PREVENTION GUIDELINES

Prevention Guidelines for Men 65+

January 24, 2018

Prevention Guidelines for Men 65+

Here are the screening tests and immunizations that most men ages 65 and older need. A screening test is done to find possible disorders or diseases in people who don't have any symptoms. The goal is to find a disease early so lifestyle changes can be made and you can be watched more closely to reduce the risk of disease, or to detect it early enough to treat it most effectively. Screening tests are not considered diagnostic, but are used to determine if more testing is needed. Although you and your healthcare provider may decide that a different schedule is best for you, this plan can guide your discussion.

Screening

Who needs it

How often

Abdominal aortic aneurysm

Men ages 65 to 75 who have ever smoked

1 ultrasound

Alcohol misuse

All adults

At routine exams

Blood pressure

All adults

Yearly checkup if your blood pressure is normal*

Normal blood pressure is less than 120/80 mm Hg*

If your blood pressure reading is higher than normal, follow the advice of your healthcare provider

Colorectal cancer

All adults ages 50 and older

According to the American Cancer Society:

For tests that find polyps and cancer:

  • Flexible sigmoidoscopy every 5 years1, or

  • Colonoscopy every 10 years, or

  • Double-contrast barium enema every 5 years1

For tests that primarily find cancer:

  • Yearly fecal occult blood test2, or

  • Yearly fecal immunochemical test every year2, or

  • Stool DNA test, interval uncertain2

Talk with your healthcare provider about which test is best for you. Testing is generally not indicated after age 75.

Depression

All men in this age group

At routine exams

Type 2 diabetes or prediabetes

All men starting at age 45 and men without symptoms at any age who are overweight or obese and have 1 or more additional risk factors for diabetes

At least every 3 years (annual testing if your blood sugar has begun to rise)

Type 2 diabetes

All men with prediabetes

Every year

Hepatitis C

Anyone at increased risk for infection

At routine exams

High cholesterol and triglycerides

All adults

At least every 5 years

HIV

Anyone at increased risk for infection

At routine exams

Lung cancer

Adults ages 55 to 80 who have smoked

Yearly screening in smokers with 30 pack-year history of smoking or who quit within 15 years

Obesity

All adults

At routine exams

Prostate cancer

All men in this age group, talk to healthcare provider about risks and benefits of digital rectal exam (DRE) and prostate-specific antigen (PSA) screening***

At routine exams

Syphilis

Anyone at increased risk for infection

At routine exams

Tuberculosis

Anyone at increased risk for infection

Check with your healthcare provider

Vision

All adults3

Every 1 to 2 years; if you have a chronic disease, check with your healthcare provider for exam frequency

Counseling

Who needs it

How often

Aspirin for primary prevention of cardiovascular events

Men ages 45 to 69 when potential benefits from a decrease in heart attacks outweigh the harm or risks from an increase in gastrointestinal bleeding

When diagnosed with risk for cardiovascular/heart disease; check with your healthcare provider before starting

Diet and exercise

Adults who are overweight or obese

When diagnosed and at routine exams

Fall prevention (exercise, vitamin D supplements)

All men in this age group

At routine exams

Sexually transmitted infection prevention

Anyone at increased risk for infection

At routine exams

Tobacco use and tobacco-related disease

All adults

Every visit

Immunization

Who needs it

How often

Tetanus/diphtheria/
pertussis (Td/Tdap) booster

All adults

Every 10 years. Tdap is recommended if you have contact with a child younger than 12 months. Either Td or Tdap can be used if you have no contact with infants.

Chickenpox (varicella)

All adults ages 65 and older who have no previous infection or documented vaccinations**

2 doses; second dose should be given at least 4 weeks after the first dose

Flu (seasonal)

All adults

Yearly, when the vaccine becomes available in the community

Haemophilus influenzae Type B (HIB)

People at risk

1 to 3 doses

Hepatitis A

People at risk4

2 doses given at least 6 months apart

Hepatitis B

People at risk5

3 doses; the second dose should be given 1 month after the first dose, and the third dose should be given at least 2 months after the second dose (or at least 4 months after the first dose)

Pneumococcal conjugate vaccine (PCV13) and pneumococcal polysaccharide vaccine (PPSV23)

All adults ages 65 and older

1 dose of each vaccine

Zoster

All men ages 60 and older

1 dose

*Recommendation from the American College of Cardiology and the American Heart Association Task Force on Clinical Practice Guideline

**Exceptions may exist; talk with your healthcare provider

***National Comprehensive Cancer Network

1If the test is positive, a colonoscopy should be done

2The multiple stool take-home test should be used. One test done by the healthcare provider in the office is not adequate for testing. A colonoscopy should be done if the test is positive.

3Recommendation from the American Academy of Ophthalmology

4For complete list, see the CDC website

5For complete list, see the CDC website

Screening guidelines from the U.S. Preventive Services Task Force, except Hepatitis C from CDC

Immunization schedule from the CDC

Updated:  

January 24, 2018

Sources:  

Evidence-based approach to prevention, Up To Date, Overview of Hypertension in Adults, Up To Date, Standards of Medical Care in Diabetes, 2016, American Diabetes Association

Reviewed By:  

Cunningham, Louise, RN,Hurd, Robert, MD,Taylor, Wanda, L., RN, PhD,Turley, Raymond Kent, BSN, MSN, RN