Here are the screening tests and immunizations that most women at age 65 and older need. Although you and your health care provider may decide that a different schedule is best for you, this plan can guide your discussion.
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Screening
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Who needs it
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How often
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Alcohol misuse
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All adults
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At routine exams
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Blood pressure
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All adults
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Every two years if your blood pressure reading is less than 120/80 mm Hg1
Yearly if your systolic blood pressure reading is 120 to 139 mm Hg or your diastolic blood pressure reading is 80 to 89 mm Hg1
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Breast cancer
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All women2
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Yearly mammogram and clinical breast exam2
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Cervical cancer
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Women ages 21 to 65 who have been sexually active and have a cervix
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Discuss with your health care provider3
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Chlamydia
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Women at increased risk for infection
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At routine exams
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Colorectal cancer
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All adults age 50 and older
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Check with your health care provider; fecal occult blood testing, sigmoidoscopy, and colonoscopy are the recommended screening methods
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Depression
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All adults who have access to a clinical practice that has staff and systems in place to assure accurate diagnosis, effective treatment, and follow-up
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At routine exams
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Diabetes mellitus, type 2
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Adults who are asymptomatic and have sustained blood pressure (treated or untreated) greater than 135/80 mm Hg
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At routine exams
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Gonorrhea
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Sexually active women who are at increased risk for infection
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At routine exams
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HIV
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Anyone at increased risk for infection
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At routine exams
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Lipid disorders
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All women ages 45 and older at increased risk for coronary artery disease
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At least every five years4
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Obesity
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All adults
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At routine exams
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Osteoporosis, postmenopausal
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Women ages 65 and older5
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Bone density test at age 655
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Syphilis
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Anyone at increased risk for infection
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At routine exams
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Tuberculosis
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Anyone at increased risk for infection
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Check with your health care provider
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Counseling
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Who needs it
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How often
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Aspirin for prevention of cardiovascular events
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Women ages 55 to 79 when the potential benefits from a reduction in ischemic strokes outweigh the potential harm from an increase in gastrointestinal hemorrhage
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Discuss with your health care provider
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Diet, behavioral counseling
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Adults with hyperlipidemia and other known risk factors for cardiovascular and diet-related chronic disease
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When diagnosed
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Tobacco use and tobacco-related disease
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All adults
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Every visit
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Immunization
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Who needs it
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How often
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Tetanus/diphtheria/pertussis (Td/Tdap) booster
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All adults
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Td: Every 10 years
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Measles, mumps, rubella (MMR)
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All adults age 65 and older who lack prior infection or documented vaccinations*
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One dose
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Chickenpox (varicella)
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All adults age 65 and older who lack prior infection or documented vaccinations*
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Two doses; second dose should be given 4 to 8 weeks after the first dose
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Flu (seasonal)
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All adults
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Yearly during flu season
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Hepatitis A vaccine
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People at risk*
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Two doses: For Havrix, at zero and 6 to 12 months; or for Vaqta, at zero and 6 to 18 months
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Hepatitis B vaccine
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People at risk*
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Three doses; the second dose should be given one to two months after the first dose and the third dose given six months after the first dose
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Meningococcal
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People at risk*
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One or more doses
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Pneumococcal (polysaccharide)
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All adults
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One dose
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Zoster
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All women age 65 and older
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One dose
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1 Recommendation from the Joint National Committee on Prevention, Detection, and Treatment of High Blood Pressure
2 Recommendation from the American Cancer Society (ACS). Currently, the U.S. Preventive Services Task Force (USPSTF) recommends screening every two years for women ages 50 to 74. The ACS recommends yearly screening for all women ages 40 and older. Women should talk with their doctors about their personal risk factors before making a decision about when to start getting mammograms or how often they should get them. The ACS also recommends annual clinical breast exams (CBEs) for women ages 40 and older. The USPSTF, however, believes there is not enough evidence to assess the value of CBEs for women ages 40 and older. Women should talk with their doctors about their personal risk factors and make a decision about whether they should have a CBE.
3 The ACS recommends a Pap test every two years. The American College of Obstetricians and Gynecologists currently recommends that women ages 30 and older get a Pap test once every three years and that women with certain risk factors (or with increased risk) may need more frequent screening. It's reasonable to discontinue screening after three or more consecutive negative Pap tests and no abnormal results within the last 10 years once a woman turns 65 or 70. the USPSTF is currently reviewing the recommendation.
