Better Health While Aging Podcast

In This Episode: Dr. K talks about the most common causes of falling in later life and how geriatricians evaluate falls. She also explains the fall prevention approaches she uses the most. She covers: Why do older adults fall? Common causes and risk factors for falls Why medical evaluation matters What a fall evaluation should include Top ways to prevent falls Do canes and walkers help? Dr. K’s approach to fall prevention What to do if you’re concerned Related episodes:  052 – Maintaining Mobility & Preventing Falls in Aging: Myths & Truths   Related Resources: 8 Things to Have the Doctor Check After an Aging Person Falls Why Older People Fall & How to Reduce Fall Risk CDC STEADI Stay Independent Questionnaire CDC Algorithm: Preventing Falls in Older Patients Videos Illustrating Otago Exercises for Fall Prevention NCOA: Evidence-Based Falls Prevention Programs Never Miss an Episode! Sign up here to be notified of our latest podcast episodes by email

  In This Episode: Dr. K talks about one of the most important medication safety tools in geriatrics: the American Geriatrics Society (AGS) Beers Criteria® — often called the “Beers List.” It’s an evidence-based list of medications that should be avoided in older adults when possible, or used with extra caution. She covers: Why the Beers List matters Why aging makes medications riskier What is the AGS Beers Criteria? Guided walkthrough: how use the Beers Criteria Common higher-risk medication groups Dr. K looks for Questions to ask your health providers Related episode:  088 – Interview: Avoiding Inappropriate Prescribing in Aging & What to Know About the Beers Criteria 090 – More on Avoiding Risky Medications & on Using the 2019 AGS Beers Criteria Related Resources: BHWA article: Medications Older Adults Should Avoid or Use with Caution: The American Geriatrics Society Beers Criteria Journal article: American Geriatrics Society 2023 updated AGS Beers Criteria® for potentially inappropriate medication use in older adults Never Miss an Episode! Sign up here to be notified of our latest podcast episodes by email

  In This Episode: Dr. K explains how kidney function changes in later life and what older adults should know about kidney disease. In this episode, she covers: What do kidneys do for the body? Kidney anatomy (nephrons, glomerulus, tubules) What labs check kidney function? (eGFR, creatinine, BUN) The three forms of kidney dysfunction Symptoms of kidney disease Kidney disease in older adults The five stages of kidney disease What causes kidney disease? How should kidney disease be medically evaluated? Treating chronic kidney disease Kidney failure: Dialysis and other options for end-stage kidney disease Kidney disease in geriatrics What to ask your doctors about kidney disease   Related episodes: 164 – 4 Must-Know Lab Tests for Older Adults: Kidney, Liver, CBC & More 163 – Dehydration in Older Adults: Symptoms, Treatment, & Prevention Related Resources: Stages of Chronic Kidney Disease (CKD) Never Miss an Episode! Sign up here to be notified of our latest podcast episodes by email

In This Episode: Dr. K explains shingles and why it’s an important issue for older adults. She also reviews how shingles is diagnosed and treated, and the many benefits of the shingles vaccine. She covers: Introduction: Why Shingles Prevention Matters What Is Shingles? Why Shingles Risk Increases With Age Common Symptoms of Shingles How Shingles Is Diagnosed and Treated Post-Herpetic Neuralgia: Chronic Nerve Pain After Shingles The Shingles Vaccine (Shingrix): What to Know Additional Benefits: Dementia, Stroke & Heart Risk Reduction Shingles Vaccine FAQs Recap and Key Takeaways Related episode: 168 – COVID & Fall Vaccines 2025: What Older Adults Should Know Related Resources: CDC: Shingles Vaccination Nature Medicine: Varicella-zoster virus reactivation and the risk of dementia Never Miss an Episode! Sign up here to be notified of our latest podcast episodes by email

