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Dementia: Study links 3 vascular health risk factors to increased risk
Dementia: Study links 3 vascular health risk factors to increased risk

Medical News Today

time11 hours ago

  • Health
  • Medical News Today

Dementia: Study links 3 vascular health risk factors to increased risk

New research finds a link between vascular health risk factors and increased dementia risk. MASTER/Getty Images There are many ways to help keep the vascular system healthy, such as not smoking and keeping blood pressure at a healthy level. A new study has found a link between certain midlife vascular risk factors — specifically high blood pressure, diabetes, and smoking — and risk for dementia. Scientists report the attributable vascular risk factors were higher in both female and Black participants, as well as non-carriers of the APOE ε4 gene, which is linked with an increased risk of Alzheimer's. The vascular system refers to all the blood vessels that run through the body. These vessels are in charge of moving oxygen throughout the body and removing waste products. Now, a new study recently published in the journal JAMA Neurology has found a link between certain midlife vascular risk factors — specifically high blood pressure, diabetes, and smoking — and risk for dementia. Scientists report the attributable vascular risk factors were higher in both self-identified female and Black participants, as well as non-carriers of the apolipoprotein ε4 (APOE ε4) gene . For this study, researchers analyzed medical data from about 7,700 participants from the Atherosclerosis Risk in Communities (ARIC) study, which ran from 1987-2020 with a 33-year follow-up. Participant risk factors were measured at ages 45-54, 55-64, and 65-74 years old. Researchers focused on three main vascular risk factors for this study: high blood pressure, diabetes, and smoking. 'There's been pretty consistent research for decades that indicates the importance of these three vascular risk factors in midlife (~ age 45-64 years) for elevating dementia risk, with less consensus on their associations in late-life (~ age ≥75 years),' Jason R. Smith, PhD, ScM, who was at the time of the study a researcher in the Department of Epidemiology at Johns Hopkins Bloomberg School of Public Health in Maryland and first author of this study, told Medical News Today . 'The prevalence of vascular risk factors also remains high in adults. So interventions for vascular factors beginning as early as midlife could potentially avert a big chunk of dementia risk,' he said. Upon analysis, researchers found that between 22–44% of dementia cases reported by participants by age 80 were attributable to midlife and late-life vascular risk factors. 'That 22-44% of population-level dementia risk by 80 years was attributed to at least one vascular risk factor from midlife through early late-life (ages 45-74 years) signals a major prevention gap,' Smith explained. 'Clinical and public health interventions targeting vascular risk beginning as early as midlife could delay or prevent a sizable fraction of dementia risk by 80 years.' 'The burden of dementia remains high,' he continued. 'It has a heterogeneous presentation and pathology, so targeting risk factors that are modifiable, more proximal to dementia expression (including hypertension, diabetes, and smoking), and that could potentially impact more than one underlying process giving rise to dementia, is paramount to reduce population-level dementia risk.' Additionally, scientists found that the vascular risk factor attributable risk was highest in participants who self-identified as female or Black, as well as those not carrying the APOE ε4 gene. 'Caution's warranted when interpreting these stratified analyses, given wide (confidence intervals),' Smith said. 'However, the analysis stratified by APOE carrier status suggests the absolute vascular contribution to dementia is larger among those at lower genetic risk for Alzheimer's disease.' 'And that the vascular contribution was larger among those racialized as Black is likely due to a higher burden of vascular risk factors in this population,' he continued. 'More inclusive and representative research is urgently needed to understand the prevention potential of vascular risk reduction in different populations.' 'While this study is not designed to provide evidence on individual-level dementia risk reduction, promoting optimal vascular health as early as midlife could be vital for reducing population-level dementia risk by 80 years,' Smith added. 'What's good for the heart is good for the brain, and the earlier prevention starts, the better.' MNT spoke with Christopher Yi, MD, a board certified vascular surgeon at MemorialCare Orange Coast Medical Center in Fountain Valley, CA, about this study. Yi commented that this study reinforces an increasingly clear message: vascular health is brain health. 'My first reaction was that the findings were both striking and practical — nearly half of dementia cases by age 80 could be linked to modifiable vascular risk factors like high blood pressure, diabetes, and smoking,' he continued. 'It's especially notable that late-life vascular health appeared even more strongly associated with dementia risk than midlife health, which challenges the idea that 'it's too late' to make a difference after midlife.' Yi explained that vascular health affects dementia risk through several interconnected mechanisms. 'High blood pressure and vascular disease can damage the small vessels that supply the brain, leading to chronic ischemia (lack of oxygen) and brain tissue damage,' he detailed. 'Silent strokes and microinfarcts are common in people with uncontrolled hypertension and diabetes and can accumulate over time, impairing cognitive function without obvious warning signs.' 'Vascular risk factors promote inflammation and free radical damage, which contribute to neurodegeneration and Alzheimer's pathology. (And) chronic vascular dysfunction can make the blood-brain barrier leaky, allowing harmful substances to enter the brain and accelerate neuronal damage.' — Christopher Yi, MD For the next steps in this research, Yi said he would like to see more intervention trials, risk factor-specific analyses, mechanistic studies, and policy translation. 'Explore how these findings could support more aggressive screening and treatment of vascular risks in primary care, with cognitive outcomes in mind,' he added.

