What Screening Tests and Treatments You Need as You Age

As we get older, we are more likely to develop chronic medical issues like high blood pressure or high cholesterol, and many of these conditions have no symptoms, so screening is important. The U.S. Preventive Services Task Force (USPSTF) has been charged with developing a list of screening and intervention items that have proven effective and should be considered by all older adults.  While your doctor is aware of these, you should know about them too, especially if you have many doctors or are forced to change doctors frequently. This will help you make sure nothing important, and potentially life-saving, falls through the cracks.

The following are among the most important screenings recommended by the USPSTF and covered by Medicare:

  • High blood pressure
    • Who: All older adults
    • How often: Yearly for people aged 40 or older. Covered as part of Medicare Annual Wellness Visit.
  • High cholesterol
    • Who: All men age 35 or older; women aged 45 or older if they are “at increased risk for coronary heart disease.”
    • How often: Per the USPSTF, about every 5 years; adjust based on previous results. Medicare covers cholesterol tests every 5 years as part of preventive care.

Obesity (measurement of body-mass index)

  • Who: all adults
  • How often: Not specified by the USPSTF. Covered yearly as part of Medicare Annual Wellness Visit.

Abnormal blood glucose and Type 2 Diabetes

  • Who: Per the USPSTF, screening is recommended for adults aged 40-70 who are obese. Medicare covers screening for people with one or more risk factors, and doesn’t specify an age range.
  • How often: About every three years, per the USPSTF. Covered every 12 months by Medicare, for people with risk factors.

Hepatitis C

  • Who: The USPSTF recommends a one-time screening for all adults born between 1945 and 1965.
  • How often: Covered at least once by Medicare for adults born during the years above. May be covered more often for those with additional risk factors for hepatitis C infection.

HIV (Human immunodeficiency virus)

  • Who: Adults aged 15-65, and older adults at increased risk for infection
  • How often: Not specified by the USPSTF. Covered annually by Medicare.

Colorectal cancer

  • Who: The USPSTF recommends for routine colon cancer screening for adults aged 50-75, and against colon cancer screening in adults aged 85 or older. For adults aged 76-85, the USPSTF recommends against “routine screening”; the CDC’s screening guidelines recommend an “individualized decision” for adults aged 75 or older.
  • How often: This depends on the screening method used. Screening colonoscopy can be done every 10 years, whereas screening by checking stool for microscopic blood requires annual stool testing.

Breast cancer

  • Who: The USPSTF recommends for routine breast cancer screening in women aged 50-74. The USPSTF recommends neither for nor against breast cancer screening in women aged 75 or older.
  • How often: The USPSTF recommends screening mammography every two years. Medicare covers screening mammograms every 12 months.

Lung cancer

  • Who: Per the USPSTF, adults who are age 55-80, have a 30 pack-year history of smoking, and either smoke or have quit within the past 15 years.
  • How often: The USPSTF recommends yearly screening for the adults meeting the criteria above, and stopping screening once it’s been 15 years since the person quit smoking. 

 

So, you thought you only needed your “shots” as a kid?  Think again—-everything seems to come full circle. Vaccines recommended as we age:

Influenza (flu) vaccine

  • Who: The CDC recommends vaccination for seasonal influenza every year, for everyone aged 6 months or older. There is no upper age limit. A high-dose influenza vaccine (Fluzone) is approved for adults aged 65+, and may be better at stimulating an aging immune system.

Pneumococcal vaccination (two types as of 2014)

  • Who: All adults aged 65+ should get both Prevnar (PCV13) and Pneumovax (PPSV23).
  • How often: Once for each, after age 65. The CDC recommends revaccinating high-risk patients who received Pneumovax prior to age 65, once it’s been five years since Pneumovax was first administered.

Shingles (herpes zoster) vaccine

  • Who: The CDC recommends vaccination against shingles for all adults aged 60+. The only approved vaccine is Zostavax.
  • How often: Once. Medicare covers this vaccine as part of a person’s Part D plan.

Tetanus-diphtheria (Td) and tetanus-diphtheria-pertussis (Tdap)

  • Who: The CDC recommends a Td booster shot every 10 years for all adults. In 2010, the CDC recommended that adults of all ages get one dose of Tdap to get protection against pertussis (whooping cough), which has become more common.
    • Pertussis vaccination is especially important for those who will be around young babies, such as grandparents or childcare providers.
  • How often: The Td booster should be given every 10 years

 

For a more comprehensive list, compiled by  Leslie Kernisan, MD MPH, check out https://betterhealthwhileaging.net/preventive-health-services-for-older-adults-healthy-aging-checklist-part-5/#summary.  This is one of the best summaries I could find, and have borrowed liberally from it.

 

Further reading:

https://betterhealthwhileaging.net/preventive-health-services-for-older-adults-healthy-aging-checklist-part-5/#summary

https://www.webmd.com/healthy-aging/guide/milestone-medical-tests-50#1