Medical guidance for people around age 75 shifts focus from maximizing life expectancy to maintaining functional independence and quality of life. At this stage, the benefits of aggressive screening for slow-growing diseases must be carefully weighed against potential harms, such as complications from diagnostic procedures, over-diagnosis, and unnecessary treatment. The decision to pursue any medical test should be highly individualized, taking into account a person’s overall health status, preferences, and estimated life expectancy.
Annual Monitoring for Chronic Conditions
Regular blood work and physical measurements are foundational for managing chronic conditions common with age. These annual or semi-annual checks help physicians proactively adjust medications and lifestyle recommendations.
Blood pressure should be measured at every visit, as hypertension is a primary driver of heart attack, stroke, and kidney disease. A Comprehensive Metabolic Panel (CMP) is typically ordered to assess overall organ health, including kidney function (creatinine and blood urea nitrogen) and liver health (liver enzymes). The CMP is also important for monitoring the safety and effect of long-term medications.
A lipid panel, which measures cholesterol, is generally recommended every one to five years, though annual screening is often advised for those over age 65. Monitoring these levels helps estimate cardiovascular risk, a leading health concern in this age group. Diabetes screening, using a fasting glucose test or a hemoglobin A1c (HbA1c) test, should also continue.
The HbA1c provides an average blood sugar level over the preceding three months. Thyroid function, measured by a Thyroid-Stimulating Hormone (TSH) test, is a common component of annual lab work because both overactive and underactive thyroid conditions are more prevalent in older adults. For a person with stable, normal thyroid function, routine retesting may be safely spaced out unless new symptoms arise.
Cancer and Bone Density Screenings
Screening guidelines for various cancers often become flexible or cease entirely after age 75, making shared decision-making with a physician paramount. Screening may not be necessary if a cancer will take longer than a person’s remaining healthy lifespan to cause harm.
Screening for colorectal cancer is generally recommended to continue through age 75. For those aged 76 through 85, continuing screening is an individualized decision based on overall health and prior screening history. If life expectancy is estimated to be less than 10 years, the risks of complications from a procedure like a colonoscopy typically outweigh the benefit of detecting a slow-growing cancer.
Screening for breast cancer with a mammogram follows a similar pattern. Women in good health with a life expectancy of 10 years or more are generally advised to continue screening, potentially transitioning to a biennial schedule. For men, routine Prostate-Specific Antigen (PSA) screening for prostate cancer is often discouraged for those over 75, unless they have a known history of aggressive disease or specific symptoms.
A dual-energy X-ray absorptiometry (DEXA) scan, which measures bone mineral density, is a screening that should continue. Osteoporosis significantly increases the risk of debilitating fractures, and screening is routinely recommended for women aged 65 and older and men aged 70 and older. Medicare often covers a DEXA scan every two years to monitor bone health and guide treatment.
Assessing Cognitive Function and Sensory Health
Beyond laboratory tests, annual assessments of cognitive and sensory function are essential for maintaining independence and personal safety. Early identification allows for interventions that can improve quality of life and slow progression.
Annual cognitive screening is recommended to detect early signs of mild cognitive impairment or dementia. Brief tools like the Montreal Cognitive Assessment (MoCA) or the Mini-Mental State Examination (MMSE) are often used in primary care. Identifying cognitive changes influences a person’s ability to manage medications, finances, and safety.
Regular, comprehensive eye exams are important to check for age-related conditions such as cataracts, glaucoma, and macular degeneration. The American Optometric Association recommends annual or biennial exams for people over age 60. Addressing vision changes is linked to reducing the risk of falls and improving quality of life, including the ability to drive safely.
Annual hearing checks are important, as hearing loss is a significant risk factor for social isolation and may be associated with cognitive decline. Untreated hearing loss affects communication, potentially leading to frustration and withdrawal from social activities. Addressing both vision and hearing deficits helps ensure a person can safely navigate their environment and remain engaged.
Preventative Measures and Safety Checks
Proactive preventative measures and safety assessments are components of care for the 75-year-old population. Immunizations are a straightforward way to defend against serious infectious diseases, which can cause severe complications in older adults.
Recommended annual vaccines include:
- A high-dose or adjuvanted influenza shot, designed to elicit a stronger immune response in older people.
- The Shingrix vaccine for shingles.
- Pneumococcal vaccines (PCV15 or PCV20) to protect against pneumonia.
- The Respiratory Syncytial Virus (RSV) vaccine for this age group.
A professional fall risk assessment should be performed annually, involving a review of gait, balance, and mobility. A physician may use a tool like the Timed Up and Go test to evaluate fall risk, as falls are a leading cause of injury. This assessment also includes a comprehensive review of all medications (prescription and over-the-counter) to identify any that might cause dizziness or drowsiness.
This annual medication review checks for unnecessary prescriptions (polypharmacy) or potentially dangerous drug interactions. The goal is to streamline the medication regimen, ensuring that every drug provides a clear benefit without undue risk.