Search Results for: blood pressure

Understanding Laboratory Tests:
10 Commonly Used Blood Tests for Older Adults

In this article, I’ll address a real mainstay of modern medicine: laboratory tests that require drawing blood.

This is sometimes referred to as “checking labs,” “doing bloodwork,” or even “checking blood.”

Most older adults have been through this. For instance, it’s pretty much impossible to be hospitalized without having bloodwork done, and it’s part of most emergency room care. Such testing is also often done as part of an annual exam, or “complete physical.”

Last but not least, blood testing is usually — although not always — very helpful when it comes to evaluating many common complaints that affect aging adults.

Fatigued and experiencing low energy? We should perhaps check for anemia and thyroid problems, among other things.

Confused and delirious? Bloodwork can help us check on an older person’s electrolytes (they can be thrown off by a medication side-effect, as well as by other causes). Blood tests can also provide us with information related to infection, kidney function, and much more.

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004 – What to Do If You’re Worried About Falls

by Leslie Kernisan, MD MPH Leave a Comment

Better Health While Aging

004 – What to Do If You're Worried About Falls

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In This Episode:

Why older adults fall
How to identify underlying health risk factors and fall triggers, so that you can personalize your fall prevention plan
The three step process Dr. Kernisan uses to create a fall prevention plan for an older person
Medications that geriatricians often reduce or stop, to reduce fall risk
How blood pressure medication can increase fall risk, and a simple test to discuss with the doctor

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5 Ways to Help Someone Age in Place

by Leslie Kernisan, MD MPH

People of all older ages often tell me they hope to age in place.

Meaning, they want to be able to remain in their home and community, even as time brings changes to life, health, and abilities.

These days, many older people do end up moving, often reluctantly. And this doesn’t have to be a bad thing; I find that after a period of adjustment, many aging adults enjoy their new homes and communities. But no one likes the thought that they might *have* to move, because it’s become too difficult or risky to remain in one’s preferred home.

Now, as for all things in life and health and aging, it’s impossible to guarantee the outcome we want. But, as in almost all things in life and health and aging, there’s plenty you can do to put the odds in your favor, when it comes to aging in place.

The key is to understand what often interferes with remaining in one’s home. Then you can think about how to anticipate, prevent, or work around many of those challenges to aging in place.

In this post, I’ll describe some of the common reasons that I see older adults struggling to age in place. Then I’ll share 5 specific things you can do, to help an older person better age in place.

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Deprescribing: How to Be on Less Medication for Healthier Aging

by Leslie Kernisan, MD MPH

Have you ever wondered whether you — or your older relative — might be taking too many medications?

You’re certainly right to ask yourself this. I consider this for all my own patients, and wish every doctor would.

In part, this is because over the years, I’ve had countless older adults express their worries and frustrations, related to their prescription drugs. These include:

The hassle of having so many pills to take
Worries about side-effects
Frustration with medication costs
Wondering whether a given medication is the “right” one for you, or for your condition
The sneaky feeling that some of those medications don’t seem to help much
The hassle of coordinating a long medication list among multiple doctors

Needless to say, all of this is not so good for quality of life while aging.

And unlike some things that people worry about, these concerns are all actually justified, given what geriatricians know about older adults and medications.

So if you’ve ever experienced the above worries — or if you (or your older relative) are taking more than five medications — then I want to make sure you know about a process that can improve or resolve all those problems that older adults have with their medications.

It’s called deprescribing, and it’s really essential to optimizing the health of an older person.

In this article, I’ll cover what every older adult and family caregiver should know about it:

What is deprescribing?
Why is deprescribing especially important for older adults?
How does deprescribing work?
What medications are most important for older adults to consider deprescribing?
How can older adults and family caregivers get doctors to address deprescribing?

This way, you’ll have a better shot at what everyone wants when it comes to medication:

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Q&A: How to Prevent, Detect, & Treat Dehydration in Aging Adults

by Leslie Kernisan, MD MPH

Q: How can we get my older mother to drink more water? She is susceptible to urinary tract infections and seems to be often dehydrated no matter what we do. We were also wondering if coffee and tea are okay, or should they be avoided to reduce dehydration? And what are symptoms of dehydration in older women that we can look out for?

A: Dehydration is indeed an important problem for older adults. It can be common even when it’s not hot outside.

Helping an older person increase her fluid intake, as you’re trying to do, is one of the best ways to reduce the risk of dehydration.

