02.Screening for better health
There are various targeted screens and tests recommended for adults middle-aged and beyond, in addition to regular tests and health screenings recommended for all adults such as skin cancer, dental health, cervical cancer (women) and body weight.
The most useful ones are as follows:
45-49 year check up
Once only for eligible people aged 45-49.
GPs can conduct a comprehensive health and lifestyle check designed to detect risks for many of the chronic conditions affecting older adults, such as type 2 diabetes, osteoporosis and heart disease. They can then help patients to make the necessary lifestyle changes to prevent or delay the onset of chronic disease.
To be eligible for the check, the doctor must identify at least one risk factor, such as unhealthy lifestyle, biomedical risk factors (high cholesterol or high blood pressure, say) or family history. About 90% of people in this age group have at least one risk factor.
75 year and older health assessment
Every year for people aged 75 and older.
A structured health assessment aimed at preventing or managing health issues and conditions, it also looks at factors that influence a person’s physical, psychological and sociological functioning.
Prostate cancer: PSA and rectal examination
Every year for men aged 50-70.
A man’s lifetime risk of prostate cancer is about 10%, and having a family history of prostate cancer increases personal risk. Early symptoms include a slow or stop-start urine stream, difficulty starting urination or increased need to urinate. For many men, though, there are no symptoms, and regular screening is the best bet for early detection.
However, screening is controversial, because the harms associated with treatment may outweigh the benefits of diagnosis – many men die with, rather than from, prostate cancer.
Prostate Specific Antigen (PSA) is a protein produced by the prostate gland, and higher than normal blood levels are found in men with prostate cancer. The test isn’t fail-proof, but a rectal examination by a doctor will help increase the detection rate.
Breast cancer: Mammogram
Every two years for women aged 50-69.
A woman’s lifetime risk of breast cancer is about 10% (rare diagnosis in men), and a family history increases the risk. Warning signs include changes to the appearance of the breast and nipples, pain and/or a lump.
Mammography using low-dose x-ray can detect cancers too small to be felt, and early detection results in a greater chance of cure.
Bowel cancer: Faecal occult blood test
Every two years for people over 50.
Bowel (or colorectal) cancer affects 4-5% of adults. The faecal occult blood test (FOBT) is available as a home-based screening kit from pharmacies or online. You take two samples from your stools and send them off for lab analysis. The kit and pathology lab analysis costs about $35-$40, though you may be eligible for Medicare or private health insurance rebate.
Hypertension: Blood pressure test
At least once a year, especially for over 50s (24-hour blood pressure monitoring may be recommended for people with high readings).
High blood pressure is usually caused by reduced elasticity and plaque build up in arteries. It can lead to heart disease, heart attack and stroke. Lifestyle changes can successfully control high blood pressure in many cases, especially if addressed in the early stages.
Cholesterol and triglycerides: Blood lipid screening
Every two years after age 45; more frequently if there are other CVD risks.
Blood tests can detect total cholesterol levels, and the levels of the main components, high-density lipoproteins (HDL) and low-density lipoproteins (LDL). HDL, also known as good cholesterol, protects against heart disease; it’s the LDL (so-called bad cholesterol) that leads to fatty deposits that line the arteries. This causes the vessels to narrow. They may eventually become blocked, which can lead to angina, heart attack or stroke. Triglycerides are also measured, and high levels show increased risk of CVD.
Type 2 Diabetes: Blood glucose tests
Every one to three years, depending on risk.
Type 2 diabetes (T2D) is most common among people over 40 years, though more and more younger people are getting it. Apart from age, the main risk factors include obesity, especially abdominal obesity (high waist circumference), existing cardiovascular disease and sedentary lifestyle. If caught in the early stages, so-called pre-diabetes, where high fasting glucose or impaired glucose tolerance have been measured, lifestyle changes can reduce the likelihood of progressing to full-blown T2D by more than 90%.
Osteoporosis: Bone mineral density (BMD) scan
For women at the start and after menopause, and for men according to risk.
Osteoporosis affects one in two women and one in three men over 60 and can lead to debilitating bone fractures, which in turn can lead to permanent disability and death. Low BMD levels are symptomless, but indicate increased risk of fracture. Detected early by BMD measurement, it can be managed or treated with lifestyle changes, nutrition supplements and/or medication.
Vitamin D deficiency
Recommended for people at risk of deficiency
Deficiency of vitamin D, which increases calcium absorption from food, can lead to bone diseases including osteoporosis. Those at risk include people who are housebound, cover skin for religious reasons, have dark skin or avoid the sun. If any of these apply to you, talk to your doctor about supplements and medication you can take to reduce your risk of deficiency.
Vision and eye health
Every two years for adults over 40.
Older adults are susceptible to:
- Cataracts – a clouding of the lens.
- Macular degeneration – degeneration of the macular, the central area of the retina, resulting in the loss of central vision.
- Glaucoma – a group of diseases where the optic nerve is gradually destroyed, usually due to raised pressure inside the eye, leading to loss of peripheral vision.
Your optometrist may also recommend reading or vision-correction glasses – see here for more about glasses.
Are your shots up to date?
Older people should be vaccinated against pneumococcal disease every five years and keep their tetanus shots up to date (you need a booster at age 50 if you haven’t had one in the last 10 years). It’s also a good idea to get an annual flu shot, which protects against the most serious and prevalent current strains.