ESSENTIAL SCREENINGS AND VACCINES FOR PEOPLE OVER 50
Some people say 50 is the new 30. But it might be hard to feel that way if you’re not current on all your screening tests and immunizations. Many of us aren’t.
For example, 1 in 3 people aged 50 to 75 aren’t on schedule with their colon cancer screenings. About 30% of people over age 65 don’t get an annual flu shot, and 2/3 opt out of the recommended shingles vaccine.
Must-Get Vaccines and Tests
Shingles. The CDC recommends all healthy adults 50 and older get two doses of Shingrix, the newest shingles vaccine. You should get the shots 2 to 6 months apart. It’s much more effective than the older Zostavax, which was taken off the market in 2020. You should get Shingrix even if you’ve had Zostavax or if you can’t remember whether you have had the chickenpox. Most people have been exposed to the virus. (The vaccine is also approved for anyone over the age of 18 who are at risk for shingles because they are or will be immunodeficient or immunosuppressed.)
Flu. Older adults should get the flu shot every year. A big majority of people who die or are hospitalized with the flu are seniors. If you’re over age 65, ask about the Fluzone High-Dose vaccine, which has four times more antigen than regular flu shots. Another vaccine called Fluad also may offer more protection to seniors.
Pneumococcal vaccine. Being older makes you more likely to get pneumonia, blood infections, or meningitis from the pneumococcal bacteria. Two vaccines — PCV13 (Prevnar 13) and PPSV23 (Pneumovax 23) — can protect you against pneumococcal disease. The CDC recommends that all adults 65 and older have both shots, a year apart. They also recommend PPSV23 for all adult smokers and for people with certain medical conditions.
- Do you recommend that I get all the vaccines the CDC advises for people over 50? Your doctor will make suggestions based on your age, lifestyle, medical history, and other things.
- Do I need any other vaccines? Some health conditions, jobs, and travel plans can make you more likely to get certain diseases, so you may need vaccines outside the standard guidelines.
- What are the side effects of these vaccines? Most people don’t have any serious side effects from vaccines. The most common ones are usually mild, and you can do some things to feel better if you have any of those afterward.
- Does Medicare cover the cost of the vaccines I need? Certain parts of Medicare, including prescription drug coverage, may pay for some vaccines.
- A1c. This measures your average blood glucose for the past 2-3 months.
- Fasting plasma glucose. It checks blood sugar levels after you’ve had nothing but water for at least 8 hours.
- Oral glucose tolerance test. This checks your blood glucose levels both before and 2 hours after you drink a special sweet drink.
Your bones can get more fragile with age. Your doctor may recommend a bone density test of your hip and spine called a DXA scan for people with higher chances of fractures. They include:
- Women 65 and older
- Younger women and men who may be more likely to get osteoporosis, including those who smoke, are underweight, have had previous fractures, regularly take prednisone or other steroids, and have more than three alcoholic drinks a day.
If your results are normal, you won’t need another scan for several years. But if you have low bone density or a full blown osteoporosis, you’ll need to get tested much more often to see how your treatment is working.
After age 50, get a comprehensive eye exam every 2 to 4 years. After age 55, you might need one as often as every year. If you have diabetes or notice any changes in your vision, ask your doctor or ophthalmologist about what to do.
Hypertension, or a reading of 120 over 80 or higher, is very common among older adults. It’s best to get it checked annually. If you are obese or overweight, or if your top reading is above 120, your doctor will help you come up with a plan to follow up.
You need a blood test to check your total cholesterol as well as high-density (good) and low-density (bad) lipoprotein cholesterol. Some cholesterol turns into plaque that clogs up your arteries that can lead to stroke and heart attack. If your levels are high, you may need testing more often.
Screenings for Women
Mammograms. Experts differ on how often most women need screening for breast cancer. The American Cancer Society calls for annual mammograms starting at age 45, then switching to once every 2 years when you reach 55. The U.S. Preventive Services Task Force recommends a less-aggressive schedule, since more screening leads to harm and expenses from false-positive tests. It says women under 50 should talk to their doctor about whether you need screening. From ages 50 and up, it recommends screening every other year and then no more after age 75.
Cervical cancer. Pap tests have long been the gold standard for testing. You can either have a PAP alone every 3 years, have an HPV (human papillomavirus) test every 5 years, or pair the two tests every 5 years. You may need to keep screening past age 65 if you have a history of abnormal cervical cells.
Screening for Men
PSA test. It checks for prostate cancer. While it’s the best screening test we have to check for prostate cancer, the PSA blood test may suggest you have prostate cancer when you don’t. This may require a biopsy to determine if cancer is indeed present. If you have an above average risk for prostate cancer, your doctor may still suggest you have this test. Talk to your doctor about whether PSA tests are worthwhile for you.