Aging & Health A to Z
Basic Facts & Information
It is always better to prevent an illness than to treat it after it develops. Some factors that affect your health are outside of your control, such as your age, gender and family history of certain diseases. However, many important risk factors are within your power to change. Steps like screening tests, vaccinations, and healthy lifestyle habits can help prevent many diseases or slow down an illness you may already have. Making small changes in your daily life can help you stay active and independent as you get older. It is never too late to start on the road to better health.
Screening for Common Diseases and Conditions
Below are general recommendations to help prevent illness in older adults. These guidelines can change over time as our understanding of diseases increases. Some screening tests may need to be done more frequently, depending on your specific risk factors. Not every older adult needs all of these tests. Your healthcare provider will work with you to determine which screening tests are likely to benefit you, based on your individual circumstances. Click on the following topics to read more.
- Glaucoma: too much pressure within the eye
- Cataracts: clouding of the lens of the eye
- Macular degeneration: loss of central vision
Some other screening tests that are recommended for older adults involve short questionnaires or written tests.
Screening for several types of common cancers is recommended to detect disease early, before there are any signs or symptoms. This is because treatment at an early stage is more likely to be successful. Cancer screening has important benefits, such as finding disease early and preventing deaths from cancer. However, it is important to remember that there are also harms associated with screening tests. These can include complications from the screening test itself, as well as fear and anxiety that could be caused by a false positive test. Screening may also identify a cancer that would never have caused symptoms or death in that person. Treating these cancers with surgery, radiation or chemotherapy can cause harm, without providing any benefit.
People who have a shorter life expectancy due to other illnesses are less likely to benefit from cancer screening tests. It is important to talk with your healthcare provider about whether screening tests for cancer are more likely to benefit or harm you.
The following recommendations are for people at average risk of disease. People at high risk, or with a history of abnormal tests, may need screening earlier and more often.
Current recommendations are for women between the ages of 50 and 75 to have a mammogram every two years. Mammograms may be appropriate for women after the age of 75 who are healthy and expected to live for at least 10 more years.
There are several tests that can be used to screen for colon cancer. A colonoscopy is the most comprehensive test, and is recommended every 10 years for adults between the ages of 50 and 75. Other screening tests that may be used instead of a colonoscopy include CT colonography (“virtual colonoscopy”) or flexible sigmoidoscopy every 5 years, or testing of a stool sample once a year. Some people age 75-85 may benefit from screening if they are very healthy, or have never been screened. People over age 85 should not be screened.
A Pap smear to test for cervical cancer is recommended for women every 3-5 years. Screening does not need to be continued in women after the age of 65 who have had regular normal screenings in the past 10 years, or in women who have had a hysterectomy for reasons other than cancer.
Screening for prostate cancer has been controversial because the disease usually progresses very slowly, and there is a lack of research to support the benefit of treatment early in the disease. Therefore, screening is no longer recommended for most older men. Your healthcare provider can advise you whether you should be screened for prostate cancer based on your risk factors.
Screening for lung cancer with a low-radiation dose CT scan once a year is recommended for people age 55-80 who are at high risk for the disease. People at high risk are those who have smoked the equivalent of one pack of cigarettes per day for 30 years, and either currently smoke, or who have quit within the past 15 years.
Because the immune system weakens with age, older adults are at higher risk for many diseases. Some of these common diseases can be prevented with vaccines. The following vaccines are recommended for most older adults. Your healthcare provider can tell you if there are additional vaccinations you should get based on your individual risk factors. In addition, some people cannot get certain vaccinations if their immune systems are severely weakened from medications or other diseases.
Up to 70% of hospitalizations and 90% of deaths from the flu occur in older adults. All older adults should get a flu shot every fall, at the start of the flu season.
There are two different types of pneumococcal vaccine that are recommended for adults 65 or older. They are called pneumococcal conjugate vaccine (PCV)13 and pneumococcal polysaccharide vaccine (PPSV)23. Older adults should receive both PCV13 and PPSV23 vaccines, given at least one year apart. Only one dose of each of these vaccines is needed.
Adults should receive a tetanus-diphtheria (Td) vaccine every 10 years. Adults age 65 and over should also receive one dose of the tetanus-diphtheria-pertussis (Tdap) vaccine. The pertussis part of the vaccine protects against whooping cough, so it is especially important for older adults who have close contact with infants under one year of age.
Shingles (herpes zoster) is a painful rash caused by the same virus that causes chicken pox. The rash usually appears as a band or strip on one side of the face or body. In some people, severe pain can persist even after the rash has healed. This persistent pain is called post-herpetic neuralgia and can last for many years. The risk of both shingles and post-herpetic neuralgia increases dramatically after the age of 50. The shingles vaccine reduces the risk of getting shingles, reduces the severity of shingles outbreaks, and reduces the risk of post herpetic neuralgia. The new herpes zoster subunit vaccine (Zoster Vaccine Recombinant, Adjuvanted) is recommended for adults age 50 and over, even if they have previously had shingles or were previously vaccinated with the live vaccine. The subunit vaccine requires two doses, with the second dose administered 2 - 6 months after the first dose. People with a history of severe allergic reaction to any component of the vaccine should not get the shot.
Updated: November 2017
Posted: March 2012