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Early indicators of dementia: 5 behaviour changes to look for after age 50

<p><em><a href="https://theconversation.com/profiles/daniella-vellone-1425451">Daniella Vellone</a>, <a href="https://theconversation.com/institutions/university-of-calgary-1318">University of Calgary</a> </em></p> <p>Dementia is often thought of as a memory problem, like when an elderly person asks the same questions or misplaces things. In reality, individuals with dementia will not only experience issues in other areas of cognition like learning, thinking, comprehension and judgement, but they may also experience <a href="https://www.alzint.org/u/World-Alzheimer-Report-2021.pdf">changes in behaviour</a>.</p> <p>It’s important to understand what dementia is and how it manifests. I didn’t imagine my grandmother’s strange behaviours were an early warning sign of a far more serious condition.</p> <p>She would become easily agitated if she wasn’t successful at completing tasks such as cooking or baking. She would claim to see a woman around the house even though no woman was really there. She also became distrustful of others and hid things in odd places.</p> <p>These behaviours persisted for some time before she eventually received a dementia diagnosis.</p> <h2>Cognitive and behavioural impairment</h2> <p>When cognitive and behavioural changes interfere with an individual’s functional independence, that person is considered to have dementia. However, when cognitive and behavioural changes don’t interfere with an individual’s independence, yet still negatively affect relationships and workplace performance, they are referred to as <a href="https://alzheimer.ca/sites/default/files/documents/other-dementias_mild-cognitive-impairment.pdf">mild cognitive impairment (MCI)</a> and <a href="https://doi.org/10.1186/s13195-021-00949-7">mild behavioural impairment (MBI)</a>, respectively.</p> <p><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9169943/">MCI and MBI can occur together</a>, but in one-third of people who develop Alzheimer’s dementia, the behavioural symptoms come <a href="http://dx.doi.org/10.1016/j.jagp.2019.01.215">before cognitive decline</a>.</p> <p>Spotting these behavioural changes, which emerge in later life (ages 50 and over) and represent a persistent change from longstanding patterns, can be helpful for implementing preventive treatments before more severe symptoms arise. As a medical science PhD candidate, my research focuses on problem behaviours that arise later in life and indicate increased risk for dementia.</p> <h2>Five behavioural signs to look for</h2> <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/551071/original/file-20230928-17-jmy46j.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img src="https://images.theconversation.com/files/551071/original/file-20230928-17-jmy46j.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/551071/original/file-20230928-17-jmy46j.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=525&fit=crop&dpr=1 600w, https://images.theconversation.com/files/551071/original/file-20230928-17-jmy46j.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=525&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/551071/original/file-20230928-17-jmy46j.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=525&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/551071/original/file-20230928-17-jmy46j.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=659&fit=crop&dpr=1 754w, https://images.theconversation.com/files/551071/original/file-20230928-17-jmy46j.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=659&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/551071/original/file-20230928-17-jmy46j.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=659&fit=crop&dpr=3 2262w" alt="Illustration of five behaviour changes that may indicate risk of dementia" /></a><figcaption><span class="caption">Spotting behavioural changes can be helpful for implementing preventive treatments before more severe symptoms arise.</span> <span class="attribution"><span class="source">(Daniella Vellone)</span></span></figcaption></figure> <p>There are <a href="https://doi.org/10.3233%2FJAD-160979">five primary behaviours</a> we can look for in friends and family who are over the age of 50 that <a href="https://doi.org/10.1186/s13024-023-00631-6">might warrant further attention</a>.</p> <h2>1. Apathy</h2> <p><a href="https://doi.org/10.1002%2Ftrc2.12370">Apathy</a> is a decline in interest, motivation and drive.</p> <p>An apathetic person might lose interest in friends, family or activities. They may lack curiosity in topics that normally would have interested them, lose the motivation to act on their obligations or become less spontaneous and active. They may also appear to lack emotions compared to their usual selves and seem like they no longer care about anything.