    In This Episode: Dr. K explains how urination changes in later life for men, and what to do if you’re having bothersome urinary symptoms or leaks. You’ll learn what doctors mean by LUTS (lower urinary tract symptoms), how an enlarged prostate (BPH) contributes to urinary problems, and the 5 main types of incontinence that affect men: urgency, stress, mixed, overflow, and functional.  She covers: Urinary Incontinence in Aging Men Male Bladder, Pelvic Anatomy & the Prostate What Is LUTS (Lower Urinary Tract Symptoms)? Why Incontinence Needs a Medical Evaluation 5 Types of Urinary Incontinence in Men Key Parts of a Good Incontinence Workup Medications That Worsen LUTS or Retention Red Flags Indicating Urgent Evaluation Treating LUTS & Incontinence Treating Benign Prostatic Hyperplasia (BPH) Medications for Overactive Bladder: Pros & Cons Next-Level Procedures and Treatment Options Special Geriatric Considerations in Frail Older Men What to Do If You’re Concerned Related episode:  170 – How to Treat Urinary Incontinence in Older Women Related Resources: Urinary Incontinence in Aging: What to know when you can’t wait to go Urinary system – male anatomy and physiology Never Miss an Episode! Sign up here to be notified of our latest podcast episodes by email

    In This Episode: Dr. K explains the 5 main types of incontinence that affect women, what a good medical evaluation should include, and the most effective and safe incontinence treatments for older women. Learn how stress, urge (overactive bladder), mixed, overflow, and functional incontinence differ, what to know about pelvic floor dysfunction and prolapse, and where urogynecology fits in.  She covers: Urinary Incontinence in Older Women Bladder & Pelvic Floor Basics (Women) Why Medical Evaluation is Needed 5 Types of Urinary Incontinence What a Medical Evaluation of Incontinence Should Include What to Know about Urogynecology Red Flags You Shouldn’t Ignore First-Line Incontinence Fixes That Work Kegels, Pelvic PT, Bladder Training & Estrogen What to Know About Pessaries Medications for Incontinence Next-Level Treatment Options Geriatric Considerations (Frailty, Memory Changes) What to Do If You’re Concerned Related episode:  Related Resources: Urinary Incontinence in Aging: What to know when you can’t wait to go Understanding Your Pelvic Floor — Introduction Understanding Your Pelvic Floor — Urinary incontinence Never Miss an Episode! Sign up here to be notified of our latest podcast episodes by email

    In This Episode: Dr. K  is joined by geriatric social worker Michelle Allen, LCSW, to discuss Michelle’s experience trying out Chapter, a national free service that helps older adults find the best Medicare plan for them. Whether you’re shopping for a better Part D drug plan or need to find the Medicare Advantage plan that covers the doctors you want, Dr. K and Michelle review what to know and cover your options for how to find the best Medicare plan for next year. For FREE help learning about your best Medicare options, Dr. K recommends calling Chapter at 771-224-0630, or visit askchapter.org/betterhealth She covers: Dates & What You Can Change Switching Between Advantage & Original Why Open Enrollment Matters How Plans Change Year to Year Cost Pitfalls to Avoid If Your Advantage Plan Won’t Renew Start Here: Cards, Accounts, & Notices Using Medicare.gov Plan Finder (Pros & Cons) Newer Option: How Chapter Works What to Gather: Meds, Doctors, Pharmacy, Hospital Unbiased Advice & How Chapter Is Free SHIP and Local Broker: When They Help 2025 Part D Out-of-Pocket Cap Key Takeaways & Next Steps Affiliate disclosure: Dr. Kernisan declined to be paid to make this episode. After evaluating Chapter, she agreed to become an affiliate. This means that if you choose to use Chapter’s free service through her referral, Better Health While Aging may receive a commission that helps support our educational work. Related episode: 147 – Essential Parts of Medicare & Open Enrollment Related Resources: AskChapter.org/betterhealth (or call 771-224-0630) Essential Parts of Medicare: The ABCDs to Know & Tips for Open Enrollment Medicare.gov Plan Finder Never Miss an Episode! Sign up here to be notified of our latest podcast episodes by email