13 Reasons Men Leave Long Marriages In Mid-Life
13 Reasons Men Leave Long Marriages In Mid-Life

Yahoo

time21 hours ago

  • General
  • Yahoo

13 Reasons Men Leave Long Marriages In Mid-Life

Marriage isn't just a ceremony or a legally binding contract; it's a journey that two people embark on, often expecting to last a lifetime. Yet, for reasons as varied as the personalities involved, mid-life can be a turning point where some men choose to walk away. This isn't just a story of betrayal or liberation—it's a complex interplay of emotions, desires, and life stages. Here, we delve into the undercurrents that can set men adrift, exploring why they sometimes choose to leave long marriages in their mid-life. As men hit mid-life, the once-looming specter of mortality becomes more tangible, prompting a desire for reinvention and rediscovery. They start questioning the choices they've made, yearning for a blank slate to redefine who they are beyond the roles they've played—as a husband, a father, or a provider. Often, this craving for a personal renaissance becomes an irresistible force, pulling them away from the familiarity of a long marriage. It's not about leaving their partner behind, but rather finding a piece of themselves they feel they've lost. According to a study by the American Psychological Association, the concept of 'mid-life crisis' is real, with men often seeking to assert their identity anew. They might choose to pursue passions or dreams they had shelved for years, only to find their marriage has become an anchor rather than a sail. This isn't about rejecting their partner; it's about reclaiming a sense of individuality. The marriage itself can become a mirror reflecting missed opportunities and unfulfilled potential, spurring the decision to step away. The gradual ebb of emotional intimacy can transform a once-vibrant connection into a hollow shell. When communication dwindles to transactional exchanges about logistics, men often feel they're more roommates than partners. This emotional void can become unbearable, driving a wedge that compels them to seek connection elsewhere. They may find themselves longing for someone who sees them anew and offers the emotional depth missing at home. Men, often conditioned to suppress vulnerability, might struggle to articulate this deep-seated need for emotional intimacy. Conversations that once came naturally now feel forced, and the laughter that once filled the room becomes a rare guest. This emotional distance can fester into resentment, making the relationship feel more like a commitment of obligation rather than affection. The quest for a rekindled emotional connection can lead them away, seeking solace in new horizons. There's an intoxicating allure to the new and undiscovered, a siren call that can compel men to abandon the familiar shores of long-term marriage. As routines become predictably monotonous, the idea of novelty offers a seductive escape from the everyday grind. Exploring new relationships can feel like a return to the vitality and spontaneity of youth, sparking a sense of aliveness that routine fails to provide. It's not just about physical attraction, but the emotional rush of new beginnings. Dr. Helen Fisher, a biological anthropologist, emphasizes that the novelty is a powerful aphrodisiac that triggers dopamine release in the brain, akin to falling in love all over again. This isn't simply about being with someone new; it's about rejuvenating a part of themselves they feared lost to time. When novelty promises a rush of emotions and experiences, the steady rhythm of a long marriage can seem dull in comparison. The pursuit of this high can sometimes override the comforting stability of the known. Old wounds don't heal with time alone; they fester beneath the surface, and for some men, mid-life brings them into sharp focus. Childhood traumas or unresolved personal issues can creep up, manifesting as dissatisfaction with the marriage. It's not that these issues are born out of the relationship, but they find fertile ground in it, exacerbating existing strains. The marriage becomes an echo chamber, amplifying insecurities and fears they've carried throughout life. In seeking resolution, men might feel the need to start anew, away from the triggers embedded in their marital history. The partner becomes an unintentional reminder of these unresolved conflicts, often without either party realizing it. The decision to leave is not out of spite, but rather a misguided attempt to find healing and peace. Unfortunately, without addressing the root issues, they may carry these unresolved problems into new relationships, continuing the cycle. As careers plateau and retirement looms, men often face an existential question: What's next? The roles that once defined them no longer hold the same weight, leading to a crisis of purpose that seeps into their marriage. Without the distraction of career ambitions or the demands of young children, they're left to confront a void that's both terrifying and liberating. This search for purpose can put severe strain on the marriage, as the partner might not understand this internal upheaval. Research from the Harvard Study of Adult Development highlights that purpose in life significantly impacts overall happiness and well-being. For many men, their roles as breadwinners or achievers fade, and they grapple with finding new meaning. The marriage, once a collaborative journey, can feel stifling if one partner is seeking directions the other cannot comprehend. This quest for newfound purpose can drive them away in hopes of finding clarity and fulfillment elsewhere. Expectations can be silent killers of a marriage, especially when they're unmet. Over the years, men might accumulate a litany of unspoken hopes and dreams that reality never quite matched. They might find themselves holding onto memories of what marriage was supposed to be, rather than what it is. This gap between expectation and reality can create a sense of disillusionment, pushing them to seek what they couldn't find at home. These unmet expectations often stem from societal pressures and personal fantasies, which collide with the harsh truths of everyday life. When the fairy tale gives way to the mundane, the dissatisfaction can become overwhelming. Men might feel trapped in a cycle of disappointment, unable to reconcile the partner they imagined with the one they have. The yearning for an ideal marriage