In This Episode:

Dr. K talks with cardiologist Cara Pellegrini, MD, to discuss the key aspects of heart failure, including its types (congestive, systolic, diastolic, HFrEF, and HFpEF), causes, symptoms, and treatment options. They also cover special considerations for frail older adults, heart failure and end-of-life issues, and much more.

They discuss:

• Introduction to Heart Failure in Aging
• Understanding Heart Failure: Definitions and Types
• What are HFrEF, HFpEF & Ejection Fraction?
• Left vs Right-sided Heart Failure
• Causes of Heart Failure
• Heart Valves in Heart Failure
• Signs and Symptoms of Heart Failure
• Diagnosing Heart Failure: The Evaluation Process
• Stages and Severity of Heart Failure
• Heart Failure Prognosis
• Treatment and Management of Heart Failure
• Medications to Treat Heart Failure
• Self-Management Strategies for Heart Failure
• Considerations for Older Adults with Heart Failure
• Procedures and Devices for Advanced Heart Failure
• Understanding Prognosis and End-of-Life Care
• Questions to Ask About Heart Failure

Related episode:

146 – Atrial Fibrillation in Older Adults: Watchman, Medications & Other Treatment Options

Related Resources:

• 6 Steps to Better High Blood Pressure Treatment for Older Adults
• American Heart Association: Heart Failure

In This Episode:

Dr. K speaks with Alzheimer’s expert Jason Karlawish, MD, Co-Director of the Penn Memory Center, about the new anti-amyloid Alzheimer’s medications lecanemab (Leqembi) and donanemab (Kisunla). Learn how biomarkers and other new developments have revolutionized the diagnosing of Alzheimer’s disease, and how these newer medications are being used to treat Alzheimer’s.

They cover:

• New Treatments for Alzheimer’s Disease
• Understanding Alzheimer’s vs Dementia
• The Evolution of Alzheimer’s Diagnosis
• The Role of Biomarkers in Alzheimer’s Diagnosis
• How Alzheimer’s Progresses Over Time
• Stages of Dementia
• Older Medications to Treat Alzheimer’s
• New Anti-Amyloid Drugs to Treat Alzheimer’s
• About Aducanumab (Aduhelm)
• Lecanemab (Leqembi) and Donanemab (Kisunla)
• How Effective Are the New Treatments?
• The Studies of Anti-Amyloids On Different Sub-groups
• Experiences at The Penn Memory Center
• Do These Work for Mixed Dementia or Difficult Behaviors?
• Can These Help with Aging in Place?
• Also Important for Alzheimer’s Treatment
• Resources

Related episode: 

• 151 – How Memory Medications Like Donepezil and Memantine Work

Related Resources:

• Penn Memory Center
  • Video: An Update on Anti-Amyloid Treatments for Alzheimer’s Disease
  • The Age of Aging Podcast
• Alzheimers.gov
• BHWA: How to Understand the Stages of Alzheimer’s & Related Dementias
• MCI, Alzheimer’s and Dementia. What’s the Difference?
• 4 Most Common Types of Dementia in Aging
• Zarit Burden Interview
• NEJM: Lecanemab in Early Alzheimer’s Disease
  • Related lecanemab forest plots (see figure S1 B)
• JAMA: Donanemab in Early Symptomatic Alzheimer Disease: The TRAILBLAZER-ALZ 2 Randomized Clinical Trial

In This Episode:

Dr. K explains the oral medications most commonly used to treat Alzheimer’s disease and related dementias, such as donepezil, rivastigmine, galantamine, and memantine (brand names Aricept, Exelon, Razadyne, and Namenda. She explains the mechanisms, efficacy, and side effects of these drugs, along with practical considerations for their use in older adults. She also discusses other important aspects of Alzheimer’s treatment.

She covers:

• Oral Medications FDA-Approved to Treat Alzheimer’s
• Understanding Aricept & Other Cholinesterase Inhibitors
• Mild vs Severe Alzheimer’s
• Efficacy and Side Effects of Cholinesterase Inhibitors
• Exploring Memantine (Namenda) and Its Role
• Do These Work for Mild Cognitive Impairment?
• Medications & Other Types of Dementia
• When to Stop Alzheimer’s Medications
• Practical Considerations for Dementia Medication Use
• Anti-amyloid Treatments for Alzheimer’s
• Best Treatments for Alzheimer’s & Dementia

Related episode:

• 026 – 4 Medications for Alzheimer’s & Other Dementias: FAQs & Tips
• 030 – Drugs for Difficult Dementia Behaviors: What to Know

Related Resources:

• • 4 Medications FDA-Approved to Treat Alzheimer’s & Other Dementias: How They Work & FAQs
  • How to Understand the Stages of Alzheimer’s & Related Dementias

In This Episode:

Dr. K talks with fellow geriatrician and guest expert Chrissy Kistler, MD, discuss UTIs in two particular groups: older adults with Alzheimer’s and dementia, and those in nursing homes. They discuss the relationship between memory problems and UTIs, how to diagnose them when there’s confusion or weakness,  and the role of asymptomatic bacteriuria (“colonized bladder”) in these cases. 

