Body Maintenance Guide for Boomers
What health screenings do you need to stay healthy?
Staying healthy is a top priority for most boomers, and health screenings can help. Screenings identify diseases as early as possible, even before symptoms appear, when diseases are easiest to treat.
For people over age 50 who do not have symptoms, the following screenings are recommended by the U.S. Preventive Service Task Force (USPSTF), the Centers for Disease Control and Prevention (CDC), the American Cancer Society, other national health organizations and/or local healthcare experts.
Use this guide to talk with your health-care provider about what you need. Many of these tests can be performed during an annual checkup. If you have had a disease or have a family history of a disease, you may need additional or more frequent tests.
SUGGESTED SCREENINGS FOR MEN AND WOMEN OVER AGE 50
At least once every five years, ask for a lipoprotein profile blood test to screen for high cholesterol, a waxy substance found in the fatty substance in your blood. Too much cholesterol can build up in your arteries and slow down or stop blood flow to your heart. According to the National Heart, Lung and Blood Institute, cholesterol levels tend to increase with age and can lead to heart disease, stroke and circulation problems. The blood test provides information about your total cholesterol, LDL (“bad” cholesterol), HDL (“good” cholesterol that keeps bad cholesterol from building up) and triglycerides, another fat in your blood.
Hepatitis C Virus (HCV)
You should be screened once for HCV infection if you were born between 1945 and 1965. You should also be screened if you ever injected drugs or received a blood transfusion before 1992. If you currently inject drugs, you should be screened regularly.
Human Immunodeficiency Virus (HIV)
If you are 65 or younger, you should be screened for HIV. If you are older, ask your doctor if you need to be screened.
High Blood Pressure
Have your blood pressure professionally checked at least every two years. High blood pressure, also known as hypertension, weakens your blood vessels over time and can cause heart attacks, strokes and kidney and vision problems. Blood pressure is measured by the systolic pressure (top number) when the heart beats, and the diastolic pressure (bottom number) when the heart is at rest between beats. Normal is defined as less than 120/80 mmHg. Prehypertension is when the systolic pressure is 120-139 or the diastolic number is 80 to 90. Anything higher is considered high blood pressure. More than half of adults over age 50 have high blood pressure, according to the CDC.
According to Dr. John Clore, an endocrinologist with the Bon Secours Medical Group, the American Diabetes Association recommends screening for diabetes or pre-diabetes by age 45, particularly in individuals with risk factors for diabetes (overweight, family history, ethnicity, history of gestational diabetes). This is usually done with a blood test, which should be repeated every three years. If results are positive for pre-diabetes, the test should be done every year. Diabetes can cause problems with your brain, kidneys, vision, nerves, feet, and other parts of your body. About 21 percent of adults ages 65 to 74 were diagnosed with diabetes in 2014, according to the CDC.
Calculate your body mass index (BMI) using an online BMI calculator. Just enter your height and weight. If your BMI is 25 or higher, you may be overweight. If it’s 30 or higher, you may be obese. Excessive weight can lead to high blood pressure, diabetes, heart disease, stroke, sleep apnea, and some types of cancer, according to the CDC.
People with an average risk of developing colorectal cancer should begin screening at age 50; African-Americans should begin at age 45, and people who have a family history of colon cancer should begin at age 40 or sooner, according to Dr. Shweta Joshi of Richmond Gastroenterology Associates. She explained that the risk for developing colon cancer increases with age: 90 percent of colon cancer cases occur in people over age 50. There are a variety of screening tests available, including colonoscopy every 10 years; other visual exams; or a stool sample test every year. Joshi recommends the colonoscopy, during which polyps can be removed. For those who choose not to have a colonoscopy, she recommends the FIT stool test.
Lung Cancer Testing
According to the American Cancer Society, if you are an active or former smoker, you should talk to your doctor about the benefits and risks of annual screenings for early lung cancer. The screening involves a low-dose CT scan. It may be beneficial if you are an active smoker or you have quit smoking within the past 15 years and you have a 30-pack-year history. (A pack-year is the number of packs of cigarettes you smoked per day times the number of years you smoked.)
The American Academy of Ophthalmology (AAO) recommends getting your eyes checked every year or two after age 65 for age-related eye diseases such as macular degeneration, diabetic retinopathy, glaucoma and cataracts. The American Optometric Association recommends vision tests every two years through age 60 and then every year to monitor age-related vision changes.
