Screening for Patients 65 years or older

From: www.priorityhealth.com

Recommend
One visit annually for vision/glaucoma
check, STI/HIV counseling, screen for
tobacco use, alcohol misuse and family
and intimate partner violence.
Health Guidance

Clinical screenings
Depression: screening During physical exam
Tobacco use: During each visit
Alcohol/drug misuse: During each visit
Height, weight, BMI and blood pressure: During physical exam;
nutrition and physical activity counseling for those identified as high risk*
Lipoprotein screening: For all adults, a fasting lipoprotein profile (total cholesterol, LDL, HDL and triglyceride) should be obtained once every five years(likely will need more often at this age group).
Diabetes screening: Once every three years (likely more often at this age group)
Tuberculin skin test (PPD): For those identified as high risk*
Hemoglobin and hematocrit Once every two years
Mammogram (women): Annually
Cervical cancer screening (women): Every two to three years. Suggest stopping at age 70 if three or more normal Pap tests in a row, no abnormal Pap test in previous ten years and not at high risk.*
Chlamydia and Gonorrhea screening (STIs): All sexually active women to be screened for STIs
HIV screening: Annually for adults at high risk*
Colorectal cancer screening: One of the following screening options:
• Fecal occult blood test annually
• Flexible sigmoidoscopy every five years
• Fecal occult blood test annually and flexible sigmoidoscopy every five years
• Double-contrast barium enema every five years
• Colonoscopy every ten years
Those with a family history of colorectal cancer, or adenomatous polyps;
colonoscopy every five years (or less as recommended by the gastroenterologist)
Osteoporosis risk factor assessment(women): Routine beginning at age 65 (does not include bone density test)
Abdominal aortic aneurysm screening (men): Between ages 65 and 75 who have ever smoked, a one-time screening for abdominal aortic aneurysm.

Immunizations
Tetanus, diphtheria and pertussis (Td/Tdap: Every ten years (Give one dose of Tdap if pertussis booster was not received previously.)
Hepatitis A (HepA): For high risk* groups
Hepatitis B (HepB): For high risk* groups
Varicella (Var): Two dose series at least four weeks apart if no history of varicella or previous vaccination.
Influenza: Annually
Pneumococcal: Once after age 65
Zoster (Shingles): One dose at age 60 and older
Meningococcal: If high risk
MMR: If high risk

2009 Preventive Health Care Guidelines 11

The Preventive Health Care Guidelines were developed and approved
by Priority Health network physicians.
References:
American Academy of Family Physicians
American Academy of Pediatrics
American Cancer Society
American College of Obstetricians and Gynecologists
American College of Physicians
American Medical Association
National Cancer Institute
U.S. Preventive Services Task Force, U.S. Public Health Service
Go to www.ahrq.gov/clinic/prevenix.htm for a complete list of evidence-based preventive services and risk factors from USPSTF.
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