Better Health While Aging

Latest Episodes:

122 – Update: COVID Vaccination in Aging (9.9.21 Edition) Sep 10, 2021

Show notes

In This Episode:

This video update covers my latest thoughts on the Delta surge, what we’ve learned about the efficacy of COVID vaccination in older adults over the last six months, breakthrough COVID cases, and whether “boosters” will be required.

(View the show notes page to watch my subtitled talk and my slides.)

This episode covers:

The current COVID situation in US
What we’ve learned about COVID vaccination over 6 months
The latest on third doses (aka “boosters”)
How to know what’s safe & answers to FAQs
My latest recommendations for older adult & families

Note: A day after I recorded my update, the CDC released three additional studies regarding COVID vaccination. You can read about them here. Basically, one study concluded that vaccinated people are 5x less likely to get COVID, 10x less likely to be hospitalized, and 11x less likely to die of COVID. Another study found that vaccine efficacy is a bit lower in adults older than 75, compared to younger than 75, and that vaccine efficacy was better with Moderna than Pfizer. And a study in veterans found that “vaccine effectiveness in preventing COVID-19–related hospitalization was 80% among adults aged ≥65 years compared with 95% among adults aged 18–64 years.”

Related Episodes:

121 – Update: COVID Vaccination in Aging (7.29.21 Edition)

Related Resources:

BHWA:
- COVID Vaccination for Aging Adults: What to Know & Do
CDC:
- CDC COVID Data Tracker (to check your local transmission rates)
- CDC: When You’ve Been Fully Vaccinated
- Nursing Home Covid-19 Data Dashboard
- COVID-19 Vaccines for Moderately to Severely Immunocompromised People (CDC)
- Effectiveness of Pfizer-BioNTech and Moderna Vaccines in Preventing SARS-CoV-2 Infection Among Nursing Home Residents Before and During Widespread Circulation of the SARS-CoV-2 B.1.617.2 (Delta) Variant — National Healthcare Safety Network, March 1–August 1, 2021
From medical journals:
- Comparison of two highly-effective mRNA vaccines for COVID-19 during periods of Alpha and Delta variant prevalence (Mayo Clinic pre-print Aug 2021)
- Viral loads of Delta-variant SARS-CoV2 breakthrough infections following vaccination and booster with the BNT162b2 vaccine (Pre-print from Israel)
From news and other media:

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121 – Update: COVID Vaccination in Aging (7.29.21 Edition) Jul 30, 2021

Show notes

In This Episode:

This video update includes my thoughts on the Delta variant and the latest CDC announcement regarding guidance for fully vaccinated adults, what to know about “breakthrough” COVID cases in nursing homes and elsewhere, recent studies on the efficacy of vaccines in older adults (and why some touted study results may not apply to older adults), who might not be well protected by the vaccine, and more.

(View the show notes page to watch my subtitled talk and my slides.)

This episode covers:

A recap of the current COVID & vaccine situation
What to know about Delta & the latest CDC mask update
“Breakthrough” COVID cases
Updates on COVID safety & efficacy in older adults and the immunocompromised
Whether boosters will be needed and whether to get one if available
My latest recommendations for older adults & families

Note: Since I recorded my update, the Washington Post has reported on the CDC’s internal presentation covering why they are so concerned about the Delta variant. The data presented is interesting and can be found here.

Related Resources:

BHWA:
- COVID Vaccination for Aging Adults: What to Know & Do
CDC:
- CDC COVID Data Tracker (to check your local transmission rates)
- Internal CDC presentation on Delta variant and breakthrough infections (July 29, 2021)
- CDC: When You’ve Been Fully Vaccinated
- Nursing Home Covid-19 Data Dashboard
- CDC Advisory Committee on Immunization Practices (meeting slides on vaccine safety and efficacy topics are usually very informative; browse for the latest ones here)
  - COVID-19 Vaccine Effectiveness studies (May 12, 2021; includes some nursing home studies)
From medical journals:
- Covid-19 Breakthrough Infections in Vaccinated Health Care Workers (July 2021)
- Effectiveness of Covid-19 Vaccines against the B.1.617.2 (Delta) Variant (July 2021)
From news and other media:

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120 – Depression in Aging: Diagnosis & Treatment May 20, 2021

Show notes

Watch the subtitled video and search the transcript by clicking above.
(For a short tutorial on how to search the transcript, see here.)