can turn into an impetus to leave, in search of a relationship that seems more in line with their dreams. After years of shared decisions and mutual compromises, the desire for personal independence can become a powerful motivator. Men might find themselves longing for the freedom to make choices without the weight of familial obligation. This isn't about selfishness; it's about reclaiming a sense of autonomy that's been diluted by decades of partnership. The allure of being answerable only to oneself can become irresistible. Sociologist Eric Klinenberg suggests in his work that the growing trend of living alone is partly driven by a desire for personal autonomy and self-exploration. For some, the prospect of carving out a space for themselves, free from the expectations of a partner, is deeply appealing. The marriage that once felt like a joint venture can become a cage, limiting their ability to explore personal growth. Seeking autonomy is often an attempt to rediscover their own desires and aspirations, unfettered by the ties of marriage. The emotional labor of maintaining a marriage can be exhausting, especially when it feels unreciprocated or unnoticed. Men might find themselves emotionally drained, having given all they can without feeling recharged. This burnout can lead to a desire to step away from the relationship, not because of a lack of love but due to sheer emotional fatigue. They might feel that leaving is the only way to recover their emotional well-being. In many cases, this burnout isn't recognized until it reaches a critical point where even small tasks feel monumental. The marriage that once provided emotional solace now feels like a burden they're too tired to carry. The decision to leave is often seen as self-preservation, a way to reclaim their emotional energy. It's a complicated dance of self-care and self-doubt, leaving them torn between staying and preserving their emotional health. Growth is an inherent part of life, but when partners grow in different directions, the chasm can become insurmountable. Men might find that their personal evolution no longer aligns with their partner's, leading to a sense of being out of sync. This isn't about one partner being right or wrong, but rather about a shift in compatibility over time. The realization that their paths have diverged can be a catalyst for leaving, seeking someone whose journey aligns more closely with their own. The growth that once brought them together now becomes the very thing that pulls them apart. Shared dreams can transition into individual aspirations, creating a divide that feels too wide to bridge. When efforts to reconnect fail, the prospect of starting fresh becomes appealing. The decision to part ways is often tinged with sadness, yet it's driven by the hope of finding a partnership that matches their current selves. Financial stress is a silent predator that can erode the foundation of even the strongest marriages. For men, the burden of financial responsibility can feel overwhelming, especially if they perceive themselves as failing in this role. Money issues can lead to feelings of inadequacy and shame, which spill over into the marital relationship. The pressure to provide combined with financial instability can make the idea of leaving seem like the lesser of two evils. Disagreements over finances can exacerbate existing tensions, turning money into a battleground rather than a shared resource. When financial struggles dominate the relationship, they can overshadow love and commitment. Men may choose to leave in hopes of finding financial stability on their own terms. This decision, painful as it is, often feels like a necessary step towards regaining control over their lives. A lack of sexual satisfaction can be a potent force driving men away from long marriages. As intimacy fades, they might find themselves yearning for a connection that reignites their passion. The absence of a fulfilling sexual relationship can lead to feelings of inadequacy and frustration, eroding the bond that once existed. Seeking physical and emotional intimacy outside the marriage can seem like the only way to reclaim a sense of vitality. This dissatisfaction isn't always about frequency; it's often about quality and mutual engagement. When sexual intimacy becomes a chore rather than a shared expression, the disconnect can become too much to bear. Men might seek the thrill and excitement they once felt, hoping to find a partner who shares their desires. The decision to leave is frequently an attempt to reclaim a part of their identity they feel has been lost. Routine can be comforting, but for some, it becomes a prison from which they long to escape. Men might find themselves craving adventure and spontaneity, which a long marriage can sometimes stifle. This isn't about rejecting stability but rather seeking a balance that allows for both security and excitement. The allure of adventure can be a powerful draw, pulling them away from the predictable patterns of married life. Mid-life can be a time of introspection, where the desire to experience life to the fullest becomes paramount. The realization that time is finite can spark a yearning for adventure that feels incompatible with the responsibilities of marriage. In leaving, they hope to explore new facets of life, embracing the unknown with open arms. This quest for adventure is often about more than just leaving the marriage; it's about embracing life's limitless possibilities. Friends, family, and societal expectations can exert profound influence on the decision to leave a long marriage. Men might find themselves swayed by the opinions and experiences of those around them, who offer perspectives that can either clarify or complicate their feelings. The pressure to conform to external expectations can sometimes overshadow personal desires. In this tug-of-war between internal and external influences, leaving might seem like the choice that aligns most with the life they wish to lead. External influences often serve as mirrors reflecting back the discontent they feel internally. Watching peers navigate different life paths can evoke envy or a sense of missing out on alternate possibilities. The decision to leave is frequently shaped by a desire to fit into a narrative that feels more authentic to them. This choice is often less about escaping the marriage and more about stepping into a life that resonates with their true self.

