Dear Savvy Senior,
What health screenings are recommended for seniors? My husband and I are very proactive about staying healthy and are wondering which screenings we really need.
Alive and Kicking
Dear Alive,
The types of health screenings a person should get will depend on their age, gender, underlying health conditions and family history. Here’s what you should know.
Recommended Tests
One of the problems with our health care system is that many Americans, and their doctors, seem to think that better health means more medical care, including as many screenings and tests as possible. But that’s not necessarily true. According to the U.S. Preventive Services Task Force (USPSTF) – an independent panel of medical experts that reviews the effectiveness of screenings – many screening tests are unproven and can not only waste your time and money but also cause more harm than good. Here’s what the task force recommends (see www.ahrq.gov/ppip/50plus) as essential tests for you and your husband, and when you should start getting them.
Everyone Over 50
• Blood pressure: Have it checked at least every two years – more frequent if you find your pressure is above 130/85.
• Cholesterol: At least every five years, get a blood cholesterol test that measures your LDL “bad” cholesterol, HDL “good” cholesterol and triglycerides. It should be more frequently if you smoke, have diabetes or a family history.
• Colorectal cancer: Begin regular screening starting at age 50. Your doctor can help you decide which test is right for you.
• Diabetes: While the USPSTF recommends being tested only if you have high blood pressure, the American Diabetes Association recommends a blood glucose test every three years starting at age 45. If you’re obese, have high blood pressure, high cholesterol, a family history of diabetes or are over age 65, check it yearly.
Women Only
• Mammograms: The controversial new guideline by the USPSTF now recommends screenings every other year beginning at age 50. However, the American Cancer Society still recommends annual screenings starting at age 40.
• Pap smear: To detect cervical cancer this test is recommended every three years, however women who’ve had a total hysterectomy, or who are age 65 or older and have had three negative pap smears in a row usually don’t need to be tested.
• Bone density scan: Osteoporosis screening is recommended starting at age 65 – earlier in post-menopausal women with risk factors.
Men Only
• Abdominal ultrasound: Men between the ages of 65 and 75 that have ever smoked should be screened for an aortic aneurysm, which can develop over many years before bursting.
• PSA screening: The jury is still out on whether men should get the PSA (prostate-specific antigen) blood test or digital rectal exam to detect prostate cancer. Men, age 40 and older, should talk to their doctor about their risk factors and what they should do.
Other Screenings
Some additional screenings to consider are skin examinations by a dermatologist to check for skin cancers; depression screening if you’ve been feeling down; dental checkups at least once a year; HIV screening if you’ve had unprotected sex with multiple partners; annual eye exams starting at age 60 to check of age-related eye diseases; hearing tests by an audiologist every five years starting at 65; and for women 50 and older, a thyroid-simulating hormone test every five years to check for thyroid disease.
Vaccinations
In addition to health screenings, the Centers for Disease Control and Prevention recommends that all seniors, 65 and older get a one-time pneumonia (pneumococcal) shot, and those over 60 should be vaccinated for shingles. It’s also recommended that everyone over 50 get a yearly flu shot, along with a tetanus-diphtheria-pertussis (Tdap) booster which is recommended every 10 years (if you’re over 65, you only need a tetanus-diphtheria booster).
Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit SavvySenior.org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book.