Preventive health check

Senior citizens are the main users of health care and hence identifying any health issue early results in better outcome. Often the problems that come up after 60 years are attributed to ageing, and ignored.

What is a preventive health check?

Preventive health check is done to identify disorders or diseases at a very early stage when there are no signs or warning about it. Senior citizens are likely to benefit from these checks if supervised by a Geriatrician.

Does doing a set of tests including scans enough?

As each individual is different the risk for ailments vary. Moreover in a senior citizen where differentiation between normal ageing and a disorder is blurred. Hence a comprehensive Geriatric assessment is required before going for tests.

Secondly most of the tests have a chance of being falsely positive or falsely negative. Hence it is vital that a clinician with adequate expertise advises on the required set of tests for a particular individual. This would help them to guide the patient as to what the results mean for them as an individual.

What is disease prevention?

In medical school prevention is broadly classified as primary and secondary prevention. Primary prevention is to take measures to prevent long before a particular disease sets in. A common example is taking medications regularly for Hypertension (high blood pressure) to prevent the chance of a stroke. Secondary prevention is the measures required after a disease has happened to minimise the chance of recurrence. In the same example if stroke has happened patients are given small dose of Aspirin to reduce the chance of further strokes.

Are there any primary prevention measures that a healthy individual can take?

Yes, there is no better medicine than a healthy lifestyle in prevention of diseases. Taking regular healthy meals and adequate physical activity are measures that are important in preventing vascular disorders like stroke and heart attack.

Other measures include:

• Smoking cessation
• Immunisation against flu
• Simple physical activity such Brisk Walking for 30 minutes every day
• Falls prevention with strength and balance training
• Balanced diet

What are the serious illnesses that can occur in the senior citizen?

Incidence of diabetes, thyroid disorders and high Blood pressure increase with age. In the initial stages many of these disorders are asymptomatic. Hence a targeted screening test will help to detect these disorders early and start appropriate treatment. In a few individuals further screening tests may be performed according to their individual risk profile for vascular events and hence a doctor’s guidance is important while choosing appropriate tests.

Women

Cancer is the most serious illness along with vascular disorders (stroke and heart attack). 50% of cancers occur in people over the age of 65 years. Studies done in the elderly populations have shown that screening for Breast cancer was beneficial. This is because of the increased life expectancy and improved quality of life due to early detection. Mammography is the screening tool and if done periodically has been proven to reduce mortality. Other less common cancers in women are cervical and ovarian cancers. There is evidence to suggest that periodic Pap smear can reduce the severity and spread of cervical cancer. But current recommendations do not advice screening after the age of 65.

Men

Men have a higher risk of vascular disorders. Prostate cancer increases with age. Screening is by examining the back passage (rectum) with a finger by an experienced clinician and a PSA test. The PSA test on its own is not found to be useful and can be misleading.

Studies on screening tests for Lung cancer have yielded mixed results. There is still debate among doctors as to the real value of screening for Lung cancer. There is some evidence to suggest benefit for certain high-risk groups such as smokers.

Bowel (Colon) cancer screening is advised for those with family history. Stool occult blood and colonoscopy are advised based on risk factors. 

Dr R Magesh MRCP(UK) CCT(Int Med) CCT(Geriatrics) FRCP(Edin)