  In This Episode: Dr. K shares what’s new for the 2025–26 fall vaccine season, especially for adults over 60. She reviews the current COVID situation, the updated vaccine options (including Moderna’s mNexspike), and the latest CDC guidelines. Plus, key reminders on this year’s flu and RSV shots and practical tips for staying healthier this winter. She covers: Fall vaccines for older adults COVID so far in 2025 Why fall vaccines matter COVID vaccines for 2025–26 Moderna mNEXSPIKE and other options Flu vaccines for 2025–26 What to know about RSV vaccines How to reduce your chances of getting sick Recap Related episode: 145 – COVID & Fall 2024 Vaccines Update Related Resources:            CDC: COVID-19 Surveillance Data in the United States Severe Viral Respiratory Illness – Updates Respiratory Virus Activity Levels – Updates Moderna mNEXSPIKE Safety & Effectiveness   BHWA: COVID & Aging Adults: 2025-2026 Updates Flu Shots for Older Adults: What to Know & Do for 2025 Respiratory Syncytial Virus: What to Know About RSV & RSV Vaccines in Aging Never Miss an Episode! Sign up here to be notified of our latest podcast episodes by email

  In This Episode: Dr. K talks with diabetes researcher and UCSF geriatrician Sei Lee, MD MAS, about how to choose the best medications to treat diabetes in older adults. They explain the pros and cons of today’s main diabetes treatments — metformin, SGLT2 inhibitors, GLP-1 receptor agonists, DPP-4 inhibitors, sulfonylureas, pioglitazone, and insulin — and how to balance benefits with risks depending on health, frailty, and life expectancy. They cover: Introduction to Diabetes Why diabetes care is different in aging Time to benefit & diminishing returns Individualizing A1C targets First-line: lifestyle & metformin Older drugs: sulfonylureas, and pioglitazone SGLT2 inhibitors: who benefits, who should avoid GLP-1s in older adults: benefits, appetite & muscle considerations Why DPP-4s are less useful Insulin in geriatrics: basal vs mealtime strategies Preventing hypoglycemia What to know about continuous glucose monitors (CGMs) Questions to ask your doctor Related episode: 166 – Diabetes in Aging: Signs, Symptoms & What to Do Related Resources: HealthinAging.org: Diabetes Care and Treatment Never Miss an Episode! Sign up here to be notified of our latest podcast episodes by email

    In This Episode: Dr. K explains what every older adult and their family should know about diabetes and prediabetes in later life. She goes into detail on how diabetes is diagnosed, monitored, and treated, including lifestyle tips, diet changes, and first-line medications like metformin for Type 2 diabetes. She covers: Introduction to Diabetes & Prediabetes in Aging Blood Sugar Basics: What Is Glucose and Insulin? Diabetes and hypoglycemia What Is Type 1 vs Type 2 Diabetes? Defining Prediabetes and Diabetes Signs & Symptoms of High Blood Sugar Long-Term Complications of Diabetes Diagnosing Diabetes in Older Adults Target A1C Goals for Older Adults Risks of Over-Treatment & Hypoglycemia Treating Diabetes: Lifestyle Changes, Metformin,& More Treating Prediabetes What to Ask Your Doctor Related episode: 164 – 4 Must-Know Lab Tests for Older Adults: Kidney, Liver, CBC & More Related Resources: HealthinAging.org: Diabetes Care and Treatment Never Miss an Episode! Sign up here to be notified of our latest podcast episodes by email