</p> <h2>2. Affective dysregulation</h2> <p><a href="https://doi.org/10.1016/j.jad.2023.03.074">Affective dysregulation</a> includes mood or anxiety symptoms. Someone who shows affective dysregulation may develop sadness or mood instability or become more anxious or worried about routine things such as events or visits.</p> <h2>3. Lack of impulse control</h2> <p><a href="https://doi.org/10.1002%2Ftrc2.12016">Impulse dyscontrol</a> is the inability to delay gratification and control behaviour or impulses.</p> <p>Someone who has impulse dyscontrol may become agitated, aggressive, irritable, temperamental, argumentative or easily frustrated. They may become more stubborn or rigid such that they are unwilling to see other views and are insistent on having their way. Sometimes they may develop sexually disinhibited or intrusive behaviours, exhibit repetitive behaviours or compulsions, start gambling or shoplifting, or experience difficulties regulating their consumption of substances like tobacco or alcohol.</p> <h2>4. Social inappropriateness</h2> <p><a href="http://dx.doi.org/10.1017/S1041610217001260">Social inappropriateness</a> includes difficulties adhering to societal norms in interactions with others.</p> <p>Someone who is socially inappropriate may lose the social judgement they previously had about what to say or how to behave. They may become less concerned about how their words or actions affect others, discuss private matters openly, talk to strangers as if familiar, say rude things or lack empathy in interactions with others.</p> <h2>5. Abnormal perceptions or thoughts</h2> <p><a href="https://doi.org/10.1038/s44220-023-00043-x">Abnormal perception or thought content</a> refers to strongly held beliefs and sensory experiences.</p> <p>Someone with abnormal perceptions or thoughts may become suspicious of other people’s intentions or think that others are planning to harm them or steal their belongings. They may also describe hearing voices or talk to imaginary people and/or act like they are seeing things that aren’t there.</p> <p>Before considering any of these behaviours as a sign of a more serious problem, it’s important to rule out other potential causes of behavioural change such as drugs or medications, other medical conditions or infections, interpersonal conflict or stress, or a recurrence of psychiatric symptoms associated with a previous psychiatric diagnosis. If in doubt, it may be time for a doctor’s visit.</p> <h2>The impact of dementia</h2> <p>Many of us know someone who has either experienced dementia or cared for someone with dementia. This isn’t surprising, given that dementia is predicted to affect <a href="https://www.ctvnews.ca/health/nearly-one-million-canadians-will-live-with-dementia-by-2030-alzheimer-society-predicts-1.6056849#:">one million Canadians by 2030</a>.</p> <p>While people between the ages of 20 and 40 may think that they have decades before dementia affects them, it’s important to realize that dementia isn’t an individual journey. In 2020, care partners — including family members, friends or neighbours — spent <a href="https://alzheimer.ca/sites/default/files/documents/Landmark-Study-1-Path-Forward-Alzheimer-Society-of-Canada-2022-wb.pdf">26 hours per week</a> assisting older Canadians living with dementia. This is equivalent to 235,000 full-time jobs or $7.3 billion annually.</p> <p>These numbers are expected to triple by 2050, so it’s important to look for ways to offset these predicted trajectories by preventing or delaying the progression of dementia.</p> <h2>Identifying those at risk</h2> <p>While there is currently no cure for dementia, there has been progress towards <a href="https://alzheimer.ca/en/about-dementia/dementia-treatment-options-developments">developing effective treatments</a>, which <a href="https://alzheimer.ca/en/about-dementia/do-i-have-dementia/how-get-tested-dementia-tips-individuals-families-friends/10">may work better earlier in the disease course</a>.</p> <p>More research is needed to understand dementia symptoms over time; for example, the online <a href="https://www.can-protect.ca/">CAN-PROTECT study</a> assesses many contributors to brain aging.</p> <p>Identifying those at risk for dementia by recognizing later-life changes in cognition, function as well as behaviour is a step towards not only preventing consequences of those changes, but also potentially preventing the disease or its progression.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/213954/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><a href="https://theconversation.com/profiles/daniella-vellone-1425451"><em>Daniella Vellone</em></a><em>, Medical Science and Imaging PhD Candidate, <a href="https://theconversation.com/institutions/university-of-calgary-1318">University of Calgary</a></em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/early-indicators-of-dementia-5-behaviour-changes-to-look-for-after-age-50-213954">original article</a>.</em></p>