In This Episode:

Guest host Dr. Nicole Didyk discusses the diagnosis and treatment of depression, including why it’s often tricky to diagnose in later life, and how it can be treated. (Note: depression in the context of dementia will be covered in an upcoming episode.) Dr. Didyk is a geriatrician in Canada, and the founder of the blog and YouTube channel The Wrinkle.

She covers:

What’s different about depression in older adults?
What are the signs that an older person might be depressed?
What medical illnesses can mimic depression?
Which medications can cause or worsen depressive symptoms?
How can depression be treated in older adults?
What to do if you’re concerned about depression in an older person

Related episodes:

053 – Interview: Addressing Loneliness in Aging

Related Resources:

Suicide Prevention Helplines (available 24/7):

IOA Friendship Line (developed for older adults): 800-971-0016
United States 1-800-273-TALK
Canada 1-833-456-4566

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119 – Update: COVID Vaccination in Aging (5.14.21 Edition) May 15, 2021

Show notes

In This Episode:

Dr. K provides commentary on the recent COVID developments, including the CDC’s latest mask guidance for vaccinated people, plus updated information on the effectiveness and safety of COVID vaccination for older adults. She also addresses FAQs about coronavirus vaccination.

This episode covers:

Why Dr. K has some concerns about the recent CDC mask update
What to know about “breakthrough” COVID cases, which have affected nursing homes and are being undercounted
The question of whether vaccinated people can transmit COVID
Recent studies related to COVID safety & efficacy in older adults
Why immunocompromised people might not be protected by the vaccine, especially if they have a “blood cancer” or are on medications that affect their B cells or T cells
How to think about COVID risk: yours and you exposing others to COVID risk
Answers to FAQs, including:
- Should I get vaccinated against COVID?
- Should my 90 year old mother get the COVID vaccine?
- How well does the vaccine work in older adults?
- Which vaccine is best for older adults? Which vaccine is safest?
- Should I worry that the vaccine might harm me (or my frail older parent)?
- Should I worry that I haven’t responded enough to the vaccine?
Dr. K’s current recommendations regarding COVID vaccination and staying safe given current conditions

Related Resources:

BHWA:
- COVID Vaccination for Aging Adults: What to Know & Do
CDC:
- Fully Vaccinated Adults 65 and Older Are 94% Less Likely to Be Hospitalized with COVID-19
- COVID-19 Vaccinations in the United States
- Interim Public Health Recommendations for Fully Vaccinated People
- Frequently Asked Questions about COVID-19 Vaccination
- Nursing Home Covid-19 Data Dashboard
- CDC Advisory Committee on Immunization Practices (meeting slides on vaccine safety and efficacy topics are usually very informative; browse for the latest ones here)
  - COVID-19 Vaccine Effectiveness studies (May 12, 2021; includes some nursing home studies)
From medical journals:
- Impact and effectiveness of mRNA BNT162b2 vaccine against SARS-CoV-2 infections and COVID-19 cases, hospitalisations, and deaths following a nationwide vaccination campaign in Israel: an observational study using national surveillance data (Pfizer vaccine in Israel, May 2021)
- Researchers Tie Severe Immunosuppression to Chronic COVID-19 and Virus Variants (May 2021)
New York Times:
- COVID-19 Vaccine Tracker
- Coronavirus Variant Tracker
- What Does the New Mask Guidance Really Mean? (NY Times 5/13/21)
Other articles:
- How Vaccine Hesitancy Is Driving Breakthrough Infections in Nursing Homes
- The CDC’s Big Mask Surprise Came Out of Nowhere

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118 – Updates: COVID Vaccination in Aging (3.26.21 Edition) Mar 26, 2021

Show notes

In This Episode:

Dr. K provides updated information on the effectiveness and safety of COVID vaccination for older adults, including information on the Pfizer, Moderna, and Johnson&Johnson vaccines. She also addresses FAQs about coronavirus vaccination.

