From the Guidelines
An 80-year-old female should receive several key preventative services during her annual wellness visit, prioritizing fall prevention through exercise or physical therapy and vitamin D supplementation, as recommended by the USPSTF 1.
Preventative Services
The following services are recommended:
- Blood pressure screening
- Weight assessment
- Vision and hearing evaluations
- Vaccinations, including:
- Annual influenza vaccine
- Pneumococcal vaccines if not previously received
- Tdap or Td booster if needed
- Shingles vaccination (Shingrix, two doses 2-6 months apart)
- Laboratory tests, including:
- Lipid panel
- Comprehensive metabolic panel
- Hemoglobin A1C
- Vitamin B12 and vitamin D levels
Cancer Screenings
Cancer screenings may include:
- Breast cancer screening through mammography (individualized based on health status and preferences)
- Colorectal cancer screening if not done recently
- Cervical cancer screening may be discontinued if adequate prior screening has been performed
Osteoporosis Prevention
Bone density testing (DEXA scan) is important to assess for osteoporosis, with medication like alendronate 70mg weekly considered if indicated 1.
Cognitive and Depression Screenings
Cognitive and depression screenings should be performed using tools like the Mini-Mental State Examination and Geriatric Depression Scale.
Fall Risk Assessment and Medication Review
Fall risk assessment and medication review are crucial to prevent adverse events, with a focus on exercise or physical therapy and vitamin D supplementation to prevent falls in community-dwelling adults aged 65 years or older who are at increased risk for falls 1.
Advanced Care Planning
Advanced care planning discussions should be initiated or updated to address age-related health concerns and maintain quality of life while preventing complications from chronic conditions common