Care Matters

By LCWMD / May 24, 2017

Care Matters

One physician’s take on traversing the healthcare system in later life. Spoiler alert. Less is more, except for exercise, eating...

Read More
By LCWMD / March 14, 2019

What is preclinical Alzheimer disease, and why should we care?

Every 65 seconds someone in the U.S. develops dementia. Science has not yet delivered meaningful treatments for dementia, but it is delivering on detection of preclinical dementia states (changes that are measurable in the brain but there are no symptoms yet) using biomarkers in spinal fluid and PET brain imaging. ...

Read More
By LCWMD / October 4, 2018

What is deprescribing?

As people get older or their health conditions change, certain medications become unnecessary or even harmful and contribute to polypharmacy. When clinicians reduce or stop such medications according to recommended guidelines it is called deprescribing. A multidisciplinary group of researchers and clinicians in Ottawa, Canada is leading the way on...

Read More
By LCWMD / April 25, 2018

Hearing loss and dementia? Sounds right

I have been reading with great interest a growing number of scientific studies on the association of age related hearing loss and dementia. Given that the majority of people over 70 have some degree of hearing loss, this is a big deal. Several large studies from multiple countries and contexts...

Read More
By LCWMD / January 25, 2018

Confessions of an unwitting Ageist

I recently viewed a TED talk that made me realize I am ageist. As a middle-aged geriatrician, and someone who spends a lot of energy trying to recognize the other “isms “ in myself, I am not proud. Ashton Applewhite, activist and author of This Chair Rocks, calls this the...

Read More
By LCWMD / November 30, 2017

FAST and FRAIL – how to know when less is more

These two measures help to determine whether you are healthy enough to benefit from surgery, or other risky interventions. Because of perverse incentives in our healthcare system, it is not uncommon for vulnerable people to be approved for and/or encouraged to have procedures that may be more harmful than helpful...

Read More
By LCWMD / October 18, 2017

Dementia and the Weaponization of hope

It is presumed there are over 100 types of dementia, in addition to Mild Cognitive Impairment (MCI) and most are understood to be overlapping in pathology, especially the common dementias of late-life. Hypertension and diabetes in particular influence blood vessels in the brain just as they do in the heart,...

Read More
By LCWMD / September 19, 2017

Sleep – simple but not easy

It seems that everyone has advice about sleep these days, and we have become immune to it. “Avoid naps, caffeine, and alcohol close to bedtime. Get exercise. Get out of bed if you can’t sleep. Turn off the TV and any electronic devices hours before bedtime. Enjoy a relaxing ritual....

Read More
By LCWMD / August 21, 2017

Star search: How to choose a nursing home

“Lisa no longer works here.” This is a familiar refrain when I attend meetings in nursing homes. In this case, Lisa was the Director of Social Services, but the turnover is similar for Directors of Nursing, and slightly less so for Nursing Home Administrators (they make more money). These are...

Read More
By LCWMD / July 31, 2017

FALLING is serious business – things you can do to lower your risk

A quick Google search for “falls in the elderly” yields about 58 million hits, with roughly 1.5 million results on Google scholar, where the more scientific articles reside. It’s a big deal. Here’s why. • 1 out of 4 Americans aged 65+ fall every year, one person every second •...

Read More
By LCWMD / June 13, 2017

Never leave home without it – the value of a health notebook

Have you ever been in a doctor’s office for yourself, or with your elderly parent, and not been able to answer “when did you first start having that symptom?” or “what medications have you tried for that, and what dose worked the best?” or “what did the specialist say about...

Read More