DEAR MAYO CLINIC: My mother is 81 years old and quite healthy. How often should she see her doctor? What are the routine tests or immunizations she needs as an older adult?
ANSWER: There’s no hard and fast rule about how often seniors should see their health care providers. For most older adults, though, it’s a good idea to have at least one medical checkup a year. At that visit, a provider can review medications, check on health concerns, talk about lifestyle topics and go over recommended tests.
Regular health care visits are the perfect opportunity to go over the medications an older adult takes — a key step in maintaining good health. It’s important for a health care provider to know about all of a senior’s medications, including prescription and nonprescription drugs, dietary supplements, and herbal medications. That way, the provider can identify any that could be interacting with one another, possibly causing health problems, and confirm that the medications are managing chronic illnesses effectively.
Going over any health concerns ─ even if they seem small ─ is also an essential part of a senior checkup. Symptoms such as memory loss, sleep problems, constipation, fatigue or weight loss, for example, could point to underlying health problems that need to be evaluated. Or they might be side effects of medication that could be eliminated with a change in prescription.
Health care providers who see seniors also review lifestyle issues that affect how a person functions day to day. For example, it’s important that seniors are able to navigate their environment in a way that allows them to do what they want, interact with others, perform daily tasks without trouble and stay healthy.
To help get a sense of that, a provider may ask questions about topics such as dressing and bathing. He or she will want to know if a senior has fallen at any point. A discussion of grocery shopping, cooking and eating, as well as ease of movement, driving, typical routines and social interaction, also can help the provider better understand how well a senior is managing daily life.
The specific tests or immunizations an older adult needs depend largely on his or her medical history. But some are appropriate for most seniors. For example, the vaccine to protect against pneumonia and a yearly flu shot typically are recommended for adults over 65.
Another example is a bone density test, which is used to screen for osteoporosis. This test is recommended at 65 for women who have never broken a bone and who don’t have other osteoporosis risk factors. For men, this test usually is recommended around 70 for those who have broken a bone at some point in their lives.
Other tests usually are based on an individual’s specific health concerns and medications. For example, tests to check blood sugar; cholesterol; and minerals, such as sodium and potassium, may be appropriate. Some people also may need regular tests to gauge kidney and liver function.
Before your mother goes to see her health care provider, encourage her to write down questions or concerns she’d like to discuss. To help the visit go smoothly, it also would be useful for her to note any significant health concerns or conditions she’s had in the past, as well as any health problems or symptoms she’s experiencing now. She should bring along a list of all her medications, including over-the-counter medications, and their dosages, too.
Based on that information and a physical exam, her health care provider can offer guidance on the tests and screenings that may be appropriate, as well as the best schedule for future checkups. He or she also can discuss lifestyle recommendations regarding exercise, nutrition and social interaction, among other topics, that can make a big difference in an older adult’s quality of life. — Dr. Paul Takahashi, Primary Care Internal Medicine, Mayo Clinic, Rochester, Minnesota