Table 10.1—Evidence-Based Preventive Services Recommended for the General Population Aged 65 and Older

Preventive Activity

Frequency (year)

Condition To Detect or Prevent

Screening

 

 

Blood pressure

≤ 1

Hypertension

Mammography

2–3

Breast cancer

Fecal occult blood testing and/or

          flexible sigmoidoscopy or

          colonoscopy

1

3–5

once

Colorectal cancer

Pap smear

≤ 3*

Cervical cancer

Height and weight

≤ 1

Obesity, malnutrition

Alcoholism questionnaire

—**

Alcoholism

Serum lipids in person with prior

          myocardial infarction, angina

1

Recurrent CAD

Vision testing

1

Sensory deficits

Hearing ability

1

Hearing impairment

Counseling to encourage:

 

 

Low-fat, well-balanced diet

1

Obesity, CAD

Adequate calcium intake

1

Osteoporosis

Physical activity

1

Immobility, CAD, osteoporosis

Injury prevention

1

Injurious falls, motor vehicle crashes, burns, other injuries

Smoking cessation

—†

COPD, many cancers, CAD

Regular dental visits

1

Malnutrition, oral cancers, edentulism

Immunization

 

 

Influenza vaccination

1

Influenza

Pneumococcal vaccination

—‡

Pneumococcal disease

Tetanus booster

10

Tetanus

Chemoprophylaxis

 

 

Discussion, implementation of      hormone replacement therapy

—§

Osteoporosis

Aspirin therapy in persons with      prior MI

daily

Additional MI, TIA, or stroke

NOTE: CAD = coronary artery disease; COPD = chronic obstructive pulmonary disease; MI = myocardial infarction; TIA = transient ischemic attack. For updates from the U.S. Preventive Services Task Force, see http://www.ahrg.gov/clinic/prevenix.htm

* May stop screening at age 65 if patient has had regularly normal smears up to that age; if never tested prior to age 65, may stop after two normal annual smears.

** Should be performed at initial visit and whenever problem drinking is suspected.

† Should be discussed at every visit of patients who smoke.

‡ Immunize once at age 65 for immunocompetent patients; revaccination after 7 to 10 years may be appropriate for high-risk immunocompromised patients.

§ Should be discussed at menopause and at least one more time after age 65.