Thanksgiving Conversations
Thanksgiving: so much turkey, stuffing and canned cranberry jelly; so much time with friends and family; so many important, meaningful conversations. I had three reactions: first, I ate too much; second, people can be incredibly thoughtful, caring, and trusting; and third, we can do better to support how we navigate cognitive health concerns.
Here are some of the questions I heard:
"I live in Georgia, but my Mom lives near Vero. Her husband has Lewy Body Disease and they both need more help, even though her husband may not think so. They don’t have easy access to resources. What can we do?"
"How do we deal with the dysfunction in our local healthcare system?"
[Email]: “We are abroad and my mother-in-law had an unexpected change in medical status. Do we stay for treatment or travel back to the US? What are the flight risks?"
"My p-tau217 is elevated—what does that mean?"
"We’re exhausted. Always. We need support, care, and direction now. What can we do?"
"I’ve been hearing about those weight loss drugs (GLP-1s). Can those help my brain health?"
"Do microplastics disrupt tau clearance? I mean, am I going to hurt my brain if we don’t clean up the Indian River Lagoon?"
These questions all map onto the same three fundamental needs.
1. "What does this signal actually mean? Is this something or is it nothing?"
This is at the heart of what Treasure Coast Cognition does: we tie signal to meaning.
Many people now receive p-tau217 results, Aβ42/40 ratios, inflammatory markers, sleep data from wearables, or confusing research headlines. The challenge is interpretation.
A biomarker is probabilistic, not deterministic. An elevated p-tau217 is a probability, not a diagnosis. Effect sizes in research don't always translate to clinically meaningful change. And what's clinically meaningful isn't always the same as the real-world changes that matter most to you.
The GLP-1 question illustrates this perfectly. The recent Alzheimer's trial results were disappointing—but that doesn't mean GLP-1s don't matter for brain health. What's true for Alzheimer's disease specifically may not be the same as what's true for midlife metabolic risk modification, late-life vascular protection, or pre-dementia cognitive reserve. A negative trial in one disease at one stage doesn't eliminate the potential for meaningful impact in a different context.
Whether the concern is p-tau217, GLP-1 trial results, microplastics, or an urgent medical decision abroad, people are trying to understand: Is this something? Or is it nothing?
At Treasure Coast Cognition, we help individuals and families determine which signals are meaningful—and which are not.
2. "What should I be monitoring over time?"
This is exactly what Treasure Coast Cognition helps you figure out.
People don't just want data—they want direction.
When someone asks "What should I expect?" or "What should I be looking for?" or "How do I know if something is shifting?"—what they're really asking is: Which patterns actually matter, and how do I track them responsibly?
You want to monitor what is meaningful—so you can know when changes are meaningful.
Questions about local healthcare dysfunction reflect this same need. Continuity and longitudinal monitoring are exactly what fragmented systems fail to provide. When the system is broken, people still need guidance—and they need it from someone who understands both the science and the context of where they live.
Traditional healthcare does not provide this continuity. Treasure Coast Cognition does.
3. "What will matter most in the next 5–10 years?"
This question is why I'm building Treasure Coast Cognition here.
Healthcare systems need to work within the context of the places and systems where we live and function. When there's dysfunction in the local healthcare system, we still need to meet the healthcare needs of the community. When someone faces an urgent decision while traveling abroad, they need clarity fast. When a family in a remote setting needs a care plan, they need guidance that works across distance.
Cognitive stewardship has to be embedded in the environment where people actually live.
Questions about why Treasure Coast Cognition exists here, or how to navigate a broken healthcare system, or whether GLP-1s help cognition all point back to a desire for long-term clarity:
How do I stay independent?
How do I protect function?
How do I keep doing the things that matter to me?
What decisions should I prepare for?
What actions actually change my trajectory?
But there's another layer to this question. The microplastics question points to something bigger: What lives in the environment around us that could be changed outside of us to improve our lives? Individual risk modification matters, but so does community-level action to decrease environmental contributors to poor brain health. Cognitive Stewardship isn't just personal—it's also environmental and systemic.
The goal isn't just early detection. It's early direction.
Where the Questions Converge
Even though Thanksgiving brought questions about biomarkers, metabolism, microplastics, healthcare systems, and urgent medical decisions, the underlying focus was the same:
What does this signal mean?
What should I monitor?
What will matter most over the next decade?
Treasure Coast Cognition exists to help people answer these questions with clarity, calm, and evidence—and to help them stay aligned with the life they want to protect.
Interpretation → insight → action.
That's Cognitive Stewardship.