Now how to actually do this? Studies — and practical experience — suggest that the best approaches include:

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How to Address Cardiovascular Risk Factors for Better Brain Health:
12 Risks to Know & 5 Things to Do

by Leslie Kernisan, MD MPH

A while back, I wrote an article on cerebral small vessel disease, a very common condition in which the small blood vessels of the brain develop signs of damage.

If you’re an older adult and you’ve had an MRI done of your brain, chances are pretty good that your scan showed signs of at least mild signs of this condition; one study of older adults aged 60-90 found that 95% of them showed signs of these white matter changes.

These are basically like teensy strokes in the brain. Most are un-noticeable to people, but if you have enough of them, you can certainly develop symptoms, such as cognitive impairment, balance problems, or even vascular dementia.

To date, the cerebral small vessel disease article has generated over 100 comments and questions from readers. A common theme was this: “My MRI shows signs of this condition. What can I do?”

As I explain in the article and the comments, the first thing to do is to work closely with your doctors to understand what is the likely cause of the damage to the brain’s small blood vessels.

Now, when you do this, you may well find that your doctor just shrugs, or waves off the question.

That’s because in most people, cerebral small vessel disease is thought to be in large part a result of atherosclerosis (more on this term below) affecting the smaller arteries of the brain. And atherosclerosis affects just about everyone as they age, because it’s related to many basic cardiovascular risk factors that become very common in late-life.

So in many cases, asking the doctor why you have signs of cerebral small vessel disease may be like asking why you might have high blood pressure, or arthritis. These are common conditions and they are usually due to medically mundane causes and risk factors, including sub-optimal “lifestyle” behaviors and the general “wear and tear” on the body that is associated with aging.

(However, in some people, damage to the small vessels in the brain may be related to one or more particular medical conditions. Younger people, in particular, seem more likely to have a particular condition or risk factor that may be causing most of the damage.)

Whether you are younger (i.e under age 60) or older, always start by asking your doctors what they think are the most likely causes for any cerebral small vessel disease, and what they recommend you do to slow the progression.

And for most people, the main advice will be this: evaluate and address your cardiovascular risk factors.

“Vascular,” as you probably already know, means “blood vessels.” And blood vessels are critical to the function of every part of the body, because blood vessels are what brings oxygen and nutrients to every cell in the body. They also carry away waste products and toxins. So, blood vessel health is key to brain health.

This article will help you better understand how to address blood vessel health. Specifically, I’ll cover:

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Cerebral Small Vessel Disease:
What to Know & What to Do

by Leslie Kernisan, MD MPH

Signs of cerebral small vessel disease. From Inzitari et al, BMJ. 2009 Jul 6;339:b2477. doi: 10.1136/bmj.b2477

This article is about the most common aging brain problem that you may have never heard of.

While leading a fall prevention workshop a few years ago, I mentioned that an older person’s walking and balance problems might well be related to the presence of “small vessel ischemic changes” in the brain, which are very common in aging adults. (This is also called “white matter disease.”)

This led to an immediate flurry of follow-up questions. What exactly are these changes, people wanted to know. Do they happen to every older adult? Is this the same as vascular dementia? And how they can best help their parents with cognitive decline?

Well, these types of brain lesions don’t happen to every older person, but they do happen to the vast majority of them. In fact, one study of older adults aged 60-90 found that 95% of them showed signs of these changes on brain MRI.

In other words, if your older parent ever gets an MRI of the head, he or she will probably show some signs of these changes.

So this is a condition that older adults and families should know about. Furthermore, these changes have been associated with problems of consequence to older adults, including:

Cognitive decline,
Problems with walking or balance,
Strokes,
Vascular dementia.

Now, perhaps the best technical term for what I’m referring to is “cerebral small vessel disease.” But many other synonyms are used by the medical community — especially in radiology reports. They include:

White matter disease
Small vessel ischemic disease
Brain lesions
Periventricular white matter changes
Perivascular chronic ischemic white matter disease of aging
Chronic microvascular changes, chronic microvascular ischemic changes
Chronic microvascular ischemia
White matter hyperintensities
Age-related white matter changes
Leukoaraiosis

In this post, I will explain what all older adults and their families should know about this extremely common condition related to the brain health of older adults.

In particular, I’ll address the following frequently asked questions:

What is cerebral small vessel disease (SVD)?
What are the symptoms of cerebral SVD?
How is cerebral small vessel disease related to vascular dementia and cerebrovascular accidents?
What causes cerebral SVD?
How can cerebral SVD be treated or prevented?
Should you request an MRI if you’re concerned about cerebral SVD?

