Preventive Health Screenings for Seniors
We all know the old adage that an ounce of prevention is worth a pound of cure. Many of us have risk factors for developing common conditions such as high blood pressure and heart disease, diabetes and certain cancers. Fortunately, there are screening procedures that can detect early changes in our bodies that may indicate a problem is developing. Because of the high cost of treating these conditions, Medicare and many insurance providers have chosen to reimburse for some of these preventive screening tests.
It is important to be an active participant in your own health and wellness, and to work as a partner with your healthcare provider in getting these screening procedures done. One way to accomplish this is to keep your own record of what procedures you need and when you get them done. Then when you visit your healthcare provider, you can remind them about which things are due.
Risk factors for almost all chronic health conditions are broken down by those that can be controlled through lifestyle changes and those that we can do nothing about. The US Preventive Services Task Force is the most widely recognized authority on preventive screenings. They have divided up their recommendations for which screenings we should have and how often based on age and gender (two of the risk factors we can’t control). The time schedule for recommendations has been carefully established based on research findings. Following the recommended schedule for these screenings is a gift that each of us can give to ourselves and our loved ones to ensure that we remain as healthy and vibrant as possible.
Following is an overview of the screening procedures that are recommended by the Task Force and their timing.
Comprehensive Screening Exam
Essentially, this would be an extended visit with your healthcare provider where you discuss your entire health picture including existing conditions, your lifestyle habits and risk factors for developing common health conditions. Your provider will do a thorough physical exam and discuss health strategies with you at this time. The frequency of this will vary based on your age and health status—discuss this with your healthcare provider. Medicare pays for this on a one time basis within six months of signing up for Medicare Part B. Private insurance plans will vary widely on their coverage of this visit but the trend is toward more reimbursement for wellness based preventative services.
Diagnostic Testing
Blood Pressure
The goal of having blood pressure tested is to identify hypertension, more commonly known as high blood pressure. High blood pressure has been referred to as the silent killer because it generally develops with out any symptoms. High blood pressure can lead to heart attack, stroke and kidney failure. This is a simple, non-invasive screening test that should be done for persons of all ages at a minimum of every two years. In reality, if you have a regular relationship with a healthcare provider, you probably have this done much more frequently. There is no extra cost for this test, and free screenings are very easy to come by. Keep in mind that your healthcare provider will recommend a much more frequent schedule for blood pressure checks if you are being treated for hypertension. The parameters for what is considered a normal blood pressure reading have gone down significantly over the past few years as a result of recent research findings. The generally accepted standard is that blood pressure readings should be no higher than 120/80 for people of all ages.
For more information on high blood pressure www.americanheart.org/presenter.jhtml?identifier=2114 - 42k-
Cholesterol
Cholesterol, a fatty substance that circulates in the blood, is actually a number of different but related compounds known as lipids (fats). At the proper level and in the right proportions these substances are a necessary part of normal metabolism and body functioning. The types of cholesterol or lipids in our blood are categorized as HDL (high density lipoproteins), LDL (low density lipoproteins) and triglycerides. The combination of these three substances makes up the total cholesterol in your blood stream. Below is the breakdown of what is considered to be acceptable levels for optimal health.
Total cholesterol- below 200 mg/dL
HDL (also known as “good cholesterol”)-above 40 mg/dL
LDL (also known as “bad cholesterol”)-below 130 mg/dL
Triglycerides-below 150 mg/dL
Elevated total cholesterol, low HDL, high LDL and high triglycerides alone or in combination with each other are proven risk factors for developing heart disease and strokes.
The recommended frequency for having these levels checked is every five years for adults over 19 years of age. Medicare pays for this screening as do many private insurance policies. Keep in mind that if you develop a problem with any of these levels, your healthcare provider will want to check them more frequently.
For more information about cholesterol go to http://www.americanheart.org/presenter.jhtml?identifier=1516
Diabetes Screening
Diabetes is a condition marked by elevated levels of glucose (sugar) in the blood stream. There are different types of diabetes, the most common of which is type 2, which is usually treated by lifestyle changes and/or oral medication (as opposed to type 1 which is treated with insulin injections). Type 1 diabetes generally has a sudden onset in childhood and has symptoms that lead to diagnosis. Type 2 diabetes can happen gradually and go unnoticed for a period of time before symptoms develop. Diabetes left undetected or not well controlled can lead to many health problems including heart disease, kidney disease and peripheral artery disease to name a few. Screening for diabetes is done through a simple blood test to check for blood sugar level. In a normally functioning body, blood sugar levels will stay below 100 mg/dl regardless of what has been ingested (unless it is extreme). Frequency of blood sugar screening varies based on your risk factors (family history, overweight, age) check with your healthcare provider.
Adults over 65 or with any risk factors for diabetes are covered for a screening up to twice per year. Check with your provider related to coverage by private insurance.
