In This Episode:

Dr. K goes beyond Alzheimer’s and explains what older adults and families should know about the most common types of dementia in older adults. She covers:

• The 4 most common types of dementia in older adults
• How doctors diagnose the specific type of dementia
• Mixed dementia and less common causes of dementia
• The most common early symptoms of Alzheimer’s dementia, vascular dementia, and Lewy body dementia
• Which types of dementia might be treatable
• Newer types of dementia pathology, such as LATE, hippocampal sclerosis, and cerebral amyloid angiopathy
• Dr. K’s approach to dementia type

Related episode: 

• 139 – How to Treat Mild Cognitive Impairment

Related Resources:

• Beyond Alzheimer’s: Common Types of Dementia in Aging
• Person-specific contribution of neuropathologies to cognitive loss in old age
• Religious Orders Study and Rush Memory and Aging Project
• The prevalence, correlation, and co-occurrence of neuropathology in old age: harmonisation of 12 measures across six community-based autopsy studies of dementia
• Alz.org: Mixed dementia

In This Episode:

Dr. K explains how exercise helps older adults maintain strength and independence, and covers the four types of exercise all older adults should be doing regularly. She also discusses why walking isn’t enough, how to avoid injuries and special situations in geriatrics, such as exercising when an older person is frail or has Alzheimer’s. This episode covers:

• The benefits of exercise in aging
• Is walking good exercise?
• Strength training in aging
• Aerobic exercise in aging
• Balance exercises for seniors
• Flexibility exercises in aging
• Best exercises for fall prevention
• How to start and maintain an exercise routine
• Managing risks of exercise and avoiding injuries
• Exercise to counter frailty and sarcopenia
• Exercise when there’s Alzheimer’s or dementia
• Getting someone else to exercise
• The role of protein and strength training

Related episodes: How to Improve Brain Health in Aging

138 – How to Promote Brain Health & Memory in Aging

005 – Interview: Otago & Proven Exercises for Fall Prevention

Related Resources:

• 4 Types of Exercise in Later Life: How to maintain strength, balance, & independence in aging
• Videos Illustrating Otago Exercises for Fall Prevention
• National Council on Aging: Evidence-Based Falls Prevention Programs
• National Institute on Aging: Four Types of Exercise Can Improve Your Health and Physical Ability
•  Nutrition Needs for Older Adults: Protein

Other references and resources:

• Even a low-dose of moderate-to-vigorous physical activity reduces mortality by 22% in adults aged ≥60 years: a systematic review and meta-analysis
• The Role of Muscle Mass Gain Following Protein Supplementation Plus Exercise Therapy in Older Adults with Sarcopenia and Frailty Risks: A Systematic Review and Meta-Regression Analysis of Randomized Trials
• Effectiveness of Whey Protein Supplementation during Resistance Exercise Training on Skeletal Muscle Mass and Strength in Older People with Sarcopenia: A Systematic Review and Meta-Analysis
• Nutritional Interventions: Dietary Protein Needs and Influences on Skeletal Muscle of Older Adults
• Protein Intake and Frailty: A Matter of Quantity, Quality, and Timing
• Ask the doctor: Stretching before exercise
•  

In This Episode:

Dr. Kernisan explains what all older adults and families should know about the treatment of mild cognitive impairment (MCI), a common memory condition that affects 20-25% of older adults. She  discusses scientifically tested approaches to treating and managing MCI and improving brain health, including the role of medications, supplements, treating hearing loss, exercise and more. In this episode, she covers:

• What is MCI 
• How MCI is related to Alzheimer’s and dementia
• What to do if you suspect MCI
• Scientifically proven approaches to treating and managing MCI 
• What to know about the “Bredesen protocol” for MCI
• What to know about Leqembi and anti-amyloid treatments for Alzheimer’s
• How Dr. K treats MCI
• Common MCI pitfalls to avoid

Related episode: 

• 138 – How to Promote Brain Health & Memory in Aging
• 069 – Evaluating Memory & Thinking Problems: 10 Causes & 10 Things to Check

Related Resources:

Useful references and resources:

• Alzheimers.gov: Find Clinical Trials
• BHWA: How to Diagnose & Treat Mild Cognitive Impairment

Scholarly resources:

• Estimating the Prevalence of Dementia and Mild Cognitive Impairment in the US: The 2016 Health and Retirement Study Harmonized Cognitive Assessment Protocol Project (2022)
• Revised Criteria for Diagnosis and Staging of Alzheimer’s Disease: Alzheimer’s Association Workgroup
• Practice guideline update summary: Mild cognitive impairment: Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology
• Association of Hearing Aids and Cochlear Implants With Cognitive Decline and Dementia: A Systematic Review and Meta-analysis
• A 2 year multidomain intervention of diet, exercise, cognitive training, and vascular risk monitoring versus control to prevent cognitive decline in at-risk elderly people (FINGER): a randomised controlled trial (2015)
• Effects of Exercise Alone or Combined With Cognitive Training and Vitamin D Supplementation to Improve Cognition in Adults With Mild Cognitive Impairment: A Randomized Clinical Trial (2023)
• Lifestyle Risk Factors and Cognitive Outcomes from the Multidomain Dementia Risk Reduction Randomized Controlled Trial, Body Brain Life for Cognitive Decline (BBL-CD) (2020)
• Effect of Personalized Risk-Reduction Strategies on Cognition and Dementia Risk Profile Among Older Adults: The SMARRT Randomized Clinical Trial (2024)
• Effectiveness of a 6-year multidomain vascular care intervention to prevent dementia (preDIVA): a cluster-randomised controlled trial (2016)
• Lecanemab in Early Alzheimer’s Disease (2023)

Critiques of the Bredesen protocol:

• Can we trust The End of Alzheimer’s?
• Bredesen Protocol offers false hope of reversing Alzheimer’s disease
• Scholarly description of the Bredesen protocol: Precision Medicine Approach to Alzheimer’s Disease: Successful Pilot Project (note: ages of included patients were 50-76, with MoCA at least 19)

In This Episode:

Leslie Kernisan, MD MPH, explains the best ways to boost brain health in aging, to help memory and thinking, as well as to prevent cognitive decline. Learn which approaches geriatricians find most effective, plus which vitamins and supplements are likely to help. Dr. K also covers emotional well-being in aging, and how this affects cognitive health.

Topics discussed:

• Helping older adults maintain brain health and memory
• Why promote your brain health
• The difference between normal and abnormal brain changes with aging
• FAQ: How to know what’s happening in your brain
• Why emotional well-being matters
• 3 key ways to boost brain health
• How to be positive about your aging
• What’s good for brain health
• What’s bad for brain health
• If you’re worried about someone else’s brain

Related episode: 

• 073 – Anticholinergic Medications & Protecting Brain Health

Related Resources:

• How to Promote Brain Health: The Healthy Aging Checklist, Part 1
• 4 Types of Brain-Slowing Medication to Avoid if You’re Worried About Memory
• Scholarly references:
• Role of Positive Age Beliefs in Recovery From Mild Cognitive Impairment Among Older Persons (2023)
• Subliminal strengthening: improving older individuals’ physical function over time with an implicit-age-stereotype intervention (2014)
• Vitamin D Supplements and Prevention of Cancer and Cardiovascular Disease (2019)
• Marine n-3 Fatty Acids and Prevention of Cardiovascular Disease and Cancer (2019)
• Effect of Vitamin D Supplementation, Omega-3 Fatty Acid Supplementation, or a Strength-Training Exercise Program on Clinical Outcomes in Older Adults: The DO-HEALTH Randomized Clinical Trial (2020)
• Effect of multivitamin-mineral supplementation versus placebo on cognitive function: results from the clinic subcohort of the COcoa Supplement and Multivitamin Outcomes Study (COSMOS) randomized clinical trial and meta-analysis of 3 cognitive studies within COSMOS (2024)
• Long-Term Cannabis Use and Cognitive Reserves and Hippocampal Volume in Midlife (2022)

In This Episode:

Geriatrician Leslie Kernisan, MD MPH, teams up with her trusted geriatric care manager colleague Michelle Allen, LCSW, to explain how Aging Life Care Professionals (also known as geriatric care managers) can help older adults and their families. They cover:

• Why geriatricians love geriatric care managers
• Aging Life Care Professionals vs Geriatric Care Managers
• What is an Aging Life Care Professional & how do they help
• How to find an Aging Life Care Professional
• What is a certified or professional geriatric care manager?
• Other types of eldercare experts
• How to hire an Aging Life Care Professional

Related episode: 

• 135 – How to Pay for Elder Care

Related Resources:

• Providing Elder Care: Covering the Cost of Home Care, Assisted Living & Other Options
• Hiring In-Home Caregivers for Aging in Place
• Find an Aging Life Care Expert
• Learn more about getting help from Dr. K & Michelle here: Helping Older Parents Online Courses & Programs.

