Preventive Medicine and Screening in Older Adults

Abstract

The goal of preventive medicine in older people should be not only reduction of premature morbidity and mortality but preservation of function and quality of life. Attempts to prevent diseases of old age should start in youth; the older the patient, the less likely the possibility or value of primary and secondary prevention, and the greater the stress must be on tertiary prevention. Age 85 is proposed as a general cutoff range beyond which conventional screening tests are unlikely to be of continued benefit; however, care must always be individualized. Emphasis should be on offering the best proven and most effective interventions to the individuals at highest risk of important problems such as cardiovascular diseases, malignancies, infectious and endocrine diseases, and other important threats to function in older people. Breast cancer screening, smoking cessation, hypertension treatment, and vaccination for infectious diseases are thus far among the most firmly proven and well accepted specific preventive measures, with physical exercise also being particularly promising. Although more research is needed, a current working approach is necessary and possible. A summary table of recommendations and information tools such as reminders or flowsheets may be valuable in helping the physician carry out prevention and screening programs.

Unhealthy Drinking Patterns and Receipt of Preventive Medical Services by Older Adults

“…1 Despite recommendations for preventive services by organizations such as the U.S. Preventive Services Task Force (USPSTF), elders' receipt of services is suboptimal. For example, one study found that although 91% of female Medicare beneficiaries aged 65 years and older receive at least one preventive service, only 10% receive all that are appropriate.…”

Older women's health priorities and perceptions of care delivery: results of the WOW health survey

“…For items related to health conditions, questions about the frequency and type of screening were based on recommendations by the Canadian Task Force on Preventive Health Care and the US Preventive Services Task Force and other relevant literature. [8][9][10] For breast cancer, respondents were asked whether they had received a mammogram or had had their breasts examined for "lumps" in the 2 years before the survey. For heart disease and stroke, they were asked about yearly blood pressure measurements and cholesterol screening.…”

Understanding Changing Risk Factor Associations With Increasing Age in Adults

“…Some illnesses may shape clinical priorities or treatment patterns and alter interest in new conditions, or they may lessen the likelihood of routine disease screening. For example, patients with Alzheimer's disease are less likely to receive routine screening tests such as mammograms (15). Comorbidity may alter disease presentation and outcomes because of combined bodily stresses.…”