Selected Screening Recommendations for Older Patients

Abdominal aortic aneurysm

Abdominal ultrasonography

Once between age 65–75

For men who have ever smoked: B recommendation by the USPSTF

For men who have never smoked: C recommendation by the USPSTF

For women who have ever smoked: I recommendation by the USPSTF

For women who have never smoked: D recommendation by the USPSTF

Abuse or neglect

Inquire about mistreatment (eg "Are there any problems with family or household members that you would like to tell me about?")

At least once

For all older patients: I recommendation by the USPSTF

Alcohol misuse

Alcoholism screening questionnaire (eg, AUDIT, AUDIT-C)

Yearly

For all adults, including those ≥ 65: B recommendation by the USPSTF

For all patients with a positive screening test: B recommendation by USPSTF for brief behavioral counseling interventions

For patients who meet the criteria for alcohol use disorder: Abstinence recommended

ASCVD (atherosclerotic cardiovascular disease [1])

Framingham criteria (up to age 75)

Reynolds Risk Score (up to age 80)

Multi-ethnic study of atherosclerosis (MESA) score (up to age 85)

Every 5 years

People with multiple global risk factors‡ more frequently

Possibly measurement of serum lipid levels, high-sensitivity C-reactive protein, and/or ABI, recommended by the ACC/AHA (2)

Older women: screened in the same way as older men

Cognitive impairment (eg, dementia, delirium)

Cognitive impairment screening instrument (eg, Mini-Cog)

Yearly

For community-living adults > 65: I recommendation by the USPSTF

Depression (major depressive disorder)

Depression screening questionnaire (eg, PHQ-2)

Yearly

For all adults, including those ≥ 65: B recommendation by the USPSTF†

Diabetes mellitus, type 2

Fasting plasma glucose level

Yearly

For adults 35–70 with overweight or obesity: B recommendation by the USPSTF

For adults > 35 with overweight, obesity, or other risk factors§: At least every 3 years recommended by the ADA (3)

Fall risk

Inquiry about falls during the previous year and about difficulty with walking or balance

Get-Up-and-Go test, STEADI, or another fall risk assessment tool

Yearly

For all adults > 65: Use of a fall risk assessment tool recommended by the AGS and BGS (4)

For community-dwelling patients ≥ 65 who have an increased risk of falls: B recommendation by the USPSTF for exercise interventions

Glaucoma

Intraocular pressure measurement

Yearly

For all adults < 40: I recommendation by the USPSTF

Hearing deficits

Bedside hearing test

Yearly

For all adults ≥ 50: I recommendation by the USPSTF

HIV infection

HIV testing of serum, blood, or oral fluid

At least once

For all adults 15–65 and for patients > 65 with HIV risk factors: A recommendation by the USPSTF

Hypertension

Blood pressure measurement

Every 3–5 years for people 18–39 with normal blood pressure and no risk factors

Annually for people > 40 and those with high-normal blood pressure and/or risk factors (eg, overweight or obesity, sedentary lifestyle, strong family history, African-American)

For all people ≥ 18: A recommendation by USPSTF (treatment based on the initial office blood pressure measurement and additional measurements outside of the office)

Obesity-related morbidity and mortality

Height and weight measurement

BMI (kg/m²) calculation¶

At least yearly as needed

For all adults with a BMI> 30: Referral for multicomponent behavioral interventions: B recommendation by the USPSTF

Osteoporosis

Dual-energy x-ray absorptiometry

At most every 2 years

For all women ≥ 65 : B recommendation by USPSTF

For women < 65 with increased risk as determined by formal screening tools: B recommendation by the USPSTF

For men ≥ 65: I recommendation by the USPSTF

Sexually transmitted infections (STIs)

Behavioral counseling

At least once

For all sexually active adolescents and for adults who have an increased risk of STIs: B recommendation by the USPSTF

Thyroid dysfunction (hypothyroidism or hyperthyroidism)

Thyroid-stimulating hormone level

NA

For all nonpregnant adults: I recommendation by the USPSTF

Tobacco use

Inquiry about tobacco use

At least once

For all adults: A recommendation by the USPSTF

For all patients who report tobacco use: Cessation counseling and appropriate medications

Visual deficits

Snellen visual acuity test

Yearly as needed

For all adults ≥ 65: I recommendation by USPSTF

Blood 25-hydroxyvitamin D level

N/A

I recommendation by USPSTF