In This Episode:

Geriatrician Leslie Kernisan, MD MPH, explains 8 things health providers should check after an older person falls, to prevent future dangerous falls in aging. In this episode:

• Why it’s vital to be proactive after a fall
• Why you should learn the 8 things Dr. K checks after a fall
• Why checking BP sitting and standing is so important
• The most useful blood tests to consider
• Medications that can worsen falls
• How to check gait and balance
• Additional referrals to consider

Related episode: 

• 034 – Preventing Falls: 10 Types of Medication to Reconsider

Related Resources:

• 8 Things to Have the Doctor Check After an Aging Person Falls
• Preventing Falls: 10 Types of Medications to Review if You’re Concerned About Falling

In This Episode:

Geriatrician Dr. Leslie Kernisan, MD MPH, teams up with experienced geriatric care manager Michelle Allen, LCSW, to discuss a common FAQ: how to pay for elder care. They cover

• What types of help do elders usually need
• What are the options for eldercare?
• How much does eldercare cost?
• How to pay for eldercare?
• What to know about long-term care insurance
• How Medicaid pays for eldercare

Related episode:

• 096 – Interview: Paying for Long-Term Care: 2019 Updates

Related Resources:

• Hiring In-Home Caregivers for Aging in Place- What to Know:  https://betterhealthwhileaging.net/hiring-home-care-for-aging-in-place/
• Caring for an aging parent? Learn about Dr. K’s Helping Older Parents programs here: https://betterhealthwhileaging.net/helping-older-parents/

Dr. K discusses the latest COVID news for August 2023, including the recent rise in COVID cases, whether to get boosted again now or later, what we know about the upcoming fall COVID vaccine, and more. 

In this episode:

• What to know about the new COVID wave
• Update on the EG.5 subvariant
• Whether vaccines work against the newest variants
• Update on the upcoming 2023 COVID vaccine booster
• Answers to FAQs
  • Should you get boosted again now or wait?
• Symptoms of COVID & what to do if you catch it
• What will really help us live with COVID

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 Episodes:

133 – COVID Summer 2023 News Update for Aging Adults

Related Resources:

• BHWA:
  • COVID & Aging Adults: 2023 & 2022 Updates
  • COVID Vaccination for Aging Adults: What to Know & Do
• To track COVID data:
  • Wastewater:
    
    • Biobot.io wastewater tracker
    • CDC Wastewater Surveillance
  • CDC Covid Data Tracker
  • CDC Weekly hospitalizations
  • CDC Weekly deaths
  • CDC Nursing Home Covid-19 Data Dashboard
• CDC & FDA information referenced in this update:
  • FDA: PAXLOVID Patient Eligibility Screening Checklist Tool for Prescribers
  • CDC: Advisory Committee on Immunization Practices (ACIP) Presentation Slides: June 21-23, 2023 Meeting
    • COVID-19 vaccine effectiveness updates (starts with slide 39)
  • CDC: Effectiveness of Up-to-Date COVID-19 Vaccination in Preventing SARS-CoV-2 Infection Among Nursing Home Residents — United States, November 20, 2022–January 8, 2023
  • CDC: Long COVID and Significant Activity Limitation Among Adults, by Age — United States, June 1–13, 2022, to June 7–19, 2023
• From medical journals and research groups:
  • Prevalence of Symptoms ≤12 Months After Acute Illness, by COVID-19 Testing Status Among Adults — United States, December 2020–March 2023
  • Outpatient treatment of COVID-19 and incidence of post-COVID-19 condition over 10 months (COVID-OUT) (June 2023)
  • Long COVID: major findings, mechanisms and recommendations (Jan 2023)
• From news and other media:
  • NPR: Coronavirus FAQ: Is it wiser to get a booster now or wait for the new fall booster? (8/11/23)
  • NBC news: What’s your current risk of getting long Covid? (March 2023)
• For masking, ventilation COVID transmission information:
  • Masks Dr. K uses:
    • 3M V-flex N95
    • 3M Aura N95
    • Powecom KN95
  • Project N95
  • Twitter resources
    • @joeyfox85
    • @masknerd  

Dr. K discusses the latest COVID news for Summer 2023, including the current COVID situation in the US, how to get COVID data now that the public health emergency has ended, updates on COVID boosters, how to know if you still should take precautions, and more.

