Medical Tests for Seniors: A Top Ten List of Essential Health Screenings

“Rather than viewing the second half of life as a time of progressive deterioration in the body and mind, we see aging as an opportunity for greater wisdom, love, creativity, meaning, joy, and increased mental and physical capacity. More people than ever are living into their eighties, nineties, and beyond with sound bodies and clear minds.”

- Deepak Chopra, M.D.

Medical Tests as Self Care

I love the quote above as it has helped me personally change my outlook and expectations of aging from one of loss, pain, and potential health problems, to an aging vision for my life that is full of vitality and happiness. In an era when we are living longer than our ancestors, many, particularly those in the science and research fields, are focusing solely on longevity, rather than the quality of one's life. Is there a point, however, of making it to 90 or 100, if our health conditions interfere with our ability to experience a comfortable, full, and happy life? Relevant questions may then be, how do we age in a way that is vivacious, stress-less, and ideally pain-free while maintaining as much independence as possible? Do we recognize that our health is literally in our hands when it comes to preventative care? How do we age with grace in a manner where our health problems do not rule our entire states of being? The answers may be to practice self-care, in all of its shapes and forms, starting right now. By taking ownership and control over our health today, by acting in a preventative rather than reactive way, with a focus on self-care, we greatly increase our odds of aging successfully, and happily.

According to the online aging resource, Next Avenue, less than 25 percent of Americans ages 50-64 and slightly than 50 percent of folks over the age of 65 keep up with preventative testing.

When I started this article, I myself was waiting to schedule a mammogram which is what has prompted me to write this piece. I had been postponing my mammograms despite suggestions from my internist, largely (in my mind anyway) to avoid related radiation from the tests, as I pride myself in predominantly relying on natural medicines and treatments. However, during the holidays this past December, I discovered something suspicious and quickly made an appointment with my physician. She was not overly concerned but ordered a diagnostic mammogram and ultrasound of the area and I'm pretty much kicking myself in the behind right now for not staying on schedule with my female-related screenings. I should know better. I should know better because of my own grandmother.

My grandma as she aged had stopped getting regular female exams, mostly because she suspected that she had a uterine tumor (she may have been told she had one at some earlier point, but we are unsure of the details). For years she procrastinated and avoided screenings and probable medical treatment, even after it had become obvious to others that something wasn't right. Even at the encouragement of loved ones and promises that we would be by her side every step of the way during treatment, my grandma could not face any definitive tests or exams. As a result, my grandmother died from what was suspected to have been, uterine cancer and its complications. My grandma lived a good and active life, but we, her loved ones and survivors, know that she could have had many more years with us if she had practiced better self-care and had gotten early exams and treatments.

There are many ways we can look after ourselves and practice self-care such as exercising, eating well, taking vitamins, attending to our spiritual needs, staying socially active, purposely seeking to release any stress, and living a life of purpose. As a believer in the mind-body connection and holistic health, I also like the thought that self-care is a divine act as well as an act of gratitude. I love all of these and feel they are equally important. However, as a nurse, I feel one of the most overlooked yet essential aspects of self-care is the preventative act of getting health screenings. While many of us see a physician on a regular basis for check-ups, we may, for a variety of reasons, avoid or postpone medical tests that the doctor suggests. Our attitude and knowledge, then, need to become our guides when addressing health screenings as essential self-care components.

What Keeps Us from Getting the Medical Tests We Need?

To prevent chronic and acute health problems, we as a whole, are typically aware that we should have regular medical tests, particularly as we age, such as mammograms, prostate exams, and lab work. However, according to a study done for the National Institutes for Health₁, folks often avoid getting the medical care they need, even if a physician suggests or orders it. According to the online aging resource, Next Avenue, less than 25 percent of Americans ages 50-64 and slightly than 50 percent of folks over the age of 65 keep up with preventative testing. In my career as a geriatric nurse, I have heard a myriad of additional reasons why my patients or clients wanted to avoid or postpone suggested screenings. It is important to recognize when we may be relying on excuses so that we can change our thoughts, attitudes, and actions going forward, again remembering that we hold our health and our futures largely in our own hands.