This episode covers:

How we can tell the COVID vaccines are working
Data on how COVID cases and deaths have fallen in nursing homes and among people aged 85+
Current COVID mortality rates in older adults
What the latest observational studies show, regarding vaccine effectiveness in people over age 80
What the Johnson & Johnson vaccine trial data shows, when it comes to older adults with chronic conditions
What’s been found so far, regarding vaccine safety
Answers to FAQs, including:
- Should I get vaccinated against COVID?
- Should my 90-year-old parent get the COVID vaccine?
- How well does the vaccine work in older adults?
- Can you get COVID if you’ve been vaccinated?
- Should you be vaccinated if you already had COVID?
- Which COVID vaccine is best for seniors? Which vaccine is safest?
- Should I worry that the vaccine might harm me (or my frail older parent)?
- When can I get vaccinated? Which vaccine should I try to get?
- If I’ve been vaccinated, is it safe to …?
Dr. K’s current recommendations regarding COVID vaccination and staying safe given current conditions

Related Resources:

BHWA: COVID Vaccination for Aging Adults: What to Know & Do
FDA (Food & Drug Administration):
- COVID-19 Vaccines
- Johnson & Johnson FDA Briefing Data
CDC:
New England Journal of Medicine:
- Safety and Efficacy of the BNT162b2 mRNA Covid-19 Vaccine (Pfizer vaccine)
- BNT162b2 mRNA Covid-19 Vaccine in a Nationwide Mass Vaccination Setting (Pfizer vaccine in Israel)
- Efficacy and Safety of the mRNA-1273 SARS-CoV-2 Vaccine (Moderna vaccine)
New York Times:
- COVID-19 Vaccine Tracker
- Coronavirus Variant Tracker
Uptodate.com COVID-19 Resources & Tools (Coronavirus Resources)
- Coronavirus disease 2019 (COVID-19): Vaccines to prevent SARS-CoV-2 infection

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117 – Leg Swelling in Aging: What to Know & Do Feb 25, 2021

Show notes

Watch the subtitled video and search the transcript by clicking above.
(For a short tutorial on how to search the transcript, see here.)

In This Episode:

Guest host Dr. Nicole Didyk explains what older adults and families should know about leg edema (swollen legs), a common condition that affects aging adults. Dr. Didyk is a geriatrician in Canada, and the founder of the blog and YouTube channel The Wrinkle.

She discusses:

Why is it common for the lower legs to swell?
What are the most common medical causes of leg edema and what are some serious causes that should not be missed?
Which common medications can make leg swelling worse?
When should you seek immediate medical attention for swollen legs?
How can chronically swollen legs be treated?
What to know about using diuretics (water pills) for swollen legs

Related episodes:

092- Interview: Addressing Nighttime Urination & Insomnia in Aging

040 – Dehydration in Older Adults: How to Prevent It, Detect It, & Treat It

113 – Interview: Urinary Incontinence in Aging

Related Resources:

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116 – Interview: Dr. K’s New Book: When Your Aging Parent Needs Help Jan 21, 2021

Show notes

Watch the subtitled video and search the transcript by clicking above.
(For a short tutorial on how to search the transcript, see here.)

In This Episode:

Dr. K talks to fellow geriatrician Dr. Nicole Didyk about her new book: When Your Aging Parent Needs Help: A geriatrician’s guide to memory loss, safety worries, resistance, and more. Dr. Didyk is the founder of the blog and YouTube channel The Wrinkle.