Mind

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Blinker wars: Quiz on correct roundabout rules sparks intense debate

<p>A simple question about the right way to indicate on a roundabout has sparked a debate after some drivers disagreed with the correct answer.</p> <p>The Department of Transport and Main Roads Queensland (TMR) tested its Facebook users on their road rules knowledge by posting a photo of a blue car entering a roundabout.</p> <p>“The blue car wants to travel straight ahead at the roundabout. How should they indicate?”</p> <p>The post garnered hundreds of comments and despite majority of users getting the answer right, it was alarming how many people failed the simple test.</p> <p>Some believed the driver wasn’t required to indicate at all when driving straight through the roundabout, a mistake that could result in a $393 fine.</p> <p>“No blinker required,” said one person.</p> <p>“Who in Qld uses an indicator when going straight and exiting … no one, no need to start today,” said another.</p> <p>Other people were certain that indication was required when entering and exiting the roundabout.</p> <p style="text-align: center;"><iframe src="https://www.facebook.com/plugins/post.php?href=https%3A%2F%2Fwww.facebook.com%2FTMRQld%2Fposts%2F2560010187375182&amp;width=500" width="500" height="639" style="border: none; overflow: hidden;" scrolling="no" frameborder="0" allowtransparency="true" allow="encrypted-media"></iframe></p> <p>“Yes the car should indicate when entering and exiting the roundabout as it has two lanes,” one motorist wrote.</p> <p>Another driver said the motorist going straight through has the option to indicate right on entry but is obligated to indicate left when leaving the roundabout.</p> <p>One user agreed, saying they were sure it was “right on entry and left on exit”, but changed their mind after searching up the rule.</p> <p>“Ugh. Just checked. Looks like I was wrong. I will track down my driving instructor from a billion years ago and have a word with him. Jerk shouted at me when I didn’t indicate on entry going straight ahead,” they wrote.</p> <p>TMR later on revealed the correct answer, saying the driver only has to indicate when exiting the roundabout.</p> <p>“Because they’re travelling straight through, the driver of the blue car *doesn’t* need to indicate when they enter the roundabout,” the post read.</p> <p>“They do though need to flick on the left indicator to exit the roundabout (and off again once they’ve exited).”</p>

Domestic Travel

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When eye contact indicates something much darker

<p>We usually interpret someone looking us straight in the eye during an interaction as a sign of trustworthiness. In fact it can be rather unsettling when someone avoids eye contact. This is at least the case in the Western world, where we use eye contact as a marker of honesty and straightforwardness – taking it as a positive attribute, particularly in those we do business with.</p> <p>But research is <a href="https://www.tandfonline.com/doi/abs/10.1080/10417940601000576">increasingly challenging</a> this standard view. Our study, <a href="https://onlinelibrary.wiley.com/doi/full/10.1002/ejsp.2336">published in the European Journal of Social Psychology</a>, shows quite the opposite: in a competitive environment where a negotiation is taking place, looking at another person directly in the eye can be a sign of competition and malevolence, rather than benevolence.</p> <p>Across three experiments, we found that looking someone directly in the eye predicted competitive behaviour – and even deceit. In the first experiment, we used an eye tracker to follow 75 people’s retinas while they had to split money with another person. We found that looking at their opponent directly in the eye predicted making a lower first offer toward that person.</p> <p>In another experiment, we assigned 53 people to look at either their opponent’s eyes or other parts of their face. People assigned to the former condition made lower first offers to their opponents in a simulated job contract negotiation than those assigned to the latter.</p> <p><strong>Split or steal</strong></p> <p>Perhaps most interestingly, we also combed through the data of 99 episodes of <a href="https://www.imdb.com/title/tt1186336/">Golden Balls</a>, a UK game show that ran from 2007-9. The show is structured to allow two players to make it to a final round – accumulating a jackpot along the way. In this final round, the players must decide what to do with this valuable pot of money. In front of each player are two balls, one marked “steal” and the other marked “split”.</p> <p>The two players engage in a dialogue about which ball they will choose. If both players choose to “split”, they get to split the jackpot. And if both players choose “steal”, neither gets anything. But if Player A chooses “split” and Player B chooses “steal”, Player A gets nothing and Player B gets the entire jackpot (or vice versa). That means each player’s goal is to convince the other to choose the “split” ball, with almost all players signalling to their opponent that this is the choice they will make.</p> <p>We watched and coded all the videotapes for the amount of direct eye contact that each player gave to another during this final conversation and then examined if this number could predict players’ ball choice. In fact it did – but in the opposite direction than most would think. Greater eye contact was linked to a player being more likely to choose the steal rather than the split ball – even when they explicitly stated otherwise.</p> <p>The direct eye contact with the other player was measured in terms of the number of times during the interaction that a contestant had direct gaze with the other player.</p> <p><strong>Real life implications</strong></p> <p>While folk wisdom tells us eye contact is a sign of honesty and trustworthiness, these findings were not a surprise to my research team and me. Animals have direct eye contact not before engaging in benevolent behaviours, but rather immediately before an attack – eye contact is a <a href="https://www.sciencedirect.com/science/article/pii/S0149763400000257">sign of challenge and threat</a> from another. We humans seem to be carrying on this tradition by (subconsciously) looking our opponent directly in the eye before we “attack”.</p> <p>What does this mean for the work place? In a competitive business environment, when taking part in negotiations or a business deal for example, be aware that people who look you directly in the eye may not be as friendly as you think. And if you want to come across as honest and trustworthy – especially in more international settings – direct eye contact may indicate the opposite. In many Asian cultures, for example, looking a person of higher status in the eye <a href="http://www.asiamarketingmanagement.com/howtobehaveinchina.html">is a sign of disrespect</a>, while looking away signals deference.</p> <p>All our experiments took place in a competitive environment – negotiations or a high-stakes game show – and must be understood within this context. This means they most likely don’t apply to social environments, such as spending time with friends, family or loved ones. In these cases, direct eye contact, often referred to as a “gaze”, <a href="https://www.psychologytoday.com/us/blog/cutting-edge-leadership/201404/5-secret-powers-eye-contact">can still be a sign of intimacy</a> and benevolence.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important; text-shadow: none !important;" src="https://counter.theconversation.com/content/113787/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: http://theconversation.com/republishing-guidelines --></p> <p><em>Written by <span>Jennifer Jordan, Professor of Leadership &amp; Organizational Behavior, IMD Business School</span>. Republished with permission of </em><a href="https://theconversation.com/think-direct-eye-contact-makes-someone-trustworthy-it-can-be-a-sign-of-something-much-darker-113787"><em>The Conversation</em></a><em>. </em></p>

Mind

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The tricky road rules quiz sparking furious debate: Which car should indicate?

<p>The Department of Transport in Western Australia has put motorists to the test with this confusing road rule that has left some drivers a little confused.</p> <p>A graphic posted to the Facebook page shows a white and red car travelling straight though a roundabout.</p> <p>The white car is in the left lane while the red car is in the right lane.</p> <p>Motorists in the comments below were left furious over the confusing road rule, which asked drivers which car should indicate.</p> <p><iframe src="https://www.facebook.com/plugins/post.php?href=https%3A%2F%2Fwww.facebook.com%2FTransportWAgov%2Fphotos%2Fa.1670878236508284%2F2194597427469693%2F%3Ftype%3D3&amp;width=500" width="500" height="639" style="border: none; overflow: hidden;" scrolling="no" frameborder="0" allowtransparency="true" allow="encrypted-media"></iframe></p> <p>Some Facebook users were left divided, while others insisted the answer was obvious.</p> <p>“Both need to indicate right then left as they are exiting,” one user wrote below in the comments.</p> <p>Another added: “White indicate right. Red indicate left.”</p> <p>Drivers were at different ends, one writing: “Can’t believe the number of seemingly serious, wrong answers... indicate left after going past the previous exit!”</p> <p>Other Facebook users made jokes about the quiz, one garnering almost 90 reactions to their comment.</p> <p>“Both should indicate left after passing the exit immediately prior,” the user wrote.</p> <p>“But in WA, no indicators are used, and complex hand and finger gestures and horn use seem to be norm.”</p> <p>Another comment read: “Doesn't matter, white car thinks they are a truck and will also use the lane the red car is using.”</p> <p>The post amassed over 150 comments, some consisting of stumped motorists, others quite sure of their answers.</p> <p>Transport WA put the matter to rest the next day.</p> <p>“The cars don't need to indicate when they're entering the roundabout because they're travelling straight through it,” the page wrote.</p> <p>“Both cars must indicate left when they’ve passed the last exit before the one you intend to use.”</p> <p>Did you guess the answer correctly? Let us know in the comments below.</p>

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The roundabout road rule sparking furious debate: "Why would you indicate right?"

<p>“The orange car wants to travel straight through the roundabout. How should they indicate?”</p> <p>It might sound like a simple question, but it has sent many people into a debate.</p> <p>The Queensland Department of Transport and Main Roads posed the question on its Facebook page and received a bit more feedback than they bargained for, with avid road users commenting their preferred way to leave a roundabout.</p> <p><iframe src="https://www.facebook.com/plugins/post.php?href=https%3A%2F%2Fwww.facebook.com%2FTMRQld%2Fphotos%2Fa.295748123801411%2F2129995160376689%2F%3Ftype%3D3&amp;width=500" width="500" height="645" style="border: none; overflow: hidden;" scrolling="no" frameborder="0" allowtransparency="true" allow="encrypted-media"></iframe></p> <p>Within many eager to prove their knowledge of the road rules, the post quickly racked up likes and comments in the hundreds – and it appears not everyone is a proficient with their road rules knowledge as they might think. </p> <p>"I indicate right going on left coming off," one woman posted.</p> <p>In reply to her response, a commenter wrote: "Why would you indicate right? You aren't going right. You only indicate when exiting the roundabout."</p> <p>Another driver added: "Indicating is not the issue, the issue is that people think that orange car can go right."</p> <p><span>The Queensland Department of Transport and Main Roads also posted a video instructing people on how to effectively use a roundabout.</span></p> <p><iframe width="576" height="324" src="https://www.youtube.com/embed/43omAQcTA-c" frameborder="0" allow="accelerometer; autoplay; encrypted-media; gyroscope; picture-in-picture" allowfullscreen=""></iframe></p> <p>One commenter said that the best way to get off the roundabout is to “use hazard lights and floor it”, with others agreeing that it’s “probably the safest option on the gold coast to be honest”.</p> <p>Another FB user pointed out that the Department of Transport had made a good joke. They said: <span>“Funny question QLD transport! We all know QLD drivers don’t have working indicators in their cars!”</span></p> <p>The correct answer was revealed to the public via the Department of Transport: <span>“Who got it right? The orange car doesn’t need to indicate to enter the roundabout, but needs to indicate left to exit. The indicator must be turned off once they have exited the roundabout.</span><span>”</span></p> <p>Did you know the answer after looking at the picture? Let us know in the comments.</p>

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Terrifying video of Aussie driver switching lanes without using indicator

<p>Using your indicator to signal when you want to change lanes is one of the first (and most important) things we learn about safe driving. But, as you can see in the footage below, it’s a task that’s still too difficult for some Aussie drivers.</p> <p>The terrifying footage, shared by <a href="https://www.facebook.com/DashCamOwnersAustralia/" target="_blank"><span style="text-decoration: underline;"><em><strong>Dash Cam Owners Australia</strong></em></span></a> on Facebook, shows what can happen when you try to switch lanes, without using an indicator.</p> <p>Keep your eye on the car directly ahead.</p> <p><iframe src="https://www.facebook.com/plugins/video.php?href=https%3A%2F%2Fwww.facebook.com%2FDashCamOwnersAustralia%2Fvideos%2F1567519896640978%2F&amp;show_text=0&amp;width=560" width="560" height="236" style="border: none; overflow: hidden;" scrolling="no" frameborder="0" allowtransparency="true" allowfullscreen="true"></iframe></p> <p>The incident, filmed in heavy traffic, would’ve been far worse if the other drivers weren’t paying attention.</p> <p>What are your thoughts on the footage?</p> <p><em>Hero image credit: Facebook / Dash Cam Owners Australia </em></p> <p><a href="https://oversixty.disconline.com.au/car/new_quote.jsp?hSty=EXOS&amp;cgpCde=00272&amp;hCenCde=10737&amp;LinkId=12071&amp;utm_source=over60&amp;utm_campaign=insurance&amp;utm_medium=in-article-banner-car-1&amp;utm_content=car-insurance" target="_blank"><img src="http://media.oversixty.com.au/images/EditorialAddon/201706_CarInsurance_EditorialAddon_468x60_1.gif" alt="Over60 Car Insurance - Get a quote!"/></a></p>

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This personality trait indicates if a child will be successful

<p>Stubbornness, disobedience, and rule-breaking are not traditionally traits you would praise in children, but new research indicates that these qualities could actually be a good thing.</p> <p>According to a recent study, published in <em>Developmental Psychology</em>, children who don’t listen to their parents are destined for success when they grow up, likely to over-achieve in education and go on to earn more in the workforce. </p> <p>The team from the University of Luxembourg, the University of Illinois and the Free University of Berlin studied a group of 745 people for 40 years, from the age of 12 into their adult life. They found that kids who had a tendency toward “rule-breaking and defiance of parental authority” were likely to earn higher incomes in adult life.</p> <p>The researchers speculated, “We might assume that students who scored high on this scale might earn a higher income because they are more willing to be more demanding during critical junctures such as when negotiating salaries or raises.”</p> <p>The study’s authors suggested that this could be due the fact that people with a stubborn nature are more willing to fight for themselves.</p> <p>The researchers wrote, “We might assume that students who scored high on this scale might earn a higher income because they are more willing to be more demanding during critical junctures such as when negotiating salaries or raises.”</p> <p>They added, “Another explanation might be that individuals with higher levels of rule-breaking and defiance of parental authority also have higher levels of willingness to stand up for their own interests and aims, a characteristic that leads to more favourable individual outcomes.”</p> <p><strong>Related links:</strong></p> <p><a href="/lifestyle/family-pets/2015/12/life-lessons-from-grandparents/"><em><strong><span style="text-decoration: underline;">Top 10 life lessons kids learn from grandparents</span></strong></em></a></p> <p> </p> <p><a href="http://www.oversixty.co.nz/lifestyle/family-pets/2016/01/5-types-of-grandparents/"><em><strong><span style="text-decoration: underline;">There are 5 different types of grandparents – which one are you?</span></strong></em></a></p> <p> </p> <p><a href="http://www.oversixty.co.nz/lifestyle/family-pets/2016/01/parents-and-kids-who-look-identical/"><em><strong><span style="text-decoration: underline;">10 pics of parents and kids who look identical</span></strong></em></a></p> <p><a href="/lifestyle/family-pets/2015/10/quotes-about-siblings/"><em><strong><span style="text-decoration: underline;"> </span></strong></em></a></p>

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