The American Dental Association recommends a teeth cleaning and oral exam once or twice a year. According to Tyler Perkinson, a dentist with Virginia Family Dentistry, boomers may experience receding gums, which can slowly expose the roots of their teeth, or dry mouth, which can lead to cavities. Dentists also visually check for nasal, tongue, throat and mouth cancer, and can identify signs of sleep apnea.
According to Dr. Jean Calhoun of Dominion Dermatology, a full-body skin exam from scalp to feet should be done around age 50 for people who live in Virginia and other Southern states. During the exam, the dermatologist will evaluate moles for any abnormalities, assess the amount of sun damage and risk of cancer, and make recommendations about treatments and additional exams based on the results. Calhoun recommends that people with no history of skin cancer should be screened every one to two years and should notify their doctor of any changing moles.
As the risk for heart disease increases with age, men should begin cardiac screenings no later than age 50 and women no later than age 60 or post-menopausal, according to Dr. P. V. Ravindra of Richmond Cardiology Associates of Bon Secours Medical Group. Individuals with one or more risk factors, including high blood pressure, diabetes, obesity, family history, smoking and high cholesterol should begin heart disease screenings at an earlier age. An electrocardiogram (EKG) or stress test may be prescribed for individuals who have no risk factors. Screenings for individuals with one or more risk factors may also include an ultrasound of the heart, a CT scan and a nuclear or chemical stress test to check for possible blockages. Additional screenings may be needed based on symptoms and risk factors. Individuals who are at a higher risk may require screenings every one to three years.
According to the U.S. Preventive Service Task Force, boomers should get a flu shot each year and a tetanus booster every 10 years. If you are 65 or older, you should also get an annual pneumonia shot. If you are 60 or older, you should get a one-time vaccine to prevent shingles.
FOR MEN OVER AGE 50
Dr. Kinloch Nelson of Virginia Urology recommends yearly PSA (prostate specific antigen) testing for healthy men ages 50 to 70. African-American men, men with a family history of prostate cancer and others at higher risk should begin testing as early as age 40. After age 70, ask your doctor if you still need to be tested. The benefit of PSA testing has been debated in recent years and Nelson encourages men to discuss the potential benefits, risks and uncertainties of prostate cancer screening with their doctors. Prostate cancer is slow growing, but it can’t be cured if it spreads, Nelson said. Since PSA screening began in the early 1990s, the death rate from prostate cancer has been reduced by more than half.
Abdominal Aortic Aneurysm
Men ages 65 to 75 who have ever smoked should have a one-time ultrasound screening for abdominal aortic aneurysm (AAA), a bulging in the abdominal aorta, according to Dr. Ashwani Kumar of Virginia Cardiovascular Specialists. If an AAA bursts, it can cause dangerous bleeding and death.
FOR WOMEN OVER AGE 50
When you turn 65, request a bone density scan to check for osteoporosis. When you have osteoporosis, your bones become weak and may break easily under normal stresses. According to the National Osteoporosis Foundation (NOF), half of all post-menopausal women will break a bone because of osteoporosis during their lifetime. The most common test for osteoporosis is an X-ray of the spine and hip called a DEXA scan. If you have other risk factors such as smoking, alcohol use, slender frame or parental history of fractured bones, you may need to be screened sooner. With treatment, osteoporosis can be slowed or even reversed to some degree, according to the NOF.
Women should have mammograms and clinical breast exams to screen for breast cancer each year, according to the American Cancer Society. As women age, breast cancer incidence and death rates tend to increase. According to the ACS, in 2015, women ages 60 to 69 had the highest incidence of new breast cancer cases and deaths than any other age group. Early detection and advances in medical treatment contributed to an overall 36 percent decline in breast cancer deaths from 1989 to 2012.
Before age 65, women should have a Pap smear to detect cervical cancer every three years, or a combination of a Pap smear and HPV (Human Papilloma Virus) test every five years. If a pre-cancer is found, it can be treated, and cervical cancer can be stopped before it gets started. More than 15 percent of cervical cancer cases occur in women over age 65; however, they rarely occur in women who were tested regularly before age 65. After age 65 or if you have had a hysterectomy, ask your doctor if you still need to be screened.
Women with a strong family history of certain breast, cervical and peritoneal cancers may also benefit from genetic counseling and BRCA genetic testing. Ask your doctor for more information.
Paula Neely writes from her home in Hanover County and is a frequent contributor to BOOMER magazine. She is very grateful to the doctors who took time to provide information for this article.