Health screening - women - over 65

Definition

All adults should visit their health care provider from time to time, even if they are healthy. The purpose of these visits is to:

• Screen for diseases
• Assess risk of future medical problems
• Encourage a healthy lifestyle
• Update vaccinations
• Maintain a relationship with a doctor or nurse in case of an illness

Alternative Names

Health maintenance visit - women - over 65; Physical exam - women - over 65; Yearly exam - women - over 65; Checkup - women - over 65; Women's health - over 65

Information

Even if you feel fine, it is still important to see your health care provider regularly to check for potential problems. Most people who have high blood pressure don't even know it. The only way to find out is to have your blood pressure checked regularly. High blood sugar and high cholesterol levels often do not produce any symptoms until the disease becomes advanced.

There are specific times when you should see your health care provider. Age-specific guidelines are as follows:

• Blood pressure screening:
  • Have your blood pressure checked every year.
  • If you have diabetes, heart disease, kidney problems, or certain other conditions, you may need to be watched more closely.
• Cholesterol screening:
  • If your cholesterol level is normal, have it rechecked every 3-5 years.
  • If you have diabetes, heart disease, kidney problems, or certain other conditions, you may need to be monitored more closely.
• Colon cancer screening: Until age 75, one of the following screening tests should be done:
  • Virtual colonoscopy (computed tomographic colonography) every 5 years
  • A stool test every year
  • Flexible sigmoidoscopy every 5 years along with a stool guaiac test
  • Colonoscopy every 10 years
• Dental exam:
  • Go to the dentist every year for an exam and cleaning.
• Diabetes screening:
  • If your blood pressure is above 135/80, your health care provider will test your blood sugar levels for diabetes.

Note: Patients with risk factors for colon cancer, including ulcerative colitis, a personal or family history of colorectal cancer, or a history of large colorectal adenomas may need a colonoscopy more often.

• Eye exam:
  • Have an eye exam every 2 years.
  • Make sure your health care provider checks for glaucoma.
• Hearing test:
  • Have your hearing tested every year.
• Immunizations:
  • If you are over age 65, get a pneumococcal vaccine if you have never had before, or if you received one more than 5 years before you turned 65.
  • Get a flu shot every year.
  • Get a tetanus-diphtheria booster every 10 years.
  • You may get a shingles or herpes zoster vaccination once after age 60.
• Physical exam:
  • Have a yearly physical exam.
  • With each exam, you should have your height, weight, and body mass index (BMI) checked.
  • Routine diagnostic tests are not recommended unless your doctor finds a problem.
  • Your health care provider will ask you questions about alcohol and tobacco use, your diet, exercise, safety such as seat belt use, and may ask you about depression
• Breast exams:
  • Women may do a monthly breast self-exam.
  • Contact your doctor or nurse immediately if you notice a change in your breasts, whether or not you do self exams.
  • A health care provider should do a complete breast exam every year.
• Mammograms:
  • Women should have a mammogram done every 1-2 years, depending on their risk factors, to check for breast cancer.
• Osteoporosis screening:
  • All women should have a bone density test (DEXA scan).
  • Ask your doctor or nurse about how much calcium you need and what exercises can help prevent osteoporosis.
• Pelvic exam and Pap smear:
  • After age 65, most women can stop having Pap smears as long as they have had three negative tests within the past 10 years.

References

Atkins D, Barton M. The periodic health examination. In:Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 14.

U.S. Preventive Services Task Force. The Guide to Clinical Preventive Services. 2010-2011. AHRQ Publication No. 10-05145, September 2010. Agency for Healthcare Research and Quality, Rockville, MD.

American College of Obstetricians and Gynecologists. Cervical cytology screening. ACOG Practice Bulletin No. 109. Obstet Gynecol.2009; 114:1409-1420.

Smith RA, Cokkinides V, Brawley OW. Cancer screening in theUnited States, 2012. A Review of Current American Cancer Society Guidelines and Issues in Cancer Screening. CA Cancer J Clin. 2012;62:129-142.

Mosca L, Benjamin EJ, Berra K, Bezanson JL, Dolor RJ,Lloyd-Jones DM, et al. Effectiveness-based guidelines for the prevention of cardiovascular disease in women--2011 update: A guideline from the AmericanHeart Association. Circulation; 2011;123(11):1243-1262.

Centers for Disease Control and Prevention. Recommended adult immunization schedule -- United States, 2012. MMWR.2012;61(4):1=7.

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