I will also address what you can do, if you are concerned about cerebral SVD for yourself or an older loved one.

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Anemia in the Older Adult:
10 Common Causes & What to Ask

by Leslie Kernisan, MD MPH

Have you ever been told that an older relative has anemia, and wondered about anemia symptoms?

Or perhaps you noticed the red blood cell count flagged as “low” in the bloodwork report? Or noticed “low hemoglobin” in a doctor’s report?

Anemia means having a red blood cell count that is lower than normal, and it’s very common in older adults. About 10% of independently living people over age 65 have anemia. And anemia becomes even more common as people get older.

But many older adults and families hardly understand anemia.

This isn’t surprising: anemia is associated with a dizzying array of underlying health conditions, and can represent anything from a life-threatening emergency to a mild chronic problem that barely makes the primary care doctor blink.

Still, it worries me that older adults and families don’t know more about anemia. If you or your relative has this condition, it’s important to understand what’s going on and what the follow-up plan is. (I’ve so often discovered that a patient didn’t know he or she had had anemia!) Misunderstanding anemia can also lead to unnecessary worrying, or perhaps even inappropriate treatment with iron supplements.

Featured Download: What to Ask Your Health Providers About Anemia. Use this free PDF to make sure you ask key questions about your anemia condition, including what’s been done to diagnose the cause, and what the plan is for treatment. Click here to download.

And since anemia is often caused by some other problem in the body, not understanding anemia often means that people don’t understand something else that is important regarding their health.

Fortunately, you don’t have to be a doctor to have a decent understanding of the basics of anemia.

This post will help you understand:

How anemia is detected and diagnosed in aging adults.
Symptoms of anemia.
The most common causes of anemia, and tests often used to check for them.
What to ask the doctor.
How to get better follow-up, if you or your relative is diagnosed with anemia.

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Urinary Incontinence in Aging:
What to know when you can’t wait to go

by Nicole Didyk, MD

“I know where every bathroom is at the mall, and my wife rolls her eyes every time I have to visit one when we just arrived – even after I went before leaving the house! What can I expect? Most old guys are in the same boat!”

If you opened this article, you probably relate to the quote above, and you’re not unlike millions of other older adults.

Incontinence doesn’t always mean wetting yourself. It can involve urgent needs to use the toilet, frequent bathroom trips, or losing tiny amounts of urine with certain activities.

Incontinence is more than inconvenient; it can be life-altering, leading to early retirement or social withdrawal, depression, and loss of independent function. Important incontinence stats include:

1 in 3 older women and 1 in 12 older men have lower urinary tract symptoms that can include incontinence
Urinary incontinence cost the US economy $66 billion in 2012
6-10% of nursing home admissions are due to urinary incontinence
Only 22% of men with urinary incontinence seek help for the problem, as compared to 45% of women

For this reason, in geriatrics, we often ask our patients about incontinence.

A while back I had the opportunity to talk to Dr. Adrian Wagg, a Geriatrician-Internist and international expert in urinary incontinence. You can listen to this interview, and find out how to download a transcript of it here. In this article, I’ll share some of his insights about the management of incontinence in older adults, and why it remains undertreated too often.

In particular, I’ll cover:

How urinary function changes with age
Types and causes of urinary incontinence in both men and women
What to do if you’re experiencing urinary incontinence and want help
How to help manage urinary incontinence in an older person you’re caring for

What happens to the Urinary System with Aging?

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Leg Swelling in Aging: What to Know & What to Do

by Nicole Didyk, MD

Swelling in the lower legs – known as “lower extremity edema” in medical terms – is a problem that often affects older adults.

The good news is that most of the time, it’s annoying, but not terribly dangerous. However, in other cases, swelling in the feet, ankles, or lower legs can be the sign of a new health problem, or a worsening chronic condition.

And, even if it’s “benign” and not related to a dangerous health condition, edema can be a major risk factor for skin breakdown and reduced mobility in aging adults.

Since leg swelling becomes so common as people get older, in this article we’ll demystify leg edema and cover the most important things that older adults and families should know about this condition. In particular, we’ll cover:

How does edema happen?
Common causes of swollen ankles or legs in aging adults
Medications that can cause leg swelling as a side-effect
How leg swelling should be medically evaluated
How to prevent and treat leg swelling
What to know BEFORE going on a “water pill”

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Search Results for: blood pressure

In This Episode:

What happens to the Urinary System with Aging?

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