In this episode:

• What’s changed since February
• Updates on the COVID bivalent booster
• What’s happening now with COVID
• How to decide if you should worry about COVID
• What are the risks of catching COVID now?
• How to avoid catching COVID this summer
• COVID booster FAQs
• COVID symptoms now
• What to do if you catch COVID & how to get Paxlovid

Note: For the masks Dr. K recommends, you can get 3M Aura here https://amzn.to/3PJJyRO, 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 Episodes:

132 – COVID 2023 News Update for Aging Adults (2.23.23 Edition)

Related Resources:

• BHWA:
  • COVID & Aging Adults: 2023 & 2022 Updates
  • COVID Vaccination for Aging Adults: What to Know & Do
• To track COVID data:
  • CDC Covid Data Tracker
  • CDC Weekly hospitalizations
  • CDC Weekly deaths
  • CDC Nursing Home Covid-19 Data Dashboard
  • Wastewater:
    • CDC Wastewater Surveillance
    • Biobot.io wastewater tracker
• CDC & FDA information referenced in this update:
  • FDA: PAXLOVID Patient Eligibility Screening Checklist Tool for Prescribers
  • CDC: Advisory Committee on Immunization Practices (ACIP) Presentation Slides: April 19, 2023 Meeting
    • COVID-19 vaccine effectiveness updates
  • CDC COVID-19 Mortality Update — United States, 2022
• From medical journals and research groups:
  • NIH COVID-19 Treatment Guidelines: Molnupiravir
  • Molnupiravir plus usual care versus usual care alone as early treatment for adults with COVID-19 at increased risk of adverse outcomes (PANORAMIC): an open-label, platform-adaptive randomised controlled trial (12/22/22)
  • Lancet: Past SARS-CoV-2 infection protection against re-infection: a systematic review and meta-analysis (2/16/23)
  • Cochrane: Physical interventions to interrupt or reduce the spread of respiratory viruses (1/30/23)
    • See related commentary: Multiple studies show that face masks reduce the spread of COVID-19; a Cochrane review doesn’t demonstrate otherwise
  • Paxlovid Associated with Decreased Hospitalization Rate Among Adults with COVID-19 — United States, April–September 2022 12/2/22
• From news and other media:
  • Your Local Epidemiologist: End of Public Health Emergency: A shift in data
  • For masking, ventilation COVID transmission information:
    • • Masks Dr. K uses:
        • • 3M V-flex N95
        • • 3M Aura N95
        • • Powecom KN95

    • • Project N95
    • • Twitter resources
        • • @joeyfox85
        • • @masknerd

Dr. K discusses the latest COVID news for 2023, including what’s most important for aging adults and their families to know for the spring. She also covers the problem of doctors inappropriately not prescribing Paxlovid (the best treatment if an older adult does catch COVID), and how to advocate to get it successfully.

In this episode:

• The current COVID & flu situation (cases & hospitalizations)
• About the new Covid variant XBB.1.5
• What the public health emergency ending will mean for you
• How to know if you need to worry about COVID
• What to know about COVID reinfections
• If you’re high risk and need to avoid catching COVID
• Update on the bivalent COVID booster
• When can you get your next COVID booster?
• Update on masks to prevent COVID
• COVID symptoms in 2023
• The best treatment for COVID (Paxlovid) & an FDA checklist that can help you get it
• Summary of what to know for COVID in Spring 2023

Note: For the masks Dr. K recommends, you can get 3M Aura here https://amzn.to/3PJJyRO, 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 Episodes:

131 – COVID Update for Aging Adults (12.8.22 Edition)

Related Resources:

• BHWA:
  • COVID & Aging Adults: 2023 & 2022 Updates
  • COVID Vaccination for Aging Adults: What to Know & Do
• To track COVID data:
  • NY Times COVID Tracker
  • Wastewater:
    • CDC Wastewater Surveillance
    • Biobot.io wastewater tracker
  • Walgreens Test Positivity Tracker
  • OurWorldInData.org Coronavirus Data Explorer
  • CDC Nursing Home Covid-19 Data Dashboard
  • CDC Variant Proportion Tracker
  • CDC COVID cases and deaths by vaccine status
• CDC & FDA information referenced in this update:
  • FDA: PAXLOVID Patient Eligibility Screening Checklist Tool for Prescribers
  • CDC: Advisory Committee on Immunization Practices (ACIP) Presentation Slides: February 22-24, 2023 Meeting
    • Updates to COVID-19 vaccine effectiveness in the United States
  • FDA: Vaccines and Related Biological Products Advisory Committee January 26, 2023 Meeting
  • Weekly U.S. Influenza Surveillance Report
  • CDC: RSV National Trends
• From medical journals and research groups:
  • NIH COVID-19 Treatment Guidelines: Molnupiravir
  • Molnupiravir plus usual care versus usual care alone as early treatment for adults with COVID-19 at increased risk of adverse outcomes (PANORAMIC): an open-label, platform-adaptive randomised controlled trial (12/22/22)
  • Lancet: Past SARS-CoV-2 infection protection against re-infection: a systematic review and meta-analysis (2/16/23)
  • Cochrane: Physical interventions to interrupt or reduce the spread of respiratory viruses (1/30/23)
    • See related commentary: Multiple studies show that face masks reduce the spread of COVID-19; a Cochrane review doesn’t demonstrate otherwise
  • Paxlovid Associated with Decreased Hospitalization Rate Among Adults with COVID-19 — United States, April–September 2022 12/2/22
• From news and other media:
  • What Not to Ask Me About My Long COVID (2/15/23)
  • PBS/KQED: When Can I Get a Second Bivalent COVID Booster? Here’s What We Know Right Now (2/22/23)
  • KFF.org The End of the COVID-19 Public Health Emergency: Details on Health Coverage and Access
    • More detailed: What Happens When COVID-19 Emergency Declarations End? Implications for Coverage, Costs, and Access
• For masking, ventilation COVID transmission information:
  • Masks Dr. K uses:
    • 3M V-flex N95
    • 3M Aura N95
    • Powecom KN95
  • Project N95
  • Twitter resources
    • @joeyfox85
    • @masknerd  

Dr. K discusses what aging adults & families should know about COVID and flu this winter.

She covers:

• The currently increasing rates of COVID & flu
• What to know about the new Omicron subvariants BQ.1 and BQ.1.1
• How well the fall COVID bivalent booster is working so far
• How to avoid getting sick and how to gather safely
• When to mask and how to do so effectively
• Why use a HEPA air purifier at home and how to choose one
• How to detect COVID now
• How to treat COVID
• Her top recommendations for staying safe during winter gatherings

Note: you can get the CO2 monitor Dr. K refers to here: https://amzn.to/3yhDtq8.

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

Dr. K’s HEPA air purifier is here https://amzn.to/3Y96crN

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

Related Episodes:

130 – COVID Booster Update for Aging Adults (9.7.22 Edition)

Related Resources:

• BHWA:
  • COVID & Aging Adults: 2022 Updates
  • COVID Vaccination for Aging Adults: What to Know & Do
• To track COVID data:
  • NY Times COVID Tracker
  • Wastewater:
    • CDC Wastewater Surveillance
    • Biobot.io wastewater tracker
  • Walgreens Test Positivity Tracker
  • OurWorldInData.org Coronavirus Data Explorer
  • CDC Nursing Home Covid-19 Data Dashboard
  • CDC Variant Proportion Tracker
  • CDC COVID cases and deaths by vaccine status
• CDC Datasets in this update:
  • Effectiveness of Bivalent mRNA Vaccines in Preventing Symptomatic SARS-CoV-2 Infection — Increasing Community Access to Testing Program, United States, September–November 2022
  • Weekly U.S. Influenza Surveillance Report
  • CDC Influenza Hospitalization Rates
• From medical journals and research groups:
  • Low neutralization of SARS-CoV-2 Omicron BA.2.75.2, BQ.1.1, and XBB.1 by parental mRNA vaccine or a BA.5-bivalent booster (12/6/22)
  • Effect of hybrid immunity and bivalent booster vaccination on omicron sublineage neutralisation (12/5/22)
  • Paxlovid Associated with Decreased Hospitalization Rate Among Adults with COVID-19 — United States, April–September 2022 12/2/22
• From news and other media:
  • ‘Indoor pandemic’: An engineer on how to clean the air you breathe
• For masking, ventilation COVID transmission information:
  • Masks Dr. K uses:
    • 3M V-flex N95
    • 3M Aura N95
    • Powecom KN95
  • Project N95
  • Twitter resources
    • @joeyfox85
    • @masknerd
    • @marwa_zaatari
  • CDC Interactive ventilation tool
  • CleanAirCrew.org Portable Air Cleaner Buying Guide
    • Air Cleaners dataset
  • The Corsi-Rosenthal Box: DIY Box Fan Air Filter for COVID-19 and Wildfire Smoke