  In This Episode: Dr. K explains why constipation happens in older adults, the signs to watch for, and what to know about laxatives and fiber supplements. She goes over which medicines commonly cause or worsen constipation, when to ask for a medical evaluation, and how to prevent complications like hemorrhoids or fecal impaction. She covers: Constipation in Aging Signs, Symptoms & What’s Normal Health Consequences of Constipation Causes of Constipation in Aging Medications that Cause or Worsen Constipation The Medical Evaluation of Constipation Treating Constipation Using Fiber for Constipation 3 Types of OTC Laxatives That Work Maintenance vs. Rescue Treatments Enemas & Treating Severe Constipation Dr. K’s Approach to Managing Constipation Recap & Key Takeaways Related episode: 064 – What to Know About Constipation & Laxatives Related Resources: How to Evaluate, Prevent & Manage Constipation in Aging Review of clinical effectiveness of Colace (docusate sodium) Never Miss an Episode! Sign up here to be notified of our latest podcast episodes by email

  In This Episode: Dr. K explains four common blood tests ordered in older adults: the Complete Blood Count (CBC), the Basic Metabolic Panel (BMP), the Comprehensive Metabolic Panel (CMP), and the Lipid Panel. She goes into detail about what these tests measure, what abnormal results might mean, and how they relate to common health problems like anemia, kidney issues, liver function changes, and high cholesterol. She covers: Why Blood Tests Matter & Why Doctors Order Bloodwork CBC: What It Measures and Why It’s Important Basic Metabolic Panel: Kidney Function, Electrolytes & Glucose Comprehensive Metabolic Panel: Liver Function & Calcium Lipid Panel: Cholesterol and Cardiovascular Risk Understanding “Normal” vs “Abnormal” Results 4 Tips to Benefit From Blood Tests Related episode: 157 – High Blood Pressure in Aging: When to Treat & Why It Matters 144 – Anemia in Aging: Symptoms and Solutions Related Resources: Understanding Laboratory Tests: 10 Commonly Used Blood Tests for Older Adults Anemia in the Older Adult: 10 Common Causes & What to Ask   Never Miss an Episode! Sign up here to be notified of our latest podcast episodes by email

  In This Episode: Dr. K talks about dehydration in aging, including signs and symptoms of dehydration, how dehydration is actually diagnosed, and how to prevent and treat it.  She also explains what to know about heat stroke and how to take precautions during heat waves. She covers: Introduction to Dehydration What is Dehydration? Why Older Adults Are at Risk Causes of Dehydration in Aging Symptoms & Signs to Watch For Diagnosing Dehydration Consequences of Dehydration How to Treat Dehydration When to See a Doctor Tips for Preventing Dehydration Managing Hot Weather Recap & Final Tips Related episode: 040 – Dehydration in Older Adults: How to Prevent It, Detect It, & Treat It Related Resources: How to Prevent, Detect, & Treat Dehydration in Aging Adults Water-loss (intracellular) dehydration assessed using urinary tests: how well do they work? Diagnostic accuracy in older people Is This Elderly Patient Dehydrated? Diagnostic Accuracy of Hydration Assessment Using Physical Signs, Urine, and Saliva Markers Q&A: Why Urine Bacteria Doesn’t Mean a UTI Needs Antibiotics Never Miss an Episode! Sign up here to be notified of our latest podcast episodes by email

In This Episode: Dr. K explains how the most common causes of chronic pain in later life, and how pain should be evaluated. She also covers treating pain through non-drug methods, and explains what to know about commonly used painkillers. In this episode: Truths about chronic pain in aging Types of chronic pain: arthritis, stenosis, myofascial, more How pain should be evaluated How geriatricians approach chronic pain Non-drug options for pain Medications used to treat pain Related episode: 161 – Tylenol, Advil, or Aspirin? What’s Safest for Older Adults Related Resources: How to Choose the Safest Over-the-Counter Painkiller for Older Adults 7 Commonly Neglected Problems to Address for Healthier Aging Never Miss an Episode! Sign up here to be notified of our latest podcast episodes by email

