Every three seconds, someone in the world develops dementia. There are over 6 million people living with dementia in the U.S. and 57 million globally.

These figures will only increase in the coming years, as rates of dementia are predicted to double by 2060. If you don’t know someone affected by dementia, you probably will at some point.

Dementia is incredibly difficult both for the person experiencing it and for their loved ones, not only because of the symptoms of the disease but also because of the social stigma associated with cognitive decline. Experiencing stigma makes it difficult for people with dementia to ask for help, increases anxiety and depression, and ultimately leads to social isolation.

Dementia-related stigma is perpetuated through media messages that portray people with dementia as mindless and incapable, as well as through daily interactions in which others dismiss and dehumanize the person living with dementia.

These forms of invalidation – usually unintentional – accelerate and intensify the loss of self-worth and identity that dementia patients are already experiencing.

Fortunately, educating and spreading awareness can help reduce behaviors that propagate stigma and dehumanizing treatment of people with dementia.

As a social scientist and researcher in interpersonal communication and family caregiving, I explore the social and relational side of dementia. Through my work with these patients and families, I’ve learned that reducing stigma and supporting self-worth for people who have dementia is often done through daily conversations.

How is dementia defined?

Dementia is an umbrella term that refers to a family of cognitive conditions involving memory loss, difficulty thinking or processing information, changes in ability to communicate and challenges with managing daily tasks.

The most common form of dementia is Alzheimer’s disease, but there are several other forms of dementia that can severely affect a person’s quality of life and that of their loved ones.

Most forms of dementia are progressive, meaning that the symptoms of the disease get steadily worse over time. A person with dementia can live with the disease for several years, and their symptoms will shift as the disease progresses.

People in the early stages of dementia, including mild cognitive impairment, continue to engage socially and participate in many of the activities they have always done. In the middle stage of the disease, people often need more help from others to complete daily tasks and may have more difficulty holding conversations. In the late stage, people with dementia are dependent on others and often lose the ability to communicate verbally.

Despite the cognitive declines that come with dementia, people living with dementia can maintain many of their former abilities as the disease progresses. Even in the late stages, research shows that people with dementia can understand tone of voice and nonverbal communication such as body language, facial expressions and gentle touch.

This makes it clear that people with dementia can continue having meaningful social connections and a sense of self-worth even as their disease progresses.

Focusing care around the person

In the 1990s, psychologist Tom Kitwood, who studied dementia patients in long-term care settings, introduced the notion of “personhood.” Personhood is a recognition of a person’s unique experiences and individual worth. He had observed that residents with dementia were sometimes treated as objects rather than people and were dismissed as being “no longer there” mentally. In response, Kitwood advocated for a new model of person-centered care.

In contrast to the medical model of care that was standard at the time, person-centered care aims to provide people with dementia comfort, attachment, inclusion, occupation and identity.

Comfort includes both physical and psychological comfort, ensuring that the person with dementia feels safe and is as pain-free as possible. Attachment and inclusion have to do with supporting a person with dementia’s closest relationships and making sure they feel included in social activities.

Occupation is about giving the person meaningful activities that are suited to their abilities, while identity is about preserving their unique sense of self. According to Kitwood, each of these elements of personhood can be upheld or threatened through a person’s interactions with others.

I find Kitwood’s work particularly important because it suggests that communication is at the heart of personhood.

Communicating to support personhood

So how can family members and friends communicate with their loved one with dementia to help preserve their sense of self?

Researchers have identified several evidence-based communication strategies that support person-centered care both in long-term care settings and within the family.

These include:

• Arranging the environment to support conversation. Have conversations in a quiet place with as few distractions as possible, sit at eye level and close to the person, make eye contact and use gestures to reinforce what you say.

• Acknowledging the person with dementia as a unique individual. Helping your loved one remember who they were before dementia is critical to supporting their sense of self-worth. In long-term care, this is done by greeting them, calling them by name and integrating their past experiences into conversations. In families, it is done by inviting the person to reminisce about their past or reminiscing together and by talking about their accomplishments and admirable qualities.