Now Foster: Saving Kids, One Weekend A Month
Now Foster: Saving Kids, One Weekend A Month

Forbes

timea day ago

  • General
  • Forbes

Now Foster: Saving Kids, One Weekend A Month

When Now Teach launched in 2017, co-founded by Financial Times columnist Lucy Kellaway and educator Katie Waldegrave, it offered a powerful new narrative: that professionals in midlife had more to give than planning retirement. And that society had more to gain—if only we created more welcoming off-ramps. It was a radical reframe of the so-called 'third quarter' of life, tapping into the talents of people ready for meaningful new careers later in life. Thousands responded. Now, Waldegrave is extending the same midlife transformation logic to one of society's most underserved spaces: foster care. Together with former social worker Laurie Kilby, she's launched Now Foster, a not-for-profit with an equally ambitious goal—to broaden who fosters kids - and how. Katie Waldegrave Now Foster The UK's foster care system is in crisis. There are not enough carers. Outcomes for what's referred to as 'children in care' remain unacceptably awful. Many are placed in residential settings as young as seven, cut off from consistent relationships, and abruptly exited from care at 18 with no support structures. It's a system over-stressed, underfunded, and ill-equipped to serve the 80,000 children currently in its remit. Katie Waldegrave, who began her career in teaching with Teach First, knew the limits of what even the best schools could do. As she dug deeper into the care system after a nudge from journalist and foster carer Martin Barrow, she was struck by the parallels with education—and the potential for change. 'Someone needs to do for fostering what you did for teaching,' he told her. So she did. Enter Now Foster's flagship programme: the Weekenders. This isn't traditional fostering. It's not 24/7 care. Instead, it's a model where trained adults open their homes to the same child one weekend a month, providing continuity, affection and new horizons. Think aunt, uncle, or honorary grandparent—not substitute parent. It's simple. It's smart. And it's working. Laurie Kilby Now Foster Laurie Kilby, who spent years on the frontlines as a social worker, calls it 'the best thing I do.' Her own weekend guest—a 14-year-old boy—calls it 'all the fun, no school run.' It offers children new experiences, and carers a meaningful connection with flexibility. Full-time carers get welcome support. Children gain a second safe adult. And the system gains a new layer of humanity. The Weekender profile echoes that of the Now Teach recruits: midlife professionals with empathy, energy and life experience. Many are still working. Some are not. Some have children, or grandchildren. Others have neither. What they share is a sense of purpose—and the time to offer it. This new format opens the door to people who might never have considered fostering. It removes the 'all or nothing' barrier and makes the first step easier. With a single weekend commitment, many more can say yes. And many more must. Too often, children leave care at 18, defined as 'adult,' with no enduring adult relationships. They are more likely to experience unemployment, homelessness, incarceration—and even shortened life expectancy. At its worst, residential care can cost £250,000 a year and deliver none of the outcomes that justify the cost. Weekenders are a low-cost, high-impact complement to full-time fostering—and potentially a powerful antidote to intergenerational disconnection. Fostering remains poorly understood. It's often confused with adoption or framed in the media through stories of crisis and failure. Few know that fostering can take many forms—from emergency stays to longer-term arrangements—and fewer still would ever consider themselves eligible. Kilby wants to change that. The mission is not just to increase recruitment, but to reframe foster care entirely. Less emergency stop-gap. More intentional relationship. Less bureaucracy. More community. NOW Foster also wants to shift the language. 'Respite care,' a term used when carers reach burnout, can stigmatise children—making them feel they are the cause of the crisis. Weekenders flip the framing. It's not about a break from children. It's about building a team around them. Now Foster is currently active in 10 London boroughs and aims to scale nationally. The long-term ambition: make weekending a recognised and resourced form of foster care in its own right. The goal is a systemic shift. That every child in care, where appropriate, has access to at least two safe, supportive adults. That we normalise intergenerational care. That fostering moves from the shadows to the centre of civic life. And that midlife becomes a powerful source of both individual and societal regeneration—not withdrawal. The parallels to Now Teach are clear. Both initiatives identify untapped potential in people at midlife. Both create smart, flexible structures for impact. Both ask: what if you could matter more in your second half? The difference? Now Foster tackles a crisis that's hidden in plain sight. Foster care is too often an afterthought in policy, philanthropy and media. And yet the costs of inaction—financial, human, and generational—are enormous. But perhaps most compelling of all is what Katie Waldegrave and Laurie Kilby hear from the children themselves. Young people matched with weekenders are beginning to thrive. One, previously restless and unsettled, discovered a love for musical theatre through a weekender's support. She's now applying to university to study it. Others are reconnecting with siblings, building confidence, and finding a thread of stability previously unknown. As Laurie Kilby puts it: 'It only takes one adult to change a child's life. And it doesn't have to be the full-time carer.'

