The Better Health While Aging Podcast

Get practical health tips from a geriatrician and other experts! We discuss common health problems that affect people over age 60, the best ways to prevent and manage those problems, and we also often address common concerns and dilemmas that come up with aging parents and other older loved ones.

080 – Interview: Smartwatches as Medical Alert Devices
(What to Know & How to Choose)

by Leslie Kernisan, MD MPH 2 Comments

Better Health While Aging

080 – Interview: Smartwatches as Medical Alert Devices
(What to Know & How to Choose)

00:00 / 1:01:31

In This Episode:

Dr. K talks with Richard Caro, PhD, a co-founder of Tech-Enhanced Life, who recently spent a few weeks carefully testing and reviewing four types of smartwatches that can serve as medical alert devices in the event of a fall or other personal health emergency. They discuss:

The Tech-Enhanced Life approach to evaluating innovations and newer technologies
The problem with existing medical alert devices
What key things to consider, when choosing a personal emergency response system (PERS) device and service
Why Richard and Dr. K recommend automatic fall-detection in a medical alert device
Which four smartwatch devices Richard selected for further testing
The difference between the Apple Watch 3 and 4, when it comes to using them as a medical alert
Why most medical alert services charge a monthly fee
How these newer smartwatch devices compare to more traditional PERS devices
The benefits of being able to “practice” summoning help
Richard’s preferred combo of medical alert features that no smartwatch offers (yet)
What to keep in mind if considering a medical alert for someone with dementia

[Read more…]

079 – QA: Advice for Older Parents Frustrated by Their Family’s Concerns

by Leslie Kernisan, MD MPH 3 Comments

Better Health While Aging

079 – QA: Advice for Older Parents Frustrated by Their Family's Concerns

00:00 / 30:14

In This Episode:

Dr. K addresses an older parent’s concerns and frustrations regarding her son’s attempts to help her with her health, and their differing views on what she needs. She covers:

What to do if you’re an older parent frustrated by your adult child’s concerns for you
How to communicate better and help your family understand what matters most to you
Why it’s essential to address goals, priorities, and advance planning
Why everyone needs to think about acceptance and boundaries
The importance of fostering a stronger relationship and more connectedness
Why older adults should be very careful about entirely cutting off their adult children
How to negotiate a better way forward, and how to get help doing so

[Read more…]

078 – Interview: The Biology of Aging & Longevity

by Leslie Kernisan, MD MPH 2 Comments

Better Health While Aging

078 – Interview: The Biology of Aging & Longevity

00:00 / 1:18:57

In This Episode:

Dr. K talks with geriatrician and geroscientist John Newman, MD PhD, about the biology of aging and his research on ketogenic diets and geriatric syndromes. Dr. Newman is an assistant professor at the Buck Institute for Research on Aging and in the Division of Geriatrics at UCSF. He also works on improving the hospital care of older adults. They discuss:

How aging biology research helps us understand fundamental aging processes that affect all animals
The complex relationship between aging and disease, and what is the geroscience hypothesis
Cellular hallmarks of aging, and biomarkers to assess physiological age
How we can assess someone’s physiological age
Why biomarkers of aging aren’t as useful as functional assessments of older people
How insulin, fasting, and other aspects of metabolism are related to aging
What Dr. Newman has learned from studying ketones and aging in mice
What is known about ketogenic diets in humans
What’s been shown to improve healthspan and lifespan (in mice)
Why metformin, a diabetes drug, is a “really good drug”
Why things that slow aging in the lab may not work in humans or under real-world conditions

[Read more…]

077 – Interview: Making Advance Care Planning Easier Through PREPARE

by Leslie Kernisan, MD MPH Leave a Comment

Better Health While Aging

077 – Interview: Making Advance Care Planning Easier Through PREPARE

00:00 / 51:20

In This Episode:

Dr. K talks with geriatrician Rebecca Sudore, MD, an expert in helping older adults address advance directives, end-of-life planning, and other aspects of advance care planning. Dr. Sudore is the creator of PREPARE, an easy-to-use online program designed to help older adults talk about what matters most with family members and health professionals. She is also a Professor in the UCSF Division of Geriatrics. They discuss:

Why Dr. Sudore created California’s first easy-to-read advance directive form in 2005
What families in focus groups told her, about making decisions for someone else
Why it’s important to address more than legal forms and end-of-life situations
Why older adults need to discuss what matters to them, with family and with their health providers
How PREPARE uses short videos and worksheets to help older adults think through what matters, and share their values with others
Her research proving that PREPARE does help older adults address planning
Why many older adults don’t address advance planning, and how we might change this
Advance care planning for Alzheimer’s and other dementias
Tips on getting reluctant older parents to talk about their wishes and address their planning
How to find an easy-to-use advance directive for all 50 states on the PREPARE website

[Read more…]

076 – Flu Shots for Older Adults: What to Know (2018 Update)

by Leslie Kernisan, MD MPH Leave a Comment

Better Health While Aging

076 – Flu Shots for Older Adults: What to Know (2018 Update)

00:00 / 40:53

In This Episode:

Dr. K explains what all older adults and family caregivers should know about annual vaccination against influenza. She also reports on the statistics from last year’s flu season. This episode covers:

What is influenza, and how many people are affected every year
Why older adults are at higher risk of harm from the flu
How the vaccine works
The two key ways you can protect yourself from the flu
How pneumococcal vaccination helps protect against flu complications
What to know about flu shots designed for older adults
Which influenza vaccine she thinks is best for most older adults
What to do if your older relative is unable or unwilling to get vaccinated
What to know about the intranasal flu vaccine available for people age 2-49

[Read more…]

075 – Preventing Falls: 4 Approaches to Ask Your Doctor About

by Leslie Kernisan, MD MPH Leave a Comment

Better Health While Aging

075 – Preventing Falls: 4 Approaches to Ask Your Doctor About

00:00 / 27:19

In This Episode:

Dr. K reviews her four most used fall prevention approaches, which are routine in geriatrics care but are often overlooked by busy primary care providers. She covers:

The three questions about falls that PCPs should be asking older adults
How the CDC’s STEADI fall prevention algorithm can help you understand what your health provider should be doing
Why medication review is an essential part of fall prevention
The importance of checking blood pressure sitting and standing
How a physical therapy evaluation can help
The recent research suggesting Tai Chi helps prevent falls
How to get a good home safety assessment done
Why Vitamin D is no longer recommended for fall prevention (but is still worth taking)

[Read more…]

074 – Interview: How the Village Model Supports Aging in Place & Community

by Leslie Kernisan, MD MPH Leave a Comment

Better Health While Aging

074 – Interview: How the Village Model Supports Aging in Place & Community

00:00 / 1:01:36

In This Episode:

Dr. K talks with UC Berkeley Professor Andrew Scharlach about his work studying the Village Model and other approaches to supporting aging in place. He is an expert on creating aging-friendly communities and formerly directed Berkeley’s Center for the Advanced Study of Aging Services. They discuss:

What is a Village and what’s usually included in the Village model
How Villages differ from Naturally Occurring Retirement Communities (NORCs)
The grassroots history of the first Village and the growth of the Village model
Why aging in community may be a better goal than aging in place
Why Professor Scharlach and his colleagues decided to study Villages, and what they’ve learned so far
How Villages appear to benefit their members
How the goals and ambitions of Villages have evolved over time
How Villages manage funding and other challenges
Whether Villages are a good fit for people who are frail or declining
Whether Villages really do prevent unwanted relocations

[Read more…]

073 – Anticholinergic Medications & Protecting Brain Health

by Leslie Kernisan, MD MPH Leave a Comment

Better Health While Aging

073 – Anticholinergic Medications & Protecting Brain Health

00:00 / 27:18

In This Episode:

Dr. K explains what older adults and families should know about anticholinergic medications and their negative impact on brain health. Many commonly used over-the-counter and prescription medications are anticholinergic, and on the Beer’s List of Medications Older Adults Should Avoid or Use With Caution. She covers:

What it means for a medication to be anticholinergic
The evidence linking anticholinergics with confusion, delirium, and dementia
Seven commonly used types of medication that are quite anticholinergic
Why it’s important to minimize anticholinergics if you’re worried about memory or have been diagnosed dementia
How you can determine whether you or your parent’s medications are anticholinergic
What to do, if you or an older person you care for is taking an anticholinergic medication

[Read more…]

072 – Cognitive Aging: How Memory & Thinking Change as One Gets Older

by Leslie Kernisan, MD MPH 2 Comments

Better Health While Aging

072 – Cognitive Aging: How Memory & Thinking Change as One Gets Older

00:00 / 47:04

In This Episode:

Dr. K explains how memory and thinking change as one gets older, due to normal cognitive aging. She covers:

How cognitive aging is different from a neurodegenerative process such as Alzheimer’s disease
6 ways that memory, other mental processes, and emotional processing change with aging
Why certain mental tasks become harder in late life
The difference between fluid and crystallized intelligence
Worrisome signs that should not be attributed to normal cognitive aging
Practical ways to maintain better brain function, and to compensate for normal age-related changes

[Read more…]

071 – Interview: How Estimating Life Expectancy Helps Older Adults Get Better Care

by Leslie Kernisan, MD MPH Leave a Comment

Better Health While Aging

071 – Interview: How Estimating Life Expectancy Helps Older Adults Get Better Care

00:00 / 1:06:44

In This Episode:

Dr. K talks with Sei Lee, MD, an expert on prognosis and using estimated life expectancy to improve medical care for older adults. Dr. Lee is an Associate Professor in the UCSF Division of Geriatrics. They discuss:

What the term “prognosis” means, especially when it comes to older adults
Why a person’s likely life expectancy should be used to tailor medical care
How the answers to simple questions can be used to predict mortality
Why even a good life expectancy calculator can’t make exact predictions for a specific person
Common forms of medical care that may not be worth doing, if life expectancy is limited
Why it’s important to reconsider intensive diabetes treatment
How the Eprognosis.org website can help people learn whether cancer screening is still likely to benefit them
The challenges of discussing prognosis and life expectancy with older adults
Examples of how we can better focus medical care on “what matters the most”

[Read more…]

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