

Aging isn't about getting weak and fragile. It's an opportunity! We can exploit this opportunity and gain enormous satisfaction in doing so. Goals. Methods. Discipline. Consistency. The strength and resilience to persist through predictable setbacks.

You just can't ask for anything better.

And here is recent scientific support for the proposition that endurance activity makes for an ever-smarter brain.

So, when I orient and `coach' the older neighbors I tell them that they should get the hell out of the exercise room and use the immensely challenging terrain around us.

BUT, when they do need to use the indoor equipment their focus should be on: building balance, cardiovascular capacity, muscle and stamina.

So ... indoor training on rollers is good for aging folks because it trains our balance and the vestibular system.

Same with the elliptical. Get on the elliptical and don't use your hands or arms. Just use your legs. You'll find that you'll need all the micromuscles in your legs and core to stay balanced and upright while you're `ellipting' along.

The indoor rower adds upper body strength, `lubricates' and `flexibilizes' the feet, ankles, knees, hips, core, lower back, chest, hands, wrists, elbows, shoulders, arms.

More on motivation ...

(I ride without music. Part of it has to do with safety. Part of it has to do with the fact that, after a while, it's like chewing dead chewing gum. At least half my reason for no music is because I get a chance to think about things.)

Yesterday, on an 8 hour ride, a few things came together for me about my own motivation.

I entered three 24 hour races in the past 12 months and finished none of them. If nothing else, I spent a lot of money traveling places just to DNF.

I didn't feel the least bit `bad' about DNF'ing three big events in a row. THAT is what really got me thinking about motivation.

Why did I put all that time and money into something that, when I DNF'd, it wasn't a problem?

On two of the 24 hour events my DNF was, what I consider, `legitimate. That is I didn't have the physical resources to finish (another story). However, this last February was different. I stopped after 14 hours because `it wasn't worth it.'

Not `worth' it?!

And no sense of disappointment in myself after DNF'ing?!

Here is where you, the reader, may want to stop reading. Although this is about `motivation' it has to do with MY motivation. Maybe generalizable to you. Maybe not.

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Work in process. That's how I consider myself these days.

First, I've learned not to be so vulnerable to other's opinion of me or my actions. We can call it many things but `maturity' is probably the most accurate.

Second, my own temperament. We each have a `temperament' and psychological research suggests that there is a great deal of heritability to temperament. I have a low tolerance for most people, despite my profession. When younger I tended to try to change people. Now, older and more mature, I realize that is disrespectful and pointless.

Finally, I am concerned about what only a very few people think of me or my actions. (And, if their opinion of me is based on my cycling performance ... we've both made a mistake).

--

Several years ago I gave an interview about why I was doing the Race Across the West - RAW (which I ultimately didn't finish). The interviewer stated that it was a certainty that I would finish. I corrected him, stating that "if I knew I could do it I wouldn't." ?!!

RAW, to me, was an unanswered question. Did I have it in me to finish? I found out that I did not have sufficient training to finish. The lesson was that Ultracycling is harder than I thought. And if I wanted to be successful at it I would have to devote more time and resources to training.

I subsequently put in more time and devoted more resources to my training. I completed a few events (including a 24 hour race) that had never been before on a recumbent.

More important, however, I learned what it takes to successfully complete significant Ultracycling events.

--

The 24 hour event that I ended after 14 hours because it wasn't `worth it' confirmed to me what I said several years earlier: If I knew I could do it I wouldn't. I knew that I could successfully complete the 24 hour event. So I stopped when the `pain v. benefit' equation became apparent.

Why, then, did I devote so much time and effort to the 24 hour event?

--

So this is what I have learned about myself, so far.

My real motive for the race was `social.'
I wanted to meet the people I had communicated with for years but never `saw.'
I wanted to spend time with a few old friends I missed.
I wanted to see the 24 hour course that so many people had talked about.

--

What a surprise.

Surprised because I recognized that the core source of motivation for me is consistent: Only a challenge that is mammoth, the outcome of which I am uncertain, is `worth it.' ("If I knew I could do it I wouldn't.")

Surprised that I was interested in the people of the event.  A `social' appeal?! This realization is counter to all the psychological defenses I have built to keep from being hurt by other's opinion of me. It counters my `hermit' temperament.

--

So, what am I going to do differently, now that I have conscious awareness of the topography of my motivation?

Well, first, I'm going to admit that I am more social than I have allowed. Deconstructing some defenses is scary, but `worth it.'

Then I'm going to be more careful about choosing cycling challenges. It turns out that I live in a location that has no end to cycling challenges. Is it `worth it' to me to attempt these challenges knowing that social approval and prestige are unlikely to be gained?   A `private' challenge.

Then there is, for me, the moral component of this.  Training for and spending money on events that I ultimately don't really care about has implications.

An intense training plan means that I short-change family and friends. When I'm training I'm absent. When I'm not training I'm tired and not much of a friend or husband.

Money is not for free. Without going into detail it is a moral `thing' for me to not `waste' money that other people deservedly need. Hotels, gasoline and road food ... these are not socially appropriate uses of money.