They cover:

• 0:32 UTIs in Alzheimer, dementia, and nursing homes
• Diagnosing UTIs in Alzheimer’s and Dementia
• Defining UTIs
• UTIs and Confusion
• Why urine cultures are often positive
• Infections in terminal dementia
• How to detect UTI in memory loss and dementia
• Can ongoing UTI cause memory loss?
• Treating & Preventing Recurrent UTIs
• UTIs in Nursing Homes
• Urinary catheters and UTIs
• Tips for families

Related episode:

149 – UTIs in Older Adults: Symptoms & Prevention

Related Resources:

• UTIs and Urine Bacteria in Aging: How to get the right diagnosis & avoid unneeded antibiotics
• 10 Things to Know About Delirium
• CDC: Urinary Tract Infection Basics
• Clinical Practice Guideline for the Management of Asymptomatic Bacteriuria: 2019 Update by Infectious Disease Society of America

In This Episode:

Dr. K talks with fellow geriatrician and guest expert Chrissy Kistler, MD, as they explore how UTIs change with age, the symptoms to watch for, and the best ways to prevent and treat them. Learn the difference between a true UTI and asymptomatic bacteriuria (also known as a “colonized bladder”) and why confusion is often mistaken for a UTI symptom. Learn when to take antibiotics for symptoms and when it’s probably unnecessary.

They cover:

• UTIs in Older Adults
• Defining Urinary Tract Infections (UTIs)
• Symptoms of UTIs
• The Impact of Aging on UTIs
• Asymptomatic Bacteriuria (“Colonized bladder”) vs. Clinical UTI
• Diagnosing UTIs in Older Adults
• Using Urine Dipsticks (Urinalysis)
• Men and UTIs
• About Chronic UTIs
• Confusion and UTIs
• Should Chronic Bladder Bacteria be Treated?
• Treating Recurrent UTIs
• Questions to Ask Healthcare Providers

Related episode: 

041 – UTIs and Urine Bacteria in Aging: How to get the right diagnosis & avoid unneeded antibiotics

Related Resources:

• • UTIs and Urine Bacteria in Aging: How to get the right diagnosis & avoid unneeded antibiotics
  • 10 Things to Know About Delirium
  • CDC: Urinary Tract Infection Basics
  • Clinical Practice Guideline for the Management of Asymptomatic Bacteriuria: 2019 Update by Infectious Disease Society of America

In This Episode:

Dr. K explains how to plan for aging and 3 key things to do, to avoid common aging problems she routinely sees families struggling with. Learn how to prevent and delay common problems, and how to plan for your own more successful aging. She also discusses the most common pathways at the end of life, and how to retain quality of life despite challenges.

She covers:

• Defining successful aging
• Key steps to prepare for successful aging
• The importance of your attitude towards aging
• How to optimize health & prevent problems
• How to plan for interdependence
• What tends to happen in aging
• Common causes of death
• How to plan for interdependence
• If you have aging parents

Related episode: 

• 140 – How to Exercise to Age Well
• 138 – How to Promote Brain Health & Memory in Aging

Related Resources:

• What is “Successful Aging”?
• How to Promote Brain Health:The Healthy Aging Checklist, Part 1
• How to Promote Physical Health While Aging: The Healthy Aging Checklist Part 2
• 4 Types of Exercise in Later Life: How to maintain strength, balance, & independence in aging
• 7 Commonly Neglected Problems to Address for Healthier Aging: The Healthy Aging Checklist Part 3
• How to Age Better by Optimizing Chronic Conditions: The Healthy Aging Checklist Part 4
• 27 Recommended Preventive Health Services for Older Adults: the Healthy Aging Checklist Part 5
• Providing Elder Care: Covering the Cost of Home Care, Assisted Living & Other Options
• Advanced care planning conversation guides:
• Prepareforyourcare.org
• Theconversationproject.org
• Plus: Preparefortheircare.org (to help someone else)

In This Episode:

Dr. K talks with social worker Michelle Allen, LCSW, about the different parts of Medicare, what is Medicare Advantage, and how to check your coverage. They also explain Medicare Open Enrollment and what to do during this time, to keep out-of-pocket costs lower for the coming year. In this episode they cover:

• Why check your Medicare coverage
• The basics of Medicare
• Medicare Part A: Inpatient Services Explained
• Medicare Part B: Outpatient Services Overview
• Medicare Part C: Medicare Advantage Plans
• Medicare Part D: Prescription Drug Coverage
• How to initially enroll in Medicare
• Medigap, Medicaid, and other options
• Why does Medicare Open Enrollment matter?
• Medicare Updates for 2025
• Steps to Take During Open Enrollment
• Resources for Medicare Assistance

Related episode: 

• 135 – How to Pay for Elder Care

Related Resources:

• Essential Parts of Medicare: The ABCDs to Know & Tips for Open Enrollment
• Medicare.gov: Ready to sign up for Part A & Part B
• Medicare.gov: Costs of Medicare
• Medicare.gov: Avoid late enrollment penalties
• What’s Medicare Supplement Insurance (Medigap)?