• Affirming and validating the person’s emotions. Even if you don’t understand what the person is thinking or feeling, avoid correcting them and instead acknowledge their underlying emotion.

• Seeking the person’s input about their care. This includes asking about their preferences for food or activities, usually using simple “yes” or “no” questions, and asking their permission before helping them with physical care such as bathing, moving or changing clothes.

• Using simple prompts to help the person successfully engage in conversation. This can be done through repeating or rephrasing questions, paraphrasing the person’s responses, pausing to give the person time to think, and providing simple prompts to help the person remember.

• Creating and maintaining connection. In families, this is done by giving a hug or kiss or saying “I love you”; doing activities together such as playing simple games, making art or playing music; and joking around and laughing together.

Communication shifts as the disease progresses

Supporting personhood requires adjusting to the communication abilities of the person with dementia. Some communication strategies are helpful in one stage of the disease but not in others.

In a recent study, my team and I found that asking the person with dementia to recall the past was affirming for those who were early in the disease and who could still recall the past. But for people who were in later stages of the disease, asking them “Do you remember?” was received more like a test of memory and led to frustration or confusion. Similarly, we found that suggesting words to prompt recall was helpful later in the disease but demeaning for people who were in earlier stages of the disease who could still find their words without help.

Providing more help in conversation than is needed can lead people with dementia to withdraw, whereas appropriately adjusting to a person’s communication abilities can empower them to continue to engage socially.

Ultimately, supporting a person with dementia’s sense of self and self-worth in conversations is about finding a communication sweet spot – in other words, matching your approach to their current capabilities.

Changing your default approach to conversations can be challenging, but making simple communication changes can make all the difference. Meaningful conversations are the key to helping your loved one live their days to the fullest, with a sense of personal worth and a feeling of meaningful connection with others.

R. Amanda Cooper, Assistant Professor of Communication, University of Connecticut

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Envision a time when hundreds of spacecraft are exploring the solar system and beyond. That’s the future that NASA’s ESCAPADE, or Escape and Plasma Acceleration and Dynamics Explorers, mission will help unleash: one where small, low-cost spacecraft enable researchers to learn rapidly, iterate, and advance technology and science.

The ESCAPADE mission launched on Nov. 13, 2025 on a Blue Origin New Glenn rocket, sending two small orbiters to Mars to study its atmosphere. As aerospace engineers, we’re excited about this mission because not only will it do great science while advancing the deep space capabilities of small spacecraft, but it also will travel to the red planet on an innovative new trajectory.

The ESCAPADE mission is actually two spacecraft instead of one. Two identical spacecraft will take simultaneous measurements, resulting in better science. These spacecraft are smaller than those used in the past, each about the size of a copy machine, partly enabled by an ongoing miniaturization trend in the space industry. Doing more with less is very important for space exploration, because it typically takes most of the mass of a spacecraft simply to transport it where you want it to go.

Having two spacecraft also acts as an insurance policy in case one of them doesn’t work as planned. Even if one completely fails, researchers can still do science with a single working spacecraft. This redundancy enables each spacecraft to be built more affordably than in the past, because the copies allow for more acceptance of risk.

Studying Mars’ history

Long before the ESCAPADE twin spacecraft Blue and Gold were ready to go to space – billions of years ago, to be more precise – Mars had a much thicker atmosphere than it does now. This atmosphere would have enabled liquids to flow on its surface, creating the channels and gullies that scientists can still observe today.

But where did the bulk of this atmosphere go? Its loss turned Mars into the cold and dry world it is today, with a surface air pressure less than 1% of Earth’s.

Mars also once had a magnetic field, like Earth’s, that helped to shield its atmosphere. That atmosphere and magnetic field would have been critical to any life that might have existed on early Mars.

ESCAPADE will measure remnants of this magnetic field that have been preserved by ancient rock and study the flow and energy of Mars’ atmosphere and how it interacts with the solar wind, the stream of particles that the sun emits along with light. These measurements will help to reveal where the atmosphere went and how quickly Mars is still losing it today.