The most popular excuses are listed below:

Time constraints. Busy schedules including work, being a family caregiver, and already spending too much time at the doctor's being the chief reasons. Time concerns can be real or a stalling technique.
Cost. Insurance coverage (or lack of) including potentially high copayments.
Perceived value. Often accompanied by the statement “If it ain't broke, don't fix it”.
Denial. Often if people are not experiencing negative symptoms, they do not feel there is a reason to get tests done. Included in this category is the belief that if one has no family history of a disease or disorder, there is no reason to screen for it.
Assumption. We may assume that if a test was needed, our physicians would order it for us. As a patient advocate, I can tell you there have been many times when I have asked a physician to order a test for patient or client that I felt may be appropriate and beneficial, and most times the doctor agreed or gave a good rationale for why he or she has not ordered it. It is good to be educated and proactive about our care or that of a loved one. Self-advocacy and asking for what we want can be a challenge for elders or those of us from certain cultures where the mentality is that of “the doctor knows best”. While I agree to a degree with this because I have great respect for physicians, doctors are human! They are busy, stressed, and they aren't always current on what tests might be beneficial in all situations. They often like suggestions and most are willing to have an open discussion about screening options.
Fear of the unknown or fear that the test will be painful/ uncomfortable. Also fear that bad news will be the result of a test often keeps us from being proactive.
Procrastination. A close relative to fear and denial. Stalling often backfires and problems are found out too late for an easy or minimal course of treatment to be effective.
A Power Struggle. The kissing cousin to fear and denial. Typically, a spouse or adult child is the one encouraging their loved one to get a test done (usually because they have noticed some behavior or symptoms in their loved one that they are worried about, such a memory loss) and getting it checked out becomes a battle of the wills.

Personal History and Risk Factors to Consider

While general preventative screenings are meant for all of us, with some tests especially meant for specific age and gender groups, there are personal risk factors that we each may have that may make us susceptible to developing certain disorders or diseases. Providing our doctors with the most thorough information and health history possible will allow them to order the very best screenings for us.

Key risk factors our physicians should be made aware of include, but are not limited to, are:

Family history. We need to be sure we let our physicians know as much as we can about any health conditions, diseases, or problems we remember our parents and grandparents having.
Stress level. Chronic stress has a profound impact on our health and on our immune systems. In addition to long-standing stress in our lives, major life changes or stressors such as the recent death of a partner, significant money problems, or a recent move, can all tax the body and its ability to stay healthy. Mention any significant stress factors to health practitioners- it's that important.
Any unusual symptoms. This includes any symptoms we may be having or have had in recent months, even if we do not think that they are a big deal. Uncharacteristic memory problems, chest pain or pressure, and occasional dizziness are all symptoms I have heard patients try to “explain away” while describing them to physicians. Don't downplay any symptoms for pride's sake- it's important to give a well-rounded, truthful picture of our health to our doctors.
Medications we are on. It is vital that our physicians know every medication, vitamin, and herbal supplement that we are taking. Certain medications and herbal supplements can alter lab results, change how other medications work in our bodies, and can put us at risk for developing secondary disorders.
Diseases or disorders that we know we already have. Examples would be diabetes or high blood pressure, as they put us at risk for more severe disorders down the road and should be carefully monitored.
Activity level, diet, alcohol, smoking and drug use or history. These are all important health influencers that our physicians should be made aware of.

Top Medical Tests Older Adults Need

Knowledge is power and this is especially applicable to our health. The more we know, the more our focus can be on prevention and early treatment of any possible disorders. Regular health screenings can catch irregularities before they turn into something more substantial and problematic; they can literally save our lives. When I meet with my clients for the first time and am looking over their medical histories and files, the following are the test results (or lack thereof) are what I focus on because medical experts agree they should be priorities.

These screenings, along with the frequency in which to have them, are suggestions only, and are not meant to be a substitute for the advice of your own doctors:

Colorectal Exam. Colonoscopy exams are recommended every five years after the age of 50, and every 10 years from 50 to 75 years of age. After that, experts agree that they may not be necessary.
Mammogram and Pap Smear for females and a PSA (Prostate-Specific Antigen) test for males. Experts tend to agree that women aged 45-55 should have a mammogram every year. After 55, it may be decreased to every two the three years depending on other factors. It is advised that women get a pap smear exam every three years until the age of 75 then it may no longer be necessary. Depending on risk factors such as family history, doctors may advise men ages 40 and over to be regularly screened for prostate cancer.
Depression Screening. Loss of a spouse or a move to an assisted living are huge changes and could cause depression in someone who normally does not suffer from the disorder. Adjustment, grief, and sadness periods are as individual as we are. After a year, however, if we are still experiencing life-altering sadness and coping problems, our doctor should know about it. Depression can be totally unrelated to major loss however, and sadness, hopelessness, or disinterest in our normal activities lasting longer than two weeks should be discussed with a practitioner.
CRP (C-Reactive Protein). CRP is a measurement of the level of inflammation in the body and is often included in yearly lab work as a way to screen for possible heart disease. High levels may indicate one's risk is higher for developing cardiac problems such as having a heart attack.
Vitamin D Level. Vitamin D plays many essential roles in our bodies and surprisingly most Americans are deficient in it. Not only is it important for healthy bones, teeth, and muscles, but it is important for both cardiac and brain health and to maintain a strong immune system. It is important to check Vitamin D levels yearly as our ability to produce it decreases significantly as we age.
Thyroid Stimulating Hormone (TSH, or full thyroid panel). As we age, women, in particular, may develop an underactive thyroid. Underactive as well as an overactive thyroid can affect our metabolism and energy levels.
Bone Density Scan. This screening measures bone mass which is key to maintaining bone and muscle strength. Men and women may both be affected by osteoporosis or the loss of bone tissue, but post-menopausal women are at high risk for developing this disorder.
Skin Cancer Exam. Imperative, especially for those with light-colored or freckled skin. Yearly exams at minimum to be safe as early detection is key.
Fasting Blood Sugar labs and/or an A1C test. After the age of 45, it is recommended that everyone have yearly blood glucose testing done. Diabetes affects so many other systems in our bodies that it is essential to monitor lab results annually or more often depending on previous test results and personal history/ risk factors.
Blood Pressure Screening. Because high blood pressure, or hypertension, can be directly related to heart disease as well as increase our odds of having a stroke, it is imperative to have our blood pressure check at minimum, yearly.

Additional Tests to Consider

Many of the screenings listed below are included in lab panels and yearly exams but some are not, often because they are not covered by standard insurance plans (such as detailed hearing and vision exams). It is advised that we discuss the need for these with our physicians, as some may be indicated due to personal risk factors.

Lipid Panel/ Cholesterol Levels. For those of us over the age of 35 (men) and 45 (women) with heart disease risk factors, a lipid panel which indicates cholesterol levels, should be done every one to five years. Often physicians include a panel in their yearly lab test orders. As high cholesterol increases our odds tremendously for developing artery disease and hardening which in turn can lead to a heart attack or stroke; finding out early and monitoring numbers closely can help us to be more proactive in lifestyle and diet changes that will lower our numbers.
Hepatitis C Screening
Memory Screening
Eye Exam
Dental Exam
Hearing Exam
Abdominal Aortic Aneurism Screening. This is worth mentioning for those of us who have been smokers at any time during our lifetimes. An ultrasound can be done to rule out that the large artery supplying blood from our heart out to our body is not damaged, enlarged, or weak which could put us at risk for an aortic rupture (a potentially fatal occurrence). This could be a one-time test or routine, depending on the results from the initial ultrasound.
Fall Risk Evaluation
Review of Vaccines. Shingles, pneumonia, and flu vaccines are high on a physician's check-off list, but they may forget to ask us when the last time was that we had a tetanus shot (it recommended to be given every 10 years).

The Future of Health Screenings

Health screenings, in general, can provide vital information, that in turn, can help us to alter the way we live and can guide preventative treatment options so we can enjoy long, healthy lives. While preventative screenings are not faultless or perfect, they are one tool we can use to take control of our health. In addition to the standard health screening physicians routinely order, there are many phenomenal and cutting edge diagnostic tests available such as those provided by companies like Advanced Body Scan that by way of a detailed CT scan, can determine one's risks for developing cancer and heart or lung disease. In-depth DNA tests that provide family gene risk factors will soon be available to the public as will retinal eye scans to screen for Alzheimer's Disease. It is very exciting that diagnostic tools are getting more specific and helpful as technology advances. I, meanwhile, have received my own screening results back and everything is in the clear, good as golden. I have learned a valuable lesson firsthand about adhering to a screening schedule during all of this and can see how important it is to follow doctor's instructions, not only for my health's sake but for my peace of mind.