HealthSheets™


Prevention Guidelines, Women Ages 65 and Older

Screening tests and vaccines are an important part of managing your health. Health counseling is essential, too. Below are guidelines for these, for women ages 65 and older. Talk with your healthcare provider to make sure you’re up to date on what you need.

Screening

Who needs it

How often

Type 2 diabetes or prediabetes

All adults ages 40 to 75 who are overweight or obese

At least every 3 years

Alcohol misuse

All women in this age group

At routine exams

Blood pressure

All women in this age group

Talk with your healthcare provider about what your blood pressure goal should be. 

Breast cancer

All women ages 50 to 74

There are no guidelines for breast cancer screening for 75 years and older. 

Mammogram every two years is endorsed by the U.S. Preventive Services Task Force and every year by the American College of Physicians and American Congress of Obstetricians and Gynecologists (ACOG). 

Cervical cancer

Only women who had abnormal screening results before age 65

Talk with your healthcare provider

Chlamydia

Women at increased risk for infection

At routine exams

Colorectal cancer

All women over the age of 50

This screening is advised against for women over 75 or if there is a life expectancy of less than 10 years. 

Multiple tests are available and are used at different times. Possible tests include: flexible sigmoidoscopy, colonoscopy, double-contrast barium enema, yearly fecal occult blood test, fecal immunochemical test, or stool DNA test as often as your healthcare provider advises. Talk with your healthcare provider about which tests are best for you.

Depression

All women in this age group

At routine exams

Gonorrhea

Sexually active women at increased risk for infection

At routine exams

Hepatitis C

Anyone at increased risk; 1 time for those born between 1945 and 1965

At routine exams

High cholesterol or triglycerides

All women in this age group who are at risk for coronary artery disease

At least every 5 years

HIV

Women at increased risk for infection–talk with your healthcare provider

At routine exams

Lung cancer

Adults ages 55 to 74 who have smoked with a 30-pack-a-year history and have smoked within the past 15 years 

Annual low dose CT scan

Obesity

All women in this age group

At routine exams

Osteoporosis

All women in this age group

Bone density test at age 65, then follow-up as advised by your healthcare provider

Syphilis

Women at increased risk for infection–talk with your healthcare provider

At routine exams

Thyroid-Stimulating Hormone (TSH)

All women in this age group with symptoms of thyroid dysfunction. There is not enough evidence to support TSH screening in women without symptoms. 

ACOG recommendation is every 5 years; American Academy of Family Physicians concludes there is not enough evidence to support routine screening in adults without symptoms. 

Tuberculosis

Women at increased risk for infection–talk with your healthcare provider

Ask your healthcare provider

Vision

All women in this age group

Every 1 to 2 years; if you have a chronic health condition, ask your healthcare provider if you need exams more often

Vaccine

Who needs it

How often

Chickenpox (varicella)

All women in this age group who have no record of this infection or vaccine

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

Hepatitis A

Women at increased risk for infection–talk with your healthcare provider

2 doses given 6 months apart

Hepatitis B

Women at increased risk for infection–talk with your healthcare provider

3 doses over 6 months; second dose should be given 1 month after the first dose; the third dose should be given at least 2 months after the second dose and at least 4 months after the first dose

Haemophilus influenza Type B (HIB)

Women at increased risk for infection–talk with your healthcare provider

1 to 3 doses

Influenza (flu)

All women in this age group

Once a year

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

All women in this age group

1 dose of each vaccine

Tetanus/diphtheria/pertussis (Td/Tdap) booster

All women in this age group

Td every 10 years, or a one-time dose of Tdap instead of a Td booster after age 18, then Td every 10 years

Zoster

All women in this age group

1 dose

Counseling

Who needs it

How often

Diet and exercise

Women who are overweight or obese

When diagnosed, and then at routine exams

Fall prevention (exercise and vitamin D supplements)

All women in this age group

At routine exams

Sexually transmitted infection prevention

Women at increased risk for infection–talk with your healthcare provider

At routine exams

Use of daily aspirin

Talk to your healthcare provider about whether or not to start taking low-dose aspirin for the prevention of cardiovascular disease (CVD) and colorectal cancer in adults ages 60 to 69 who have at least a 10% risk of getting CVD within the next 10 years.

People who are not at increased risk for bleeding, have a life expectancy of at least 10 years, and are willing to take low-dose aspirin daily for at least 10 years are more likely to benefit. When the advantages of taking low-dose aspirin outweigh the risks, people may choose to start taking a low-dose aspirin.

There is not enough data to support the use of aspirin in people over the age of 70. 

When your risk is known

Use of tobacco and the health effects it can cause

All women in this age group

Every exam

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