Yearly Checkups for Seniors

Most of us know we should have an annual checkup, but do we actually do it? If we have one every year, do we actually know if it is complete? And do we understand the tests and examinations we are having done? Most of us will answer "no" to at least one of those questions.

However, there is no excuse for not having a thorough yearly exam. Medicare now covers many of the tests that should be done during your annual checkup.

Routine Tests for All

There are some examinations that everyone should undergo on an annual basis. Depending on the specific markers and symptoms you may be exhibiting, having a year-to-year baseline to compare your numbers to can be of great benefit to getting to the root of any medical problems. The U.S. Preventive Services Task Force (USPSTF) recommends the following routine tests everyone should undergo:

• Blood Pressure: Your blood pressure should be checked during every visit to your healthcare provider. Checking it at your yearly checkup will set a baseline.
• Height: Significant loss of height can indicate the acceleration of osteoporosis. Height is lost as a result of compression of the spinal cord.
• Weight: Significant weight loss or gain without trying can signify serious health problems. Weight gain can mean fluid retention or perhaps heart, liver, or kidney disease. Weight loss could indicate infection, thyroid problems, or cancer.
• Blood work: Yearly blood work should include a complete blood count to rule out any bleeding problems, glucose levels to detect diabetes, thyroid function tests to rule out any thyroid disorder, and blood electrolyte counts, which can detect kidney problems and early heart problems. Your healthcare provider may also check some additional labs depending on your personal and family history.
• EKG: It is recommended that a baseline EKG be done for people around age 50. It should then be done at least every two to three years, or more often if necessary.
• Fecal occult blood test: This test should also be done yearly. Blood in the stool can be an early indication of colorectal cancer.
• Flexible sigmoidoscopy/colonoscopy: For the average patient, screening for colon cancer is every five years with flexible sigmoidoscopy, and every 10 years with colonoscopy. It is now recommended that these screenings start at age 45 (previously age 50), but may be more frequent for those at higher risk. There is some question about whether screenings should continue after age 75 to 80.

Yearly screenings, even when you feel healthy, are crucial to assessing your risk for future problems. These screenings can encourage a healthier lifestyle, allows you to build a relationship with your healthcare provider, update any vaccinations, and of course, screen for any health issues you may be having at the moment.

Depending on your sex assigned at birth (male or female), there may be additional tests that you should undergo.

Tests for Women

• Mammogram: Every woman should discuss their risk factors, and the pros and cons of regular screening mammograms with their healthcare providers. Many experts believe that routine mammograms should begin at age 40. According to the American Cancer Society, women between ages 45 and 54 should have a yearly mammogram, and switch to every other year after age 55. During your annual physical, your healthcare provider should perform a clinical breast exam. Monthly self-breast exams should also be done, and you can be taught this technique during your yearly checkup.
• Pap smear and pelvic exam: Women should have a yearly gynecological exam along with their annual physical to assess for vaginal cancer or other abnormalities. However, a pap smear screens for cervical cancer, and needs only be done every three years for women ages 21-65. Women should be tested for human papillomavirus (HPV) after the age of 30 as well, which can be done along with the pap smear. Exams should be more frequent for women at a higher risk for cervical or vaginal cancer. Women over the age of 65 can discontinue having pap smears as long as they have had two negative paps and are negative for HPV.
• Measurement of bone mass: The  USPSTF recommends screening for osteoporosis with bone measurement testing (eg. DEXA scan) to prevent osteoporotic fractures in women 65 years and older. For women younger than that, screening may be indicated if there are other risk factors, such as smoking, heavy alcohol intake, taking cortisone-like drugs, or a family history of hip fractures.

Tests for Men

• Prostate exam: Starting at age 50, a man should be screened for prostate cancer with a digital exam of his prostate. The healthcare provider uses a gloved finger in the rectum to determine if there is any enlargement of the prostate. Enlargement could indicate benign enlargement or even cancer.
• Prostate Specific Antigen (PSA): Prostate Specific Antigen is a blood test that can indicate prostate cancer. If the level is high, a biopsy of the prostate may be needed. Routine PSA screening is recommended by some healthcare providers, but not by others. Men over the age of 50 should discuss the pros and cons of PSA screening with their healthcare providers.

Addressing Other Health Concerns

At a checkup, you should also review all medications with your healthcare provider, even over-the-counter medications. You should discuss having your vaccinations updated for the flu, tetanus, shingles, COVID-19, and pneumonia.

If you are a diabetic, your healthcare provider should examine your feet and you should have your eyes examined for retinopathy.

Your annual checkup is also the time to discuss any emotional problems you are having. If you feel sad or lack energy, tell your healthcare provider. Your emotional health is just as important as your physical health.