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Issue Date: February 2006 Issue


Testing after 60

Seven medical tests you may not know you need.    


Eileen Beal

Dread all the pricking, probing and prodding during medical tests? Think of all those screenings, work-ups, scans and evaluations as an early warning system.

Tests 'don't just help physicians detect and diagnose a problem,' says Dr. Robert Palmer, head of geriatrics at The Cleveland Clinic. They also 'guide treatment options and measure treatment success. And in many cases they can predict outcomes, too.'

As you head into your 60s, you probably know you should be getting a PSA test for prostate cancer or a mammogram for breast health, as well as riding herd on your cholesterol to ward off heart disease. But you should also be talking to your doctor about several other tests. Some can be done when you are at the doctor's office for a follow-up visit or flu shot; others require their own appointment. Here are some other important tests, according to Harvard Medical School's easy-to-read book 'Medical Tests: A Practical Guide To Common Tests.'

1. Bone density test. Osteoporosis and osteopenia (pre-osteoporosis) can be treated, and even reversed a bit, but only when diagnosed. All women 65 and older should have a bone density test. Different than a bone scan, a density test uses either ultrasound, dual energy X-ray absorptiometry (DEXA) or radiographic absorptiometry. Women who have multiple risk factors should start getting tested 10 years earlier. Men at high risk should also get an exam. Risk factors include being small-framed, a sedentary lifestyle, a lifetime diet low in calcium, a heavy smoker or drinker, long-term corticosteroid use, a bone break before age 55 and a family history of osteoporosis.

2. Diabetes tests. Middle-age spread can morph into diabetes as you hit your 60s, especially if you have a close relative with diabetes, had gestational diabetes when you were pregnant or delivered a baby weighing more than 9 pounds. If you have high cardiovascular risks, such as a history of smoking, obesity, high cholesterol or high blood pressure, you should get two tests every year after age 60: an A1C (blood sugar average) test and either a fasting plasma glucose test or an oral glucose tolerance test. Results above 7 on the A1C test and above 130 on the blood glucose tests warn you are headed down the slippery slope toward full-blown diabetes.

3. Skin cancer screening. Skin cancer is the most common form of cancer - and the easiest to cure. An annual skin inspection by a doctor is recommended for everyone over 60; twice a year is suggested for those who are fair-skinned, have a lot of moles, have a family history of skin cancer or spent a lot of time in the sun when they were young.

4. Eye exam. Eyes should be examined every year after 60, or every two years if you have perfect vision. If you wear contacts or have diabetes, exams should be done twice a year by an ophthalmologist, who has more experience with 'abnormal' eye conditions.

5. Hearing exam. After 60, get occasional hearing tests as part of your annual exam by a family physician, or when a noticeable change in hearing occurs. What's a noticeable change' You have to strain to hear normal conversations; you turn the TV or radio up loud; you don't hear the doorbell.

6. Dental exam. After 60, continue seeing a dentist twice a year and get X-rays as needed. Your dentist isn't looking so much for cavities (which aren't a major problem for seniors), but for plaque buildup (an indication of systemic infection and possible heart disease), gum disease (caused by dry mouth, bacteria and plaque buildup), mouth and tongue cancers, worn-out fillings and jawbone erosion.

7. Blood test for vitamin, mineral and hormonal deficiencies or overloads. If you're suffering from multiple or chronic diseases, or you're taking a medication that prevents your stomach from properly absorbing vitamins and minerals, the glands producing hormones can slow down and your stomach and intestines are less able to absorb important vitamins and minerals, including vitamin B12, calcium and iron. This can cause deficiencies and overloads that affect everything from bone health to libido. Common blood tests will enable your physician to detect these deficiencies or overloads and prescribe treatments to offset them.

Before you take any test, Palmer cautions, make sure you fully understand its purpose, risks and margins for error. Some tests - an X-ray or blood draw, for instance - carry a slight risk for cell damage or injury. Few are 100 percent accurate, so be aware of the possibility of false negatives and positives.

Another key to staying healthy after 60 is to make sure your immunizations are up to date. Get a flu vaccine every year. Check whether you need vaccinations or boosters for pneumonia, tetanus, hepatitis B and childhood diseases, such as chicken pox or measles, that you missed as a child.


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