Routine Healthcare for Older Men

Routine checkups can find treatable problems early. For many medical problems, early treatment can help prevent more serious complications. The value of checkups and how often you have them depend mainly on your age. Your personal medical history and that of your family are also important.

What needs to be checked and how often?

The tests listed below are recommended for routine healthcare by the US Preventive Services Task Force (USPSTF) and the American Academy of Family Practice (AAFP). They are the minimum checkup recommendations. You must discuss with your healthcare provider how often you should have physical exams and how often you need these or other tests. The frequency depends on your symptoms and your personal and family medical history.

• Blood pressure measurement: all men
• Cholesterol test: if you are age 45 or older
• Fasting blood sugar for type 2 diabetes: if your blood pressure or blood lipids (cholesterol) are high or you have a family history of type 2 diabetes
• Colorectal cancer test: if you are 50 or older. Recommended tests include a yearly test for blood in the stool, called the fecal occult blood test (FOBT) or fecal immunochemical test (FIT), and one of the following tests:
  • sigmoidoscopy every 5 years
  • double-contrast barium enema every 5 years
  • colonoscopy at least every 10 years.

  You may need to start colorectal cancer screening earlier if a member of your immediate family has had colon cancer, especially if their cancer occurred before they were 50 years old.

• Gonorrhea, syphilis, and HIV tests: if you are at high risk for these infections, including if you have sex with other men or you have a new partner, more than 1 partner, a history of STDs (sexually transmitted diseases), or a partner with an STD
• Tuberculosis (TB) test: if you have a high risk of TB; for example, because you are a health worker, drug user, or immigrant, or because you have close contact with someone infected with TB
• Hearing test: if you are 65 or older
• Vision test: if you are 65 or older.

Remember, these are the minimum recommendations for routine tests. You and your healthcare provider must discuss what is right for you based on your symptoms and your personal and family medical history.

The PSA, or prostate specific antigen, test is widely used to look for prostate cancer, but its use as a routine test is controversial. Many studies have been done, but they do not yet show that it is practical to do it on all men at their checkups. The test often gives misleading results and can cause undue anxiety, expense, and unnecessary medical procedures. You should discuss when to start doing this test with your healthcare provider, especially if you are African-American or have a family history of prostate cancer.

Many other tests are often done at routine checkups, but there is no current evidence that they are helpful as routine screening tests for healthy men. Examples of such tests are a CBC (complete blood count), thyroid tests, and urine tests. When you have no symptoms of illness, you should discuss the pros and cons of these and other tests with your healthcare provider. Each test involves some expense.

What shots do I need?

The following shots are recommended for adults:

• Tetanus (Td) booster shot at least every 10 years. If you are under age 65, you should get the new Tdap booster to protect you better against whooping cough (pertussis) as well as tetanus. If you are 65 or older, this new vaccine has not yet been approved for your age group. Because babies are most susceptible to complications from whooping cough, Tdap is especially recommended for adults caring for children, even if it has been less than 10 years since your last tetanus booster.
• Flu shot every fall if you are 50 or older, you have a high risk for complications from the flu, or you might spread the flu to others who are at high risk.
• Hepatitis A shot if you are at risk, for example, through travel or your job, including military service
• Hepatitis B shot for adults who are at risk of infection. This includes, for example, men who have sex with other men, have more than 1 sex partner, have a sexually transmitted infection, abuse IV drugs, or plan to travel where hepatitis B is common.
• Pneumococcal pneumonia shot if you are age 65 or older. You may need to get it at a younger age if you have a high-risk medical condition, such as diabetes.
• Varicella (chickenpox) if you have never had chickenpox.
• Zoster (shingles) vaccine: if you are 60 or older. The vaccine can help prevent shingles. It can also reduce the pain caused by shingles.

What other things I can do to stay healthy?

You should expect your healthcare provider to advise you regularly on other ways to stay healthy. Some of these may include:

• Substance use: Do not use tobacco or illegal drugs. Avoid using alcohol while driving, swimming, boating, etc.
• Diet and exercise: Try to maintain your weight at a comfortable, healthy level. Limit the fat and cholesterol in your diet. Include a lot of whole grains, fruits, and vegetables in your diet. Get regular physical activity or exercise.
• Injury prevention: Use lap and shoulder belts when you drive. Use a helmet when you ride a motorcycle or bicycle. If you are around guns or other firearms, practice safe handling and make sure to keep them in locked cabinets when they are not in use. Install smoke detectors in your home. Set your hot water heater to less than 120°F (49°C).
• Dental health: Visit your dentist regularly. Brush your teeth with fluoride toothpaste daily. Also floss your teeth daily.
• Sexual behavior: Prevent sexually transmitted infections by avoiding high-risk sexual behavior and by using latex or polyurethane condoms every time you have sexually contact if you are not in a long-term relationship with just one partner who has no other partners.