They discuss:

What led Dr. K to create this step-by-step guide for children of aging parents
Why the book is set up in four sections: taking stock, taking aim, taking action, plus taking the long view
How to communicate with your aging parent attentively and respectfully
How dementia and other memory or thinking issues often play a key role in an older adult’s resistance to change
Why she included practical “real-life” examples and printable downloadable “cheatsheets” that readers can reference
The A-B-C-D-E framework for taking action to help an aging parent
Why adult children often need to check themselves and accept their parents’ choices

Related Resources:

More information on the book: When Your Aging Parent Needs Help
9 Types of Issues to Address When Helping Older Parents

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115 – COVID Vaccination in Aging (12.17.20 Edition) Dec 18, 2020

Show notes

In This Episode:

Dr. K discussed the new Pfizer coronavirus (COVID-19) vaccine, with a special focus on understanding how well it works and how safe it is, in aging adults.

This episode covers:

What to know about vaccine media reports and older adults
Why it’s important to try to find out the actual ages (and age distribution) of older participants in vaccine trials
How Dr. K looks at a published study to determine whether the vaccine works for her patients
Why the current Pfizer data can’t tell us whether the vaccine works in people over age 75
Why an expert dissented from the CDC’s decision to prioritize vaccination for nursing home residents
Dr. K’s current recommendations regarding COVID vaccination and keeping frail older adults safe during the pandemic

Related Resources:

BHWA: COVID Vaccination for Aging Adults: What to Know & Do
FDA (Food & Drug Administration):
- COVID-19 Vaccines
- FDA: Emergency Use Authorization for Vaccines Explained
CDC:
CDC advisory panel’s lone dissenter on why long-term care residents shouldn’t receive Covid-19 vaccine first
New England Journal of Medicine:
- Safety and Efficacy of the BNT162b2 mRNA Covid-19 Vaccine (12/10/20 publication of the Pfizer vaccine phase 2/3 trial data)
New York Times:
- COVID-19 Vaccine Tracker
- F.D.A. Clears Pfizer Vaccine, and Millions of Doses Will Be Shipped Right Away
Uptodate.com COVID-19 Resources & Tools (Coronavirus Resources)
- Coronavirus disease 2019 (COVID-19): Vaccines to prevent SARS-CoV-2 infection

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114 – Coronavirus Updates & Suggestions (11.18.20 Edition) Nov 20, 2020

Show notes

Watch the subtitled video and search the transcript by clicking above. (For a short tutorial on how to search the transcript, see here.)

In This Episode:

Dr. K shares an update on the coronavirus (COVID19) situation and more recommendations to help older adults and people concerned about aging parents.

This episode covers:

The coronavirus situation today
Why COVID rates are so high right now
Latest developments in treatment & vaccination
What this means for older adults
If you’re wondering “Is it safe to…?”
Dr. K’s recommendations for the holidays and winter

Resources:

Uptodate.com COVID-19 Resources & Tools (Coronavirus Resources)
What is a pulse oximeter
Center to Advance Palliative Care COVID Response Resources – see info in the symptom management section.
TheConversationProject.org:
- Conversation Guide: Being Prepared in the Time of COVID-19
PrepareForYourCare.org
- Get their easy advance directives for almost all states here.
- Get their COVID resources, including their PREPARE for COVID-19 Tip Sheet here.
POLST.org
- Learn how POLST helps frail and seriously ill adults get better care, and find out what is available for your state.
Institute on Aging Friendship Line
- This free service provides trained volunteers to talk to older adults who are lonely or depressed; they are also qualified as a crisis line for anyone contemplating harming themselves

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113 – Interview: Urinary Incontinence In Aging Oct 14, 2020

Show notes

In This Episode:

Dr. K discusses urinary incontinence in aging with geriatrician Dr. Nicole Didyk, founder of the blog and YouTube channel The Wrinkle. They discuss:

Why this is such an important health issue to detect and address
Why aging tends to bring on urinary continence issues
The four main types of urinary incontinence to know about
The DIAPPERS mnemonic geriatricians often use to check for common causes of incontinence
Which medications can cause or worsen incontinence
How health providers should evaluate and diagnose incontinence
How to prevent and treat urinary issues
Timed toileting and other approaches to managing incontinence in Alzheimer’s and other dementias