In This Episode:

Dr. K talks about atrial fibrillation (afib) with Cara Pellegrini, MD, a specialist in cardiac electrophysiology and an expert on the Watchman device and other ways to treat this common heart arrhythmia. They cover:

• What is afib & what causes it?
• What are the symptoms of afib & how is it diagnosed?
• How is afib treated?
• What to know about blood-thinners for afib
• Treating afib in frail older adults
• Atrial fibrillation & stroke risk
• Watchman for afib & stroke prevention
• Who should consider Watchman?
• Afib in dementia
• How lifestyle changes can powerfully affect afib
• What to ask doctors about afib
  

Related episode: 

• 016 – 3 Reasons You Should Have a Home Blood Pressure Monitor

Related Resources:

• Heart & Rhythm Society: Guide to Atrial Fibrillation
• CHA₂DS₂-VASc Score for Atrial Fibrillation Stroke Risk
• Dr. Cara Pellegrini’s Watchman Videos

In This Episode:

Dr. K provides an update on COVID so far this year, and explains the available vaccines for the three respiratory viruses likely to be very active this fall and winter: COVID, influenza, and RSV. She also addresses other ways to protect oneself this winter.
She covers:

• 2024 vaccines for older adults
• COVID so far in 2024
• Why COVID remains worse than flu
• COVID vaccines for 2024-25
• Flu vaccines for 2024
• What to know about RSV vaccine
• How to stay healthier this winter

Note: For the masks Dr. K recommends, you can get the 3M V-flex here https://amzn.to/3OxrsRY, and the Powecom KN95 here https://amzn.to/3W9frXf

These are Amazon affiliate links, so any purchases will help support Better Health While Aging, thank you!

Related episode: 

134 – COVID & Aging August 2023 Update: Staying Safe, Boosters & More

Related Resources:

• BHWA:
  • COVID & Aging Adults: 2024- 2025 Updates
  • Flu Shots for Older Adults During COVID Times: What to Know & Do for 2024
  • Respiratory Syncytial Virus: What to Know About RSV & RSV Vaccines in Aging
• Waste Water:
  • COVID Wastewaterscan.org
• CDC:
  • COVID Data By Age Group
  • COVID Hospitalization Tracker
  • COVID Weekly Death Trends
  • COVID Variants Trackers
  • COVID Nursing Home Data Dashboard
  • Respiratory Virus Hospitalization Surveillance Network
  • Provisional COVID-19 Mortality Surveillance
  • Severe Viral Respiratory Illness Dashboard
  • Respiratory Illnesses Data Channel

In This Episode:

Dr. K explains what to know and what to do if you’re concerned about unsafe driving in an older adult, including when driving should stop and what to know if you’re dealing with Alzheimer’s or a related type of dementia. She covers:

• How aging impacts driving abilities
• Common causes of unsafe driving in older adults
• How to make driving safer in aging
• Driving warning signs to look out for
• How Alzheimer’s/dementia affects driving
• When it’s time to stop driving
• What to do if someone won’t stop driving
• How to get help if you’re concerned
• Her approach to driving in aging and in dementia

Related episode: 

• 124 – Does Your Aging Parent Need Help? What to check & how to talk about it

Related Resources:

• The Hartford: Warning Signs for Driving
• NHTSA: Older Drivers Traffic Safety Facts (2022)
• American Academy of Neurology: Practice Parameter update: Evaluation and management of driving risk in dementia

In This Episode:

Dr. K explains why the best dose of vitamin D for older adults is lower than you might think. She explains why vitamin D is important and how the latest research suggests that high doses of vitamin D might actually be risky for older adults. This episode covers:

• What is vitamin D
• What is an optimal level of vitamin D
• When to test vitamin D levels
• What is vitamin D deficiency
• Official vitamin D intake recommendations
• Key vitamin D research findings
• Vitamin D and fall prevention
• The vitamin D dose she recommends for older adults

Related episode: 

• 138 – How to Promote Brain Health & Memory in Aging

Related Resources:

• Vitamin D: What to Know (& Why to Be Careful About High Doses)
• Vitamin D total unit calculator
• NIH: Vitamin D Fact Sheet for Health Professionals
• Scholarly articles:
• The Relationship of Falls With Achieved 25-Hydroxyvitamin D Levels From Vitamin D Supplementation: The STURDY Trial
• Monthly High-Dose Vitamin D Treatment for the Prevention of Functional Decline
• Vitamin D supplementation and risk of falling
• Medium doses of Vitamin D Decrease Falls and Higher Doses of Daily Vitamin D3 Increase Falls
• Effect of High-Dose Vitamin D Supplementation on Volumetric Bone Density and Bone Strength
• Vitamin D for the Prevention of Disease: An Endocrine Society Clinical Practice Guideline