At a dinner party, everyone wants to talk about longevity. Almost no one wants to talk about gerontology. My guest today, Dr Deborah Kado, has spent more than three decades in the field that longevity science quietly rebranded, and she brings a perspective the supplement stacks and biological age tests tend to miss.
Deborah is a professor of medicine at Stanford University, director of the Geriatrics Research Education and Clinical Center at the VA Palo Alto, and co-director of the Stanford Longevity Center. While the longevity industry sells optimisation, her field has been quietly working out what actually determines who ages well: balance and power, bones that don’t break, medication lists that don’t balloon, a gut microbiome in rhythm, and, perhaps most surprisingly, the attitude you hold towards ageing itself.
What We Cover:
- Why the number of geriatricians is shrinking while the population ages, and what that means for all of us
- The Yale finding that a positive attitude towards ageing in your thirties predicts a roughly 50% lower dementia risk decades later
- The balance test you can try at home, and why power matters more than slow strength for preventing falls
- Why, after decades of observing patients, she’d choose dancing as the single best activity for ageing well
- The media scare that led millions to abandon bone medications that halve fracture risk
- Why the weight you’re carrying after menopause might be your “insurance policy”
- Her research linking vitamin D, sleep regularity, and the gut microbiome
- What a 101-year-old physicist and a Costco walker can teach us about purpose
This conversation changed how I think about ageing: not as a decline to be optimised against, but as a stage of life to be lived well. I suspect it will do the same for you.
To connect with Dr Deborah Kado, visit her Stanford profile or find her on LinkedIn.
- What Gerontology and Geriatrics Mean (00:00)
- Why Geriatricians Are So Rare (02:44)
- Empathy and Ageism in Aging (06:42)
- How Attitudes Affect Dementia Risk (12:09)
- How to Stay Independent While Aging (17:21)
- Why Healthy Longevity Beats Healthspan Hype (20:26)
- Vertebral Fractures and Spine Curvature Research (30:27)
- The 4 Ms Framework Explained (33:15)
- Best Exercise for Bone Health (35:53)
- How to Train Power and Balance (40:01)
- Why Dancing Beats Every Other Exercise (43:27)
- Bisphosphonate Risks and Jaw Necrosis (45:31)
- Atypical Thigh Fractures From Bone Drugs (49:17)
- How to Choose Bone Medication (52:08)
- Deprescribing Mistakes to Avoid (55:43)
- Nutrition for Healthy Aging (01:02:48)
- How the Gut Microbiome Affects Aging (01:07:05)
- Sleep, Microbiome, and Preventing Dementia (01:15:04)
- How to Find Purpose in Old Age (01:24:52)
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More about Dr Deborah Kado
Deborah Kado, MD, MS professor of medicine at Stanford University, specialises in geriatrics and gerontology. She serves as the Director of the Geriatrics Research Education and Clinical Center (GRECC) for the Veterans Affairs Palo Alto Healthcare System, co-director of the Stanford Longevity Center, and Research Chief of the Geriatric Section of the Department of Medicine. She integrates biological, pharmacological, lifestyle, and psychological perspectives and research to optimise health and empower her patients. She has a special interest in bone health, conducting extensive research focused on osteoporosis and the related disorder hyperkyphosis, commonly known as the “dowager’s hump.” Her discoveries helped define the causes, consequences, and ways to improve it through spinal strengthening exercises. In the past decade, her research has focused on the interactions between ageing and the gut microbiome with regards to vitamin D metabolism, sleep and mortality risk. She has over 140 peer-reviewed publications in highly cited journals such as the Annals of Internal Medicine, The Journal of Bone and Mineral Research, Nature Metabolism, and Nature Communications. She has been continuously funded by the National Institutes of Aging since 2000 and is a member of multiple professional organisations, including the American Geriatrics Society, the American Society of Bone and Mineral Research, the Gerontological Society of America, and the Endocrine Society. Dr Kado currently serves on the NIH Council of Councils Disability Health Research Working Group and is a frequent commentator for many newspapers including the San Francisco Chronicle, New York Times, Washington Post, Wall Street Journal and magazines such as Women’s Health, Vogue, Real Simple, Self, and Good Housekeeping.