For more information on diabetes go to www.diabetes.org
Colon Cancer Screening
Colon cancer is a common cancer and is treatable and often curable in the early stages. Since colon cancer incidence rises with age, the recommendation for screening starts at age 50. The exception to this rule is people who have a family history in a primary relative (parent, child, sibling). Types of screening include a test for fecal occult blood, which consists of checking a stool sample for blood that is not detectable to the naked eye—this should be done yearly AND sigmoidoscopy (looking at the lower portion of the colon with a scope) or barium enema (an x-ray test) every five years OR colonoscopy (looking at the entire colon with a scope) every 10 years. All of the above tests are covered by Medicare at the recommended frequency and many private health insurers cover them as well. This is an issue to discuss with your healthcare provider.
For more information on colon cancer go to www.cancer.gov/cancertopics/types/colon-and-rectal
Vision Exam
Vision screening can detect changes in near and far vision that may occur with age. In addition, glaucoma, an increase in pressure in the eye that can lead to vision problems can be tested on routine exams. Those at high risk for glaucoma are those who: are diabetic, have a family history of glaucoma, are African American and are over 50, are Hispanic and over 65. Frequency of eye exams will depend on your risk factors and should be discussed with your healthcare provider. Medicare pays for glaucoma testing if your healthcare provider says you are at risk. Vision care is usually an optional coverage through an employer.
For more information about glaucoma go to www.glaucoma.org.
Hearing Screening
Hearing loss is not common among younger adults but increases with age, beginning at about age 50. Screening entails listening to tones through a set of earphones at various frequencies (high pitched frequencies tend to diminish first). The recommendation for screening for younger adults age 19-39 is every 10 years and then discuss with your healthcare provider regarding the frequency after age 40. Hearing screening and hearing loss aids are not covered by Medicare. Coverage through private insurance will vary.
For more information on hearing loss go to nihseniorhealth.gov/hearingloss/toc.html
Men Only
Prostate Cancer Screening
Prostate cancer is a relatively common form of cancer in men and can be detected early and successfully treated. PSA is a blood test that screens for the presence of prostate cancer. A digital rectal exam is also used as a screening for prostate cancer. While all men are at risk for prostate cancer, your risk increases
• If you have a father, brother, or son who has had prostate cancer, especially if your relatives were young
when they got the disease.
• If you are African-American. Prostate cancer is more common in this group for unknown reasons.
• As you get older. About two out of three prostate cancers are found in men over age 65.
• You may also be at risk for prostate cancer if you eat a lot of red meat or high-fat dairy products.
Medicare pays for digital rectal exam and PSA yearly. The recommendations for frequency of these tests vary and should be discussed with your healthcare provider.
For more information on prostate cancer go to www.cancer.gov/cancertopics/types/prostate
Women Only
Breast Cancer Screening
Breast cancer is the most common form of non-skin cancer in women and is the second leading cause of cancer death among women in the US. Screening for breast cancer is extremely important. Women who have their breast cancer detected at an early stage have the best chance of long-term survival. Starting at age 40 all women should have mammograms every one-to-two years along with a clinical breast exam. Women at high risk are those who have had a breast cancer, those with one or more primary relatives who have had breast cancer (sister, mother, daughter) and those who had a first baby after 30 or who have not had a baby.
A mammogram is an image study that can detect a tumor before it can be detected through clinical exam. Medicare pays for yearly mammograms. The vast majority of health insurance policies pay for mammograms.
For more information on breast cancer go to www.cancer.gov/cancertopics/types/breast.
Cervical Cancer Screening/Pelvic Exam
Cervical cancer is a relativity common cancer in women. Cervical cancer risk goes up in women who have multiple sexual partners, have STDs such as human papillomavirus (HPV) or HIV infection, had sex before the age of 16 or whose mothers took a hormonal drug known as DES while pregnant. The screening test for cervical cancer is a Pap smear, which is done as part of a gynecological examination. Women between the ages of 19-65 should have PAP tests done every one two three years depending on risk. Over the age of 65, if you have had normal PAP tests in the past, the exam only needs to be done at the discretion your healthcare provider.
PAP tests and pelvic exams for women on Medicare are covered every 24 months. Most health- care policies cover this screening test.
For more information about cervical cancer go to www.cancer.gov/cancertopics/types/cervical/.
Osteoporosis
Osteoporosis is a condition marked by thinning of the bones. While it can occur in men, it is much more prevalent in women and the risk goes up with age especially after menopause. People with osteoporosis are at high risk for fractures that can be very debilitating and painful. Some factors that may put you at risk for osteoporosis include, if you
• are age 50 or older.
• are a woman.
• have a family history of broken bones.
• have a personal history of broken bones.
• are Caucasian or Asian.
• are small-boned.
• have low body weight (less than about 127 pounds).
• smoke or drink a lot.
• have a low-calcium diet.
Osteoporosis is diagnosed through a bone density test. The recommendation for this test is: at least once after age 65 or younger if at high risk. Medicare pays for this test once every 24 months for anyone whose healthcare provider thinks they are at risk-more often if medically necessary.
For more information about osteoporosis go to www.nof.org.
Other preventive strategies
In addition to altering your lifestyle factors related to your health, like quitting smoking, eating right, exercising and reducing stress, it is important to get yearly flu shots, a one-time pneumonia vaccine and other vaccines as recommended by your healthcare provider.
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