I rowed against ‘C' – the new MI6 chief Blaise Metreweli
I rowed against ‘C' – the new MI6 chief Blaise Metreweli

Telegraph

time4 days ago

  • Sport
  • Telegraph

I rowed against ‘C' – the new MI6 chief Blaise Metreweli

The thing about rowing is that you are never really aware of what the people you row with – or against – do when they are not charging up and down the river. I woke up on Monday morning to discover that the new MI6 chief was a woman. 'Great!' I thought. 'And how very James Bond.' It wasn't until I saw pictures of Blaise Metreweli in her Cambridge University Women's Boat Club kit that I realised I had been racing against her for the past few years. While this particular race has only been running for four years, I think she's taken part in at least three of them, for Cambridge. She's really friendly, down-to-earth and very charming. With some of the Cambridge rowers there is still a hint of the old rivalry in relations post race. Obviously when we are out on the river we want to win, and some of them carry that with them afterwards, but not Blaise. Whether they've won or lost, she's always warm and approachable and, I sense, up for a laugh. She's not going to be a stuffy boss – far from it, she'll be a refreshing change. In 2024, we had a historically close race that ended in a dead heat (awarded to us, by one foot). Afterwards, as we had a drink and shared the hoisting of the trophy, I chatted to Blaise about what midlife rowing meant to us. We agreed that the sport was a chance to get away from all the other stresses of midlife and recreate those bonds we had when we were younger. Many of the older rowers have fairly high-powered jobs, and fit in training alongside. Despite that, I'm impressed she has managed to juggle her career in intelligence with such a committed rowing schedule. But it's no surprise to me that a rower has been promoted to such a high-level position. There are certain qualities that rowers possess that make us highly effective people. One is time management (albeit that messing about in boats always takes longer than you think it should). You can't possibly perform at work and on the river unless you strictly timetable your training. Another is determination. In the early Nineties, women's rowing was still very much a second-class sport. While our male counterparts had hundreds of thousands of pounds of sponsorship from the likes of Beefeater Gin, we celebrated when we were given a tiny portion of that for our kit. At Cambridge, Blaise will have experienced something similar. It makes you resolute and determined to overcome gender bias. Now she has. Then there is the determination required to push yourself to the max. That dead heat was such a fantastic example of midlife women refusing to say die, raging against the perception of 40 and 50-something women as irrelevant and invisible. When she takes over her post as 'C' from Sir Richard Moore on October 1, Metreweli, 47, will become the first woman to run MI6 in its 116-year history. As the only named member of the organisation, Britain's foreign intelligence chief has a dual role as an operational leader and a public figurehead. 'The historic appointment of Blaise Metreweli comes at a time when the work of our intelligence services has never been more vital,' said Sir Keir Starmer, the Prime Minister, adding that he was confident that 'Blaise will continue to provide the excellent leadership needed to defend our country and keep our people safe'. Tall and athletic, with cropped hair and striking blue eyes, Metreweli does not fit the stereotype of an intelligence chief. ' She's almost a female James Bond,' says one source. 