Weathering space on a budget

Space is not a friendly place. Most of it is a vacuum – that is, mostly empty, without the gas molecules that create pressure and allow you to breathe or transfer heat. These molecules keep things from getting too hot or too cold. In space, with no pressure, a spacecraft can easily get too hot or too cold, depending on whether it is in sunlight or in shadow.

In addition, the Sun and other, farther astronomical objects emit radiation that living things do not experience on Earth. Earth’s magnetic field protects you from the worst of this radiation. So when humans or our robotic representatives leave the Earth, our spacecraft must survive in this extreme environment not present on Earth.

ESCAPADE will overcome these challenges with a shoestring budget totaling US$80 million. That is a lot of money, but for a mission to another planet it is inexpensive. It has kept costs low by leveraging commercial technologies for deep space exploration, which is now possible because of prior investments in fundamental research.

For example, the GRAIL mission, launched in 2011, previously used two spacecraft, Ebb and Flow, to map the Moon’s gravity fields. ESCAPADE takes this concept to another world, Mars, and costs a fraction as much as GRAIL.

Led by Rob Lillis of UC Berkeley’s Space Sciences Laboratory, this collaboration between spacecraft builders Rocket Lab, trajectory specialists Advanced Space LLC and launch provider Blue Origin – all commercial partners funded by NASA – aims to show that deep space exploration is now faster, more agile and more affordable than ever before.

How will ESCAPADE get to Mars?

ESCAPADE will also use a new trajectory to get to Mars. Imagine being an archer in the Olympics. To hit a bull’s-eye, you have to shoot an arrow through a 15-inch – 40-centimeter – circle from a distance of 300 feet, or 90 meters. Now imagine the bull’s-eye represents Mars. To hit it from Earth, you would have to shoot an arrow through the same 15-inch bull’s-eye at a distance of over 13 miles, or 22 kilometers. You would also have to shoot the arrow in a curved path so that it goes around the Sun.

Not only that, but Mars won’t be at the bull’s-eye at the time you shoot the arrow. You must shoot for the spot that Mars will be in 10 months from now. This is the problem that the ESCAPADE mission designers faced. What is amazing is that the physical laws and forces of nature are so predictable that this was not even the hardest problem to solve for the ESCAPADE mission.

It takes energy to get from one place to another. To go from Earth to Mars, a spacecraft has to carry the energy it needs, in the form of rocket fuel, much like gasoline in a car. As a result, a high percentage of the total launch mass has to be fuel for the trip.

When going to Mars orbit from Earth orbit, as much as 80% to 85% of the spacecraft mass has to be propellant, which means not much mass is dedicated to the part of the spacecraft that does all the experiments. This issue makes it important to pack as much capability into the rest of the spacecraft as possible. For ESCAPADE, the propellant is only about 65% of the spacecraft’s mass.

ESCAPADE’s route is particularly fuel-efficient. First, Blue and Gold will go to the L2 Lagrange point, one of five places where gravitational forces of the Sun and Earth cancel out. Then, after about a year, during which they will collect data monitoring the Sun, they will fly by the Earth, using its gravitational field to get a boost. This way, they will arrive at Mars in about 10 more months.

This new approach has another advantage beyond needing to carry less fuel: Trips from Earth to Mars are typically favorable to save fuel about every 26 months due to the two planets’ relative positions. However, this new trajectory makes the departure time more flexible. Future cargo and human missions could use a similar trajectory to have more frequent and less time-constrained trips to Mars.

ESCAPADE is a testament to a new era in spaceflight. For a new generation of scientists and engineers, ESCAPADE is not just a mission – it is a blueprint for a new collaborative era of exploration and discovery.

This article was updated on Nov. 13, 2025 to reflect the ESCAPADE launch’s date and success.

Christopher Carr, Assistant Professor of Aerospace Engineering, Georgia Institute of Technology and Glenn Lightsey, Professor of Space Systems Technology, Georgia Institute of Technology

This article is republished from The Conversation under a Creative Commons license. Read the original article.

A “black box” warning on a health product sounds pretty scary – maybe even more so when it’s suddenly being taken off the packaging.