In This Episode: Dr. K explains what counts as low blood pressure, why it becomes common with aging, and what to do about it. She also explains orthostatic hypotension, a common problem that affects many older adults and can lead to symptoms, such as dizziness or even falls. She covers: Defining Hypotension and Low Blood Pressure Causes of Very Low Blood Pressure Vasovagal Hypotension Common Low Blood Pressure Causes in Aging Understanding Orthostatic Hypotension Signs and Symptoms of Low Blood Pressure Managing Low Blood Pressure in Geriatrics If You’re Concerned About Low Blood Pressure Related episodes: 159 – Best Ways to Treat High Blood Pressure 157 – High Blood Pressure in Aging: When to Treat & Why It Matters Related Resources: Low Blood Pressure – When Blood Pressure Is Too Low What the Blood Pressure Guidelines — & Research — Mean For Older Adults 6 Steps to Better High Blood Pressure Treatment for Older Adults Choosing & Using a Home Blood Pressure Monitor, & What to Ask the Doctor Never Miss an Episode! Sign up here to be notified of our latest podcast episodes by email

  In This Episode: Dr. K explains the best ways to lower blood pressure in older adults, using both lifestyle changes and medications that are safe and effective for aging bodies. She goes into detail on the DASH diet, sodium and potassium intake, types of blood pressure medications (like calcium channel blockers and ACE inhibitors), and how to decide on the right blood pressure goals for your age and health status. She covers: Defining hypertension Causes of high blood pressure How high is too high? How to lower BP Lifestyle changes to lower BP DASH diet for hypertension Reducing dietary sodium Potassium and blood pressure Medications for hypertension treatment Special hypertension considerations for older adults Related episode: 157 – High Blood Pressure in Aging: When to Treat & Why It Matters Related Resources: 6 Steps to Better High Blood Pressure Treatment for Older Adults What the Blood Pressure Guidelines — & Research — Mean For Older Adults ACC/AHA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults (2017) 2023 European Society of Hypertension Guidelines for the management of arterial hypertension 2023 ESH Hypertension Guideline Update: Bringing Us Closer Together Across the Pond Systolic Blood Pressure Intervention Trial (SPRINT): A Randomized Trial of Intensive versus Standard Blood-Pressure Control Important Blood Pressure Studies: What to Know About SPRINT-Senior & Other Research Dietary Approaches to Stop Hypertension (DASH) Diet and Blood Pressure Reduction in Adults with and without Hypertension: A Systematic Review and Meta-Analysis of Randomized Controlled Trials Sodium reduction and weight loss in the treatment of hypertension in older persons: a randomized controlled trial of nonpharmacologic interventions in the elderly (TONE) Effect of increased potassium intake on cardiovascular risk factors and disease: systematic review and meta-analyses Never Miss an Episode! Sign up here to be notified of our latest podcast episodes by email

  In This Episode: Dr. K speaks with cardiologist and electrophysiology expert Cara Pellegrini, MD, to explain bradycardia (slow heart rate), how it’s diagnosed and treated, and when a pacemaker might be recommended. Dr. Pellegrini also explains the different types of pacemakers, including traditional and leadless options, what to expect during implantation and recovery, and how modern pacemakers are monitored. She covers: Introduction to Bradycardia and Pacemakers What is a pacemaker? What is bradycardia & when is it a problem? Signs, symptoms & diagnosis of bradycardia Causes of bradycardia in aging How to treat bradycardia How different pacemakers work Implantable Cardiac Devices: Pacemakers vs. ICDs Understanding pacemaker insertion & recovery Monitoring and adjusting pacemakers Pacemakers in frailty or Alzheimer’s End-of-life considerations for pacemakers Recap of bradycardia and pacemakers Battery changes for pacemakers Questions to ask your doctor Related episode: 146 – Atrial Fibrillation in Older Adults: Watchman, Medications & Other Treatment Options Related Resources: American Heart Association – Bradycardia Upbeat – Pacemakers Pacemakers – HRS Patient Info American Heart Association – Pacemaker Guide Cleveland Clinic – Leadless Pacemakers Never Miss an Episode! Sign up here to be notified of our latest podcast episodes by email

  In This Episode: Dr. K explains what blood pressure numbers really mean, what’s normal BP in older adults and what’s considered too high, and why managing hypertension is so important for long-term health. She also talks about what causes high blood pressure and what to do if you’re concerned. She covers: What is blood pressure? Defining hypertension How to accurately measure BP What causes high blood pressure? Signs and symptoms of high BP How high is too high for BP? The concept of a “BP” goal Related episode:  018 – High Blood Pressure Treatment in Older Adults: Research Findings & Practical Tips Related Resources: What the Blood Pressure Guidelines — & Research — Mean For Older Adults ACC/AHA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults (2017) 2023 European Society of Hypertension Guidelines for the management of arterial hypertension 2023 ESH Hypertension Guideline Update: Bringing Us Closer Together Across the Pond Systolic Blood Pressure Intervention Trial (SPRINT): A Randomized Trial of Intensive versus Standard Blood-Pressure Control Important Blood Pressure Studies: What to Know About SPRINT-Senior & Other Research   Never Miss an Episode! Sign up here to be notified of our latest podcast episodes by email

  In This Episode: Dr. K addresses a common question: which type of Vitamin B12 supplement to take? She takes a closer look at the two most common forms  — methylcobalamin and cyanocobalamin — to help older adults make an informed choice about which type of Vitamin B12 to take. She covers: Vitamin B12 Deficiency Overview The Main Types of Vitamin B12 Supplements Features of Cyanocobalamin vs Methylcobalamin How Different Types of Vitamin B12 Work in the Body Clinical Evidence on Different Types of Vitamin B12 Dr. Kernisan’s Interpretation of Vitamin B12 Science Recommendations on Methylcobalamin vs Cyanocobalamin Related episode: 155 – Vitamin B12 Deficiency in Aging: Causes, Symptoms and Treatment Related Resources: Vitamin B12 in Foods, Food Supplements, and Medicines—A Review of Its Role and Properties with a Focus on Its Stability Comparative Bioavailability and Utilization of Particular Forms of B12 Supplements With Potential to Mitigate B12-related Genetic Polymorphisms Wikipedia: Vitamin B12 How to Detect & Treat Vitamin B12 Deficiency in Older Adults   Never Miss an Episode! Sign up here to be notified of our latest podcast episodes by email

In This Episode: Dr. K explains how older adults can detect, treat, and prevent vitamin B12 deficiency, a common problem that can affect nerve function, red blood cells and brain function.  She covers: Introduction to Vitamin B12 Deficiency What is Vitamin B12? Common Causes of Vitamin B12 Deficiency in Older Adults Symptoms of Vitamin B12 Deficiency Pernicious Anemia and Its Relation to B12 Deficiency Why Vitamin B12 Deficiency is Often Missed Who Should Be Checked for Vitamin B12 Deficiency? Testing for Vitamin B12 Deficiency Treatment Options for Vitamin B12 Deficiency Preventing Vitamin B12 Deficiency Note: For the vitamins Dr. K recommended in the episode, you can get them here: Thorne Vitamin B12: https://amzn.to/4jYsYO9 Natrol Dissolving Vitamin B12: https://amzn.to/4hHWwxH Get 15% off your first purchase with Adapt Naturals with code BHWA: https://adaptnaturals.com/BHWA Buy the Multi and get Omega+ free!: https://adaptnaturals.com/BHWAFREEOMEGA These are affiliate links, so any purchases will help support Better Health While Aging, thank you!   Related episode: 144 – Anemia in Aging: Symptoms and Solutions Related Resources: How to Detect & Treat Vitamin B12 Deficiency in Older Adults Neuropsychiatric disorders caused by cobalamin deficiency in the absence of anemia or macrocytosis Oral versus intramuscular administration of vitamin B12 for vitamin B12 deficiency in primary care: a pragmatic, randomised, non-inferiority clinical trial (OB12) Vitamin B12 in Foods, Food Supplements, and Medicines—A Review of Its Role and Properties with a Focus on Its Stability   Never Miss an Episode! Sign up here to be notified of our latest podcast episodes by email