'She's action-packed, she's urbane, she's charming, she's the right age. If you were going to cast a female Bond, you could do much worse.' A 'geek' who wanted to be a spy Her appointment marks the culmination of a remarkable ascent. Metreweli joined the service in 1999 after reading Anthropology at Pembroke College. (She is the third 'C' from Pembroke, after Sir Colin Figures and Sir Richard Dearlove). At Cambridge, Metreweli was part of the victorious Cambridge team in the 1997 Boat Race. She initially applied to be a diplomat before moving into the Secret Intelligence Service (SIS). She is said to speak excellent Arabic, and spent much of her early career in the Middle East, at a time when Britain was involved militarily in Afghanistan and Iraq. She is currently the director general of the 'Q' section – the gadget shop in James Bond – responsible for technology and innovation, and previously held other senior level director roles in MI5. 'Obviously [her gender] is historically significant, but she is a fantastic appointment in terms of her skill set and her career in SIS,' says Claire Hubbard-Hall, author of Her Secret Service: The Forgotten Women of British Intelligence. 'She's spent over half her career overseas, some of that time in active war zones. She is an Arabic speaker, she has the tech expertise.' Metreweli has also shown an unusual nous for public relations. In 2021, as 'Director K', MI5's head of hostile states counter-intelligence, she gave an interview to The Telegraph in which she spoke of the need to overhaul the Official Secrets Act, arguing that new laws were needed to 'disrupt what is increasingly damaging activity' from 'malign' foreign powers. 'One of the reasons nobody in the media has ever previously interviewed a Director K is we do our work in secret,' she said. 'Necessarily – it's really sensitive work. But one of the reasons I am talking to you now is we need a whole of society effort.' The National Security Act 2023 that ensued has proved to be a useful tool for security forces. In 2022, under the pseudonym 'Ada', Metreweli gave another interview to the Financial Times in which she revealed that she was a 'geek' who had only ever wanted to be a spy. She recalled growing up abroad commandeering an Usborne spycraft manual from an older brother, learning to write in code. As a handler for field agents, she had to get to grips with nuclear technology as well as managing 'incredibly close relationships with a number of different agents who were risking their lives to be able to share secrets with us'. 'No man's land' Being a woman in a man's world had advantages as well as disadvantages. 'In the moments where you're deciding to become an agent, you're having to make thousands of risk-based calculations, but you're not quite sure how to respond emotionally,' she said. 'There's no etiquette. Ironically, it becomes a bit of a no man's land.' In that space, being a woman could make it easier to break down boundaries. 'I have done some extraordinary things in extraordinary places,' she said. 'And I've had some difficult experiences, both professional and personal. I've had times of trauma and come through the other side, with immense support from the service.' Where previous chiefs have come from diplomatic roles, Metreweli is more of an insider. 'Anyone in the service is going to be very pleased that an insider has been chosen,' says one senior source. 'She's very highly regarded. It's a welcome appointment. She comes across very well. She's very accessible, and importantly for someone in that job, very empathetic.' If there is a question mark over Metreweli, it may be her age. At 47, she is almost a decade younger than her predecessor was when he took on the role. 'She is rather young for the appointment,' says Sir Richard Dearlove, who was MI6 chief from 1999-2004. 'I don't know much about her personally. She is a forceful presence, however. She might turn out to be rather good.' The nation will hope so. When she takes up her new job she will have an unenviable inbox. There are threats from Russia, China and Iran, wars in the Middle East and Ukraine, ever more sophisticated cyberattacks, the endless threat of terrorism. Then there is how to handle the USA, which is an increasingly unpredictable intelligence partner with Donald Trump as president.

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