Americans were reminded of this type of public health messaging on Nov. 10, 2025, when the Food and Drug Administration announced it is removing the “black box” warning from hormone replacement therapy for menopause.

But what are these warnings, anyway? What’s their history, and how do they affect a drug’s use?

I am a clinical pharmacologist and pharmacist studying drug prescribing, safety and effectiveness for over 25 years.

Black box warnings – or as the FDA officially calls them, boxed warnings – are a tool for alerting pharmacists and clinicians that the medication may have serious risks. These health care professionals are then expected to communicate those risks to consumers.

An official source of drug information

Black box warnings for particular medications appear on the product package inserts that the FDA requires pharmaceutical companies to create for each prescription drug.

Product package inserts provide official information about the drug to health care professionals. These pamphlets are attached to bulk containers of drugs purchased by pharmacies so that the pharmacist has the most updated official information on the product. The package inserts are also published in textbooks such as the Physician’s Desk Reference and on websites maintained by drug manufacturers.

The requirement for product package inserts came out of a consumer protection law passed in 1966, called the Fair Packaging and Labeling Act, which aimed to prevent unfair or deceptive packaging in products used by consumers.

The package insert carries a set of official information about the drug, provided by the manufacturer and regulated by the FDA. The insert must include who the drug is approved for, proper dosing and administration, and a description of the key clinical trial results that showed it was effective and safe.

It must also disclose any health risks that the drug poses – such as a boxed warning.

Flagging safety risks

The FDA has two categories for the health risks that medications could pose: precautions and warnings. Both are listed on the package insert.

Precautions warn clinicians of possible harm that could result in minor or moderate injury to patients. Warnings, on the other hand, alert them to the potential risk of dangerous adverse events that could result in serious injury or death. The most serious warnings for a drug are called boxed warnings. The text of those warnings is enclosed by a black box on the insert so they will not be missed by clinicians.

According to a 2022 study, more than 400 medications currently carry black box warnings.

Antidepressants are one example. While such drugs can lessen the severity of depression symptoms, researchers have found that during the first few weeks of taking them, patients have an increased risk of suicide – particularly children and young adults. The FDA first issued a black box warning about the drugs’ use in children and adolescents in 2004 and expanded the warning to young adults in 2007.

Another example is clozapine, a drug used to suppress delusions experienced by people with schizophrenia. Although the drug is very effective, the FDA first gave it a black box warning when it was reintroduced to the market in 1989 because it can stop the production of white blood cells, potentially leading to life-threatening infections.

Hormone replacement therapy for menopause got its black box warning in 2003 after a clinical trial called the Women’s Health Initiative pointed to an increased risk of breast cancer without a reduced risk of heart disease in women who used it.

In subsequent years, reanalyses of the Women’s Health Initiative results, as well as data from other studies, have shown that the therapy is safe in women ages 50 to 60. Newer, safer formulations of estrogen and progestin have also emerged. These factors prompted the FDA to remove the warnings in November 2025, saying the therapy doesn’t pose significant risks.

Medical and legal realities

Black box warnings can influence clinicians’ choice of whether or not to prescribe a particular drug. For example, since other drugs for schizophrenia do not carry the serious risks that clozapine does, clinicians usually reserve that medicine for people who could not use those other drugs.

The black box warnings can also play a role in malpractice cases. In some states, package inserts and any warnings they contain can be used to establish a standard of care, leaving clinicians who deviate from them liable for damages. In other states, the warnings they list can be used to support findings of negligence.

For instance, the black box warning on the insert of the drug thalidomide states it can cause birth defects. It instructs clinicians to obtain a a negative pregnancy test before use and ensure the patient is not able to get pregnant or is taking precautions to avoid pregnancy before prescribing. Failure to do so could make the clinician liable if the person taking the drug bears a child with birth defects.

Product package inserts are living documents. As new information becomes available, the FDA may find a medication’s risk is untenable and request the drug be removed from the market. Or it may decide to remove the boxed warning from the drug if new data shows the drug is less dangerous than previously thought.

C. Michael White, Distinguished Professor of Pharmacy Practice, University of Connecticut

This article is republished from The Conversation under a Creative Commons license. Read the original article.