Prevention Guidelines for Women 65+

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. Click to see prevention plans for men and women in different age groups and learn more about each screening:

 

Screening

Who needs it

How often

Alcohol misuse

All adults

At routine exams

Blood pressure

All adults

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

Breast cancer

All women2

Yearly mammogram and clinical breast exam2

Cervical cancer

Women ages 21 to 65 who have been sexually active and have a cervix

Discuss with your health care provider3

Chlamydia

Women at increased risk for infection

At routine exams

Colorectal cancer

All adults age 50 and older

Check with your health care provider; fecal occult blood testing, sigmoidoscopy, and colonoscopy are the recommended screening methods

Depression

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

At routine exams

Diabetes mellitus, type 2

Adults who are asymptomatic and have sustained blood pressure (treated or untreated) greater than 135/80 mm Hg

At routine exams

Gonorrhea

Sexually active women who are at increased risk for infection

At routine exams

HIV

Anyone at increased risk for infection

At routine exams

Lipid disorders

All women ages 45 and older at increased risk for coronary artery disease

At least every five years4

Obesity

All adults

At routine exams

Osteoporosis, postmenopausal

Women ages 65 and older5

Bone density test at age 655

Syphilis

Anyone at increased risk for infection

At routine exams

Tuberculosis

Anyone at increased risk for infection

Check with your health care provider

Counseling

Who needs it

How often

Aspirin for prevention of cardiovascular events

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

Discuss with your health care provider

Diet, behavioral counseling

Adults with hyperlipidemia and other known risk factors for cardiovascular and diet-related chronic disease

When diagnosed

Tobacco use and tobacco-related disease

All adults

Every visit

Immunization

Who needs it

How often

Tetanus/diphtheria/pertussis (Td/Tdap) booster

All adults

Td: Every 10 years

Measles, mumps, rubella (MMR)

All adults age 65 and older who lack prior infection or documented vaccinations*

One dose

Chickenpox (varicella)

All adults age 65 and older who lack prior infection or documented vaccinations*

Two doses; second dose should be given 4 to 8 weeks after the first dose

Flu (seasonal)

All adults

Yearly during flu season

Hepatitis A vaccine

People at risk*

Two doses: For Havrix, at zero and 6 to 12 months; or for Vaqta, at zero and 6 to 18 months

Hepatitis B vaccine

People at risk*

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

Meningococcal

People at risk*

One or more doses

Pneumococcal (polysaccharide)

All adults

One dose

Zoster

All women age 65 and older

One dose

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.

4 Recommendation from the College

5 Recommendation under review by the USPSTF

* Exceptions may exist; discuss with your health care provider

Other guidelines from the USPSTF

Immunization schedule from the CDC

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