Preventive health care for adults over 65

Dec. 29, 2020
An older couple ice skates. Exercise is one preventive health measure everyone can practice.
Exercise is one preventive health measure men and women can practice to remain healthy into their golden years. Photo: Getty Images.

For people age 65 and older, preventive health care is more important than ever. Dr. Sarah Hopfenbeck, an internal medicine physician in Steamboat Springs and a member of the medical staff at UCHealth Yampa Valley Medical Center, outlines what older adults need to know about taking care of their health below.

An annual exam

It’s recommended that all patients see their medical provider each year for a physical.

Through Medicare, patients are eligible for a one-time initial preventive physical exam. After that initial exam, Medicare covers an annual wellness visit. This exam is sometimes done by nurses, and while it doesn’t include a hands-on physical exam, it’s a chance to review routine health maintenance and screen a patient for risks of falls, depression and cognition issues.  Advanced directives are also discussed. The wellness exam should be followed up by an office visit with the provider to discuss results and for an actual exam.

Cancer screenings

Mammograms are recommended every one to two years for women ages 65 and older.

“Personally, I recommend an annual mammogram,” Hopfenbeck said. “But it’s true for any of these tests that we like to participate in shared decision making. Instead of directing a patient to do something, we have a conversation about what various organizations recommend, what we recommend and what the patient feels.”

For women over 65, Pap smears to screen for cervical cancer are generally no longer recommended, though women who smoke or have new sexual partners should continue with the test.

Men in this age group are generally screened for prostate cancer through a blood test for prostate-specific antigen, or PSA, every one to two years.

Both men and women at average risk for colon cancer should continue with screening for the disease by having a colonoscopy every 10 years, or the at-home Cologuard stool test every three years. High-risk individuals should be screened with a colonoscopy more frequently.

When to stop screenings

Typically, cancer screenings cease when a patient has a life expectancy of less than 10 years.

“There’s no crystal ball. I have patients in their nineties who are going strong, and if I had told them to quit screening 20 years ago, that may not have been appropriate,” Hopfenbeck said.

“But some people will say, ‘If I get something at this stage in my life, I’m not going to treat it.’ It’s very important to talk with each person in terms of where they stand with their health, what their goals are, what they want their life to be like.”

Bone density checks

A bone density test to screen for osteoporosis is recommended for women older than 60, as well as for some men with risk factors, such as smoking or steroid use. If results are normal, the test may be repeated every 10 to 15 years, depending on risk factors. Checks every two to three years are recommended for patients who have low or decreasing bone mass.

Immunizations

Recommendations are similar to those for younger adults, with the addition of a high dose flu shot each year, as well as the pneumonia vaccine, which is recommended once at 65 and boosted every 10 years, or more frequently for people with chronic health conditions.

Medication review

Older adults may take a range of medications, and it’s important to regularly review that list.

“As people get older, they don’t tolerate some medications as well, and others could have potential interactions,” Hopfenbeck said. “It’s good to sit down with your doctor each year and see which medications you’re on and if they’re all necessary.”

The power of being proactive

The old adage holds – an ounce of prevention is worth a pound of cure.

“It remains true in older adults that the earlier we pick things up, the sooner we can do something about them,” Hopfenbeck said. “We know that as our bodies age, the incidence and risk for a lot of these things, such as breast cancer and prostate cancer, increase. We want to do everything we can to help people age gracefully and in a healthy way.”

About the author

Lindsey Reznicek is a communications specialist at UCHealth Yampa Valley Medical Center in Steamboat Springs, Colorado. She has spent the last ten years working in marketing and communications in health care, an industry she never considered but one to which she's contributed through her work in media relations, executive messaging and internal communications. She considers it an honor to interact with patients and write about their experiences; it’s what keeps her coming back to work each day.

A native of Nebraska, Lindsey received a Bachelor of Arts degree in journalism, with a focus on public relations, from the A.Q. Miller School of Journalism and Mass Communications at Kansas State University – she bleeds purple.

She could see a Broadway musical every week, is a huge animal lover, enjoys a good shopping trip, and likes spending time in the kitchen. Lindsey and her husband have two daughters and enjoy hiking in the summer and skiing all winter long.

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