Atherosclerosis Ultrasound – Stroke Prevention Testing & Screening Near Me

Stroke Prevention  and also Screening near me
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Atherosclerosis Ultrasound


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5 Preventive Health Screenings for these Diseases:



Carotid Artery Disease – Atherosclerosis Ultrasound

An ultrasound is done to evaluate the carotid arteries (a pair of capillary in the neck that delivers blood to your brain) for the accumulate of fatty plaque. Atherosclerosis ultrasound.  This accumulation, called atherosclerosis, is just one of the leading reasons for stroke.

Carotid (kuh-ROT-id) ultrasound is a secure, pain free treatment that uses acoustic waves to examine the blood flow through the carotid arteries. Atherosclerosis ultrasound.

Your  2 carotid arteries  lie on each side of your neck. They  supply blood from your heart to your  mind.

Carotid ultrasound  examinations for blocked or  tightened carotid arteries, which can  enhance the  threat of stroke. Atherosclerosis ultrasound.  The outcomes can assist your physician determine a therapy to lower your stroke threat.

Ischemic stroke. A carotid ultrasound is performed to  evaluate for narrowed carotid arteries, which  boost the risk of stroke.

Carotid arteries are generally tightened by a buildup of plaque – comprised of fat, cholesterol, calcium as well as other compounds that circulate in the bloodstream. Early diagnosis and treatment of a narrowed carotid artery can decrease stroke danger.

Your doctor will advise carotid ultrasound if you have transient ischemic attacks (TIAs) or specific kinds of stroke as well as may recommend a carotid ultrasound if you have clinical problems that raise the danger of stroke, consisting of:

  • Hypertension.
  • Diabetes mellitus.
  • High cholesterol.
  • Family history of stroke or cardiovascular disease
  • Recent short-term ischemic attack (TIA) or stroke.
  • Unusual audio in carotid arteries (bruit), spoted by your medical professional utilizing a stethoscope.
  • Coronary artery  condition.

To evaluate for narrowed or obstructed blood vessels in various other locations of the body, you might require added tests, including:

 Stomach ultrasound. Atherosclerosis ultrasound.  You might have an abdominal ultrasound to check for conditions impacting the capillary or organs in your abdominal area.

Ankle-brachial index test. This test procedures as well as contrasts the blood pressure in between your ankle and your arm. The examination reveals decreased or blocked blood circulation to your legs.

Cardiac stress test. Atherosclerosis ultrasound.  This examination shows how well your heart executes when under tension, such as during exercise. Results can show inadequate blood flow to the heart.

Atherosclerosis ultrasound.  Your medical professional might likewise get imaging examinations to detect coronary artery illness.

Other uses of carotid ultrasound.
Your doctor may  get a carotid ultrasound to:.

 Review blood flow through the artery after surgery to remove plaques (carotid endarterectomy).

Evaluate the placement as well as performance of a stent, a mesh tube utilized to improve blood flow through an artery.

Find a collection of clotted blood (hematoma) that might stop blood circulation.

Detect  various other carotid artery  irregularities that  might  interfere with blood flow.



Outer Arterial Disease (PAD) – Atherosclerosis Ultrasound

Atherosclerosis ultrasound.  An Ankle-Brachial Index (ABI) test is done utilizing blood pressure cuffs on the arms as well as legs. It is very important to screen for PAD since it raises the threat of coronary artery disease, heart attack, or stroke.

Peripheral artery  condition ( additionally called  outer arterial  condition) is a  usual condition in which  tightened arteries  decrease blood  circulation to the arms or legs.

In peripheral artery disease (PAD), the legs or arms–  typically the legs– don’t  get  adequate blood  circulation to  stay on par with  need. Atherosclerosis ultrasound.  This may cause leg discomfort when walking (claudication) and also various other symptoms.

Peripheral artery illness is normally a sign of a build up of fatty down payments in the arteries (atherosclerosis). Atherosclerosis creates constricting of the arteries that can decrease blood circulation in the legs as well as, sometimes, the arms.

Peripheral artery disease  therapy  consists of  working out, eating a  healthy and balanced  diet plan  as well as not  cigarette smoking or  making use of  cigarette.

 Signs and symptoms.
 Many individuals with peripheral artery  illness have mild or no  signs and symptoms. Some people have leg pain when  strolling (claudication).

Claudication signs include muscle mass pain or cramping in the legs or arms that starts throughout exercise and also finishes with rest. Serious leg discomfort may make it tough to walk or do various other kinds of physical task.

Other peripheral artery disease  signs  might include:

  • Coldness in the reduced leg or foot, particularly when compared to the opposite.
  • Leg pins and needles or weakness.
  • No pulse or a weak pulse in the legs or feet.
  • Excruciating cramping in one or both of the hips, upper legs or calf bone muscular tissues after certain activities, such as strolling or climbing up stairs.
  • Shiny skin on the legs. Atherosclerosis ultrasound.
  • Skin color changes on the legs.
  • Slower growth of the toenails.
  • Sores on the toes, feet or legs that will not {heal| recover,
  • Discomfort when utilizing the arms, such as hurting and cramping when knitting, composing or doing various other manual tasks.
  • Erectile dysfunction.
  • Hair loss or slower hair  development on the legs.

If  outer artery  illness  worsens, pain  might  take place during rest or when  relaxing. The  discomfort may  disrupt sleep. Hanging the legs over the edge of the bed or walking  might  briefly  alleviate the  discomfort.

Development of atherosclerosis. Atherosclerosis ultrasound.  Peripheral artery disease is typically triggered by a build-up of fatty, cholesterol-containing down payments (plaques) on artery walls. This procedure is called atherosclerosis. It decreases blood flow with the arteries.

Atherosclerosis  influences arteries throughout the body. When it  happens in the arteries supplying blood to the  arm or legs, it  triggers peripheral artery  illness.

Less  usual causes of peripheral artery disease  consist of:

  • Blood vessel swelling.
  • Injury to the arms or legs.
  • Adjustments in the muscles or ligaments.
  • Radiation exposure.
  • Threat elements.
  •  Smoking cigarettes or having  diabetes mellitus  significantly  boosts the risk of  establishing  outer artery disease.


Other  points that  boost the risk of peripheral artery  condition  consist of:.

  • A family history of outer artery illness, cardiovascular disease or stroke.
  • Hypertension.
  • High cholesterol. Atherosclerosis ultrasound.
  • High degrees of an amino acid called homocysteine, which raise the danger for coronary artery disease.
  • Increasing age, specifically after 65 (or after 50 if you have danger factors for atherosclerosis).
  • Obesity (a body mass index over 30).


Complications of peripheral artery condition caused by atherosclerosis consist of:

Atherosclerosis ultrasound.   In this condition, an injury or infection  creates tissue to  pass away.  Signs include open sores on the  arm or legs that  do not  recover. 

Stroke as well as heart attack. Plaque accumulation in the arteries can likewise impact the capillary in the heart and mind.

 The very best way  to stop leg pain  because of  outer artery disease is to maintain a healthy  way of living.

That  suggests:.

  • Don’t smoke.
  • Control blood sugar.
  • Consume foods that are low in saturated fat.
  • Obtain routine workout – but consult your treatment provider regarding what kind and how much is finest for you.
  • Maintain a healthy and balanced weight
  •  Handle blood pressure and cholesterol.


Abdominal Aortic Aneurysm (AAA) – Atherosclerosis Ultrasound

Atherosclerosis ultrasound.  An ultrasound is executed to screen the stomach aorta for the visibility of an augmentation or aneurysm. AAA can result in a fractured aortic artery, which is a significant medical emergency.

An abdominal aortic aneurysm is an  bigger area in the lower part of the  significant vessel that  provides blood to the body (aorta). Atherosclerosis ultrasound.  The aorta runs from the heart with the center of the upper body as well as abdomen.

The aorta is the largest capillary in the body, so a fractured abdominal aortic aneurysm can trigger lethal blood loss.

 Relying on the  dimension of the aneurysm  as well as  just how  quick it’s growing, treatment varies from watchful waiting to emergency  surgical treatment.

 Abdominal aortic aneurysms  commonly  expand slowly without  recognizable  signs and symptoms, making them  tough to  find. Some aneurysms  never ever  burst. 

If you have an expanding abdominal aortic aneurysm, you may notice:

  • Deep, consistent pain in the stubborn belly area or side of the stubborn belly (abdomen).
  • Back pain.
  • A pulse near the belly button.

Aneurysms can develop anywhere along the aorta, but  a lot of aortic aneurysms  take place in the part of the aorta that’s in the  stubborn belly area ( abdominal area).

Several points can contribute in the growth of an abdominal aortic aneurysm, including:

  • Setting of the arteries (atherosclerosis). Atherosclerosis takes place when fat and also various other substances build up on the lining of a capillary.
  • Hypertension. High blood pressure can damage and damage the aorta’s walls.
  • Blood vessel  illness. These are  conditions that  trigger  capillary to become inflamed.
    Infection in the aorta. Rarely, a microbial or fungal infection may cause an stomach aortic aneurysms.
  • Trauma. For example, being hurt in a automobile mishap can cause an stomach aortic aneurysms.
  •  Threat  elements.

Stomach aortic aneurysm threat factors consist of:

Smoking is the strongest danger aspect for aortic aneurysms. Cigarette smoking can damage the walls of the aorta, increasing the risk of aortic aneurysm and also aneurysm tear.

Age. Stomach aortic aneurysms happen most often in people age 65 and also older.

Being  man. Atherosclerosis ultrasound.  Guy create stomach aortic aneurysms far more frequently than females do.
Being white. People  that are white  go to higher risk of  stomach aortic aneurysms.

Family history. Having a family history of abdominal aortic aneurysms increases the  danger of having the condition.

Other aneurysms. Having an aneurysm in another  big  capillary, such as the artery behind the knee or the aorta in the  upper body (thoracic aortic aneurysm), might  enhance the risk of an  stomach aortic aneurysm.

Atherosclerosis ultrasound.  If you’re at danger of an aortic aneurysm, your doctor could recommend other measures, such as drugs to reduce your blood pressure as well as relieve stress and anxiety on damaged arteries.

Splits in one or more of the layers of the wall of the aorta (aortic breakdown) or a fractured aneurysm are the main problems. A rupture can trigger lethal internal blood loss. In general, the bigger the aneurysm as well as the quicker it grows, the better the threat of tear.

Signs and symptoms that an aortic aneurysm has fractured can include:

  • Sudden, intense and relentless abdominal or neck and back pain, which can be described as a tearing experience.
  • Reduced blood pressure.
  • Fast pulse.
  • Aortic aneurysms also increase the  threat of  establishing  embolism in the  location. If a  embolism breaks loose from the inside wall of an aneurysm  and also  obstructs a  capillary  somewhere else in your body, it can  create pain or block blood  circulation to the legs, toes, kidneys or abdominal organs.


To stop an aortic aneurysm or keep an aortic aneurysm from aggravating, do the following:

  • Do not smoke or make use of tobacco items. Quit smoking or eating tobacco and also stay clear of secondhand smoke. If you need assistance stopping, talk with your physician concerning medicines and also therapies that might assist. Atherosclerosis ultrasound.
  • Consume a healthy diet regimen. Concentrate on eating a variety of vegetables and fruits, entire grains, fowl, fish, and also low-fat dairy products. Avoid saturated and also trans fats as well as limit salt.
  • Keep your blood pressure and cholesterol controlled. If your medical professional has actually recommended medicines, take them as instructed.
  •  Get  normal  workout. Try to get at  the very least 150 minutes a week of  modest  cardiovascular activity. 


Atrial Fibrillation (AFib) – Atherosclerosis Ultrasound

A 6-lead electrocardiogram (EKG) is done by positioning sensors on the arms as well as legs to screen for Atrial Fibrillation.  Atherosclerosis ultrasound. AFib can bring about blood clots, stroke, as well as heart failure, and other heart-related complications.

Atrial fibrillation (A-fib) is an irregular and also typically very quick heart rhythm (arrhythmia) that can bring about embolism in the heart. A-fib boosts the risk of stroke, cardiac arrest and other heart-related problems.

Throughout atrial fibrillation, the heart’s top chambers (the room) beat chaotically as well as off-and-on – out of sync with the reduced chambers (the ventricles) of the heart. For lots of people, A-fib may have no symptoms. Atherosclerosis ultrasound.  Nevertheless, A-fib might trigger a quickly, pounding heartbeat (palpitations), shortness of breath or weak point.

Episodes of atrial fibrillation might come and go, or they may be persistent. A-fib itself typically isn’t dangerous, it’s a significant clinical problem that requires correct treatment to protect against stroke.

Treatment for atrial fibrillation  might  consist of  drugs, therapy to reset the heart rhythm  and also catheter  treatments to  obstruct  damaged heart signals.

A person with atrial fibrillation may  likewise have a related heart rhythm  issue called atrial flutter. Although atrial flutter is a  various arrhythmia, the  therapy is quite similar to atrial fibrillation. 

 Signs and symptoms.
Some people with atrial fibrillation (A-fib) don’t notice any  signs and symptoms. Atherosclerosis ultrasound.  Those who do have atrial fibrillation signs may have symptoms and signs such as:.

  • Experiences of a fast, trembling or pounding heartbeat (palpitations).
  • Upper body discomfort.
  • Wooziness.
  • Fatigue.
  • Impaired thinking.
  • Reduced capability to exercise.
  • Shortness of breath.
  •  Weak point.


Atrial fibrillation might be:

Occasional (paroxysmal atrial fibrillation). A-fib signs come and go, generally lasting for a few mins to hrs. In some cases symptoms happen for as long as a week as well as episodes can happen repeatedly. Some people with occasional A-fib need therapy.

Persistent. With this sort of atrial fibrillation, the heart rhythm does not return to regular by itself. If a individual has A-fib symptoms, cardioversion or treatment with medications may be utilized to bring back as well as maintain a regular heart rhythm.

Long-lasting relentless. This sort of atrial fibrillation is continual and lasts longer than 12 months.
Permanent. Atherosclerosis ultrasound.  In this type of atrial fibrillation, the uneven heart rhythm can’t be restored. Drugs are needed to manage the heart rate and also to stop embolism.

To understand the  reasons for A-fib, it  might be  practical to  understand how the heart typically  defeats.

The typical heart has four chambers – two top chambers (atria) and 2 reduced chambers (ventricles). It creates the signal that starts each heart beat.

In a normal heart rhythm:

  • The signal travels from the sinus node with both top heart chambers (atria).
  • The signal passes through a path between the top and reduced chambers called the atrioventricular (AV) node.
  • The movement of the signal creates your heart to press ( agreement), sending blood to your heart and also body.
  • In atrial fibrillation, the signals in the upper chambers of the heart are chaotic. As a result, the upper chambers shake (quiver). The AV node is  after that  pestered with signals  attempting to get through to the lower heart chambers (ventricles). This causes a  quick  as well as  uneven heart rhythm. 


The heart rate in atrial fibrillation  might  vary from 100 to 175 beats a minute. The normal  array for a heart  price is 60 to 100 beats a minute.

 Root causes of atrial fibrillation.
 Troubles with the heart’s  framework are the most  typical  reason for atrial fibrillation. Atherosclerosis ultrasound.  Possible reasons for atrial fibrillation include:.

  • Coronary artery disease.
  • Heart attack.
  • Heart defect that you’re born with ( genetic heart problem).
  • Heart valve problems.
  • High blood pressure.
  • Lung illness.
  • Physical stress as a result of surgical treatment, pneumonia or various other ailments.
  • Previous heart surgery.
  • Issue with the heart’s all natural pacemaker ( ill sinus disorder).
  • Rest apnea.
  • Thyroid condition such as an over active thyroid (hyperthyroidism) and other metabolic discrepancies.
  • Use of energizers, consisting of certain medications, caffeine, cigarette and also alcohol.
  • Viral infections.

Some  individuals who have atrial fibrillation have no known heart problems or heart damage.

Threat factors. Atherosclerosis ultrasound.
Things that can  boost the  danger of atrial fibrillation (A-fib)  consist of:.

Age. The older a  individual is, the  higher the  danger of  establishing atrial fibrillation.

Heart disease. Anyone with cardiovascular disease– such as heart valve issues, congenital heart disease, coronary infarction, coronary artery disease, or a background of heart attack or heart surgery– has actually an boosted danger of atrial fibrillation.

High blood pressure. Having hypertension, especially if it’s not well controlled with lifestyle changes or drugs, can raise the risk of atrial fibrillation.

Thyroid disease. In some individuals, thyroid issues may activate heart rhythm problems (arrhythmias), consisting of atrial fibrillation.

Other persistent health conditions. Individuals with particular chronic problems such as diabetic issues, metabolic disorder, chronic kidney condition, lung condition or rest apnea have actually an enhanced danger of atrial fibrillation.

Drinking alcohol. For some people, drinking alcohol can trigger an episode of atrial fibrillation. Binge alcohol consumption further rises the risk.

Obesity.  Atherosclerosis ultrasound.  People that have weight problems are at higher danger of developing atrial fibrillation.

Family history. An enhanced risk of atrial fibrillation occurs in some households.

Blood clots are a  hazardous  problem of atrial fibrillation that can  bring about stroke.

In atrial fibrillation, the chaotic heart rhythm can  create blood to collect in the heart’s  top chambers ( room) and form  embolisms. Atherosclerosis ultrasound.  If a embolism in the left upper chamber (left atrium) breaks devoid of the heart location, it can travel to the brain as well as cause a stroke.

The risk of stroke from atrial fibrillation increases as you  age. Other health  problems  likewise may increase your risk of a stroke  as a result of A-fib,  consisting of:.

  • High blood pressure.
  • Diabetic issues.
  • Cardiac arrest.
  • Some valvular cardiovascular disease.
  • Blood  slimmers are commonly prescribed  to avoid  embolism  and also strokes in people with atrial fibrillation.

Healthy and balanced lifestyle selections can lower the danger of cardiovascular disease as well as might prevent atrial fibrillation. Atherosclerosis ultrasound.  Here are some fundamental heart-healthy tips:

  • Eat a nourishing diet plan.
  • Obtain routine workout and keep a healthy and balanced weight.
  • Don’t smoke.
    Avoid or limit alcohol and caffeine.
  • Manage  tension, as  extreme stress and  rage can  create heart rhythm  troubles.


Weakening of bones Risk – Atherosclerosis Ultrasound

An ultrasound is  executed to  gauge the shin bone for  unusual bone mass density. Atherosclerosis ultrasound.  This can assist assess the threat of osteoporosis, a disease where bones end up being weak as well as weak.

Osteoporosis causes bones to become weak and fragile – so fragile that a autumn or even light anxieties such as flexing over or coughing can cause a crack. Osteoporosis-related fractures most generally take place in the hip, wrist or spinal column.

Osteoporosis influences males and females of all races. However white and Asian females, particularly older women who are previous menopause, are at greatest risk. Medicines, healthy and balanced diet plan and also weight bearing exercise can assist stop bone loss or strengthen already weak bones.

 Signs and symptoms.
There generally are no signs and symptoms in the beginning of bone loss. As soon as your bones have been deteriorated by osteoporosis, you may have indications and signs and symptoms that consist of:

  • Pain in the back, triggered by a fractured or broke down vertebra.
  • Loss of height with time.
  • A stooped stance.
  • A bone that  damages  a lot more easily than  anticipated.

 Contrasting the  inside of a healthy bone with one that  has actually become porous from  weakening of bones.
Osteoporosis  compromises bone.

 Just how likely you are to  establish  weakening of bones depends  partially on how much bone mass you attained in your youth. Peak bone mass is partly inherited  as well as  differs  likewise by ethnic group. The higher your  optimal bone mass, the  even more bone you have “in the  financial institution”  as well as the  much less likely you are to develop osteoporosis as you age.

 Threat factors.
A number of variables can boost the chance that you’ll create weakening of bones– including your age, race, way of life options, as well as clinical problems as well as treatments. Atherosclerosis ultrasound.

Unchangeable  dangers.
Some threat elements for weakening of bones run out your control, consisting of:

  • Your sex. Women are far more likely to establish weakening of bones than are males.
  • Age. The older you get, the better your danger of osteoporosis.
  • Race. You’re at greatest risk of weakening of bones if you’re white or of Asian descent.
  • Family history. Having a parent or sibling with osteoporosis places you at higher threat, particularly if your mom or daddy fractured a hip.
  • Body structure size. Males and female who have little body frameworks have a tendency to have a higher danger due to the fact that they could have much less bone mass to draw from as they age.
  • Hormone  degrees.

Weakening of bones is more usual in people that have too much or inadequate of certain hormonal agents in their bodies. Examples include:

Sex  hormonal agents. Lowered sex  hormonal agent  degrees  have a tendency to weaken bone. The fall in estrogen levels in  females at menopause is one of the  toughest risk factors for developing osteoporosis.  Therapies for prostate cancer that  lower testosterone levels in  guys  as well as treatments for breast  cancer cells that reduce estrogen  degrees in  ladies are likely to  increase bone loss. 

 Nutritional factors.
 Weakening of bones is more likely to occur in  individuals who have:

Reduced calcium intake. A long lasting lack of calcium plays a role in the development of weakening of bones. Reduced calcium consumption adds to decreased bone thickness, early bone loss and also an raised risk of fractures.

Eating disorders. Severely limiting food consumption and also being underweight deteriorates bone in both men and women.

Long lasting use of dental or injected corticosteroid medications, such as prednisone as well as cortisone, disrupts the bone-rebuilding procedure. Atherosclerosis ultrasound.  Weakening of bones has actually also been connected with medicines utilized to deal with or stop:

  • Seizures.
  • Gastric reflux.
  • Cancer cells.
  • Transplant rejection.
  • Medical  problems.

The risk of  weakening of bones is higher in  individuals  that have certain medical  issues,  consisting of:.

  • Celiac disease.
  • Inflammatory bowel disease.
  • Kidney or liver condition.
  • Cancer.
  • Several myeloma.
  • Rheumatoid arthritis
  •  Way of life  options.

Some bad habits can raise your threat of osteoporosis. Instances consist of:

Inactive lifestyle. People who invest a lot of time resting have a higher risk of weakening of bones than do those that are more active. Any type of weight bearing exercise and tasks that advertise balance and great position are advantageous for your bones, but walking, running, jumping, dance and also weight-lifting seem specifically useful.
 Extreme alcohol  usage. Atherosclerosis ultrasound.  Normal usage of more than two alcoholic drinks a day raises the risk of osteoporosis.

Tobacco usage. The exact duty tobacco plays in osteoporosis isn’t clear, however it has been shown that cigarette use contributes to weak bones.

How  weakening of bones can  trigger vertebrae to crumple  and also collapse.
Compression  cracks.

 In many cases,  back  cracks can  happen even if you  have not  dropped. The bones that  comprise your  back (vertebrae) can weaken to the point of collapsing, which can  cause  pain in the back,  shed height  as well as a  stooped  ahead  pose.

Good  nourishment  and also regular exercise are  vital for  maintaining your bones  healthy and balanced throughout your life.

Men and women between the ages of 18  and also 50 need 1,000 milligrams of calcium a day. This daily  quantity increases to 1,200 milligrams when  females  transform 50  and also men  transform 70.

Great sources of calcium consist of:

  • Low-fat dairy products.
  • Dark eco-friendly leafy {vegetables| veggies
  • Tinned salmon or sardines with bones.
  • Soy items, such as tofu.
  • Calcium-fortified cereals  as well as orange juice.


The Health  and also Medicine Division of the National Academies of Sciences, Engineering, and Medicine  suggests that total calcium intake, from supplements  and also diet  incorporated, should be no more than 2,000 milligrams daily for  individuals older than 50.

Vitamin D.
Vitamin D improves the body’s  capacity to absorb calcium  and also  enhances bone health in other  means. Atherosclerosis ultrasound.  Individuals can get several of their vitamin D from sunshine, however this may not be a great resource if you stay in a high latitude, if you’re housebound, or if you regularly utilize sunscreen or avoid the sun as a result of the risk of skin cancer cells.

Dietary sources of vitamin D include cod liver oil, trout and salmon.  Several types of milk and  grain have been  strengthened with vitamin D.

Most  individuals  require  a minimum of 600  global  systems (IU) of vitamin D a day. That  referral  boosts to 800 IU a day after age 70.

Individuals without various other resources of vitamin D as well as especially with limited sun exposure may require a supplement. The majority of multivitamin items contain between 600 and 800 IU of vitamin D. Up to 4,000 IU of vitamin D a day is safe for many people.

Exercise can assist you develop solid bones and also sluggish bone loss. Atherosclerosis ultrasound.  Workout will certainly profit your bones anytime you start, but you’ll get one of the most advantages if you begin working out frequently when you’re young and remain to exercise throughout your life.

Weight-bearing workouts– such as walking, jogging, running, stair climbing, avoiding rope, winter sports as well as impact-producing sporting activities– impact primarily the bones in your legs, hips as well as lower back. Equilibrium exercises such as tai chi can reduce your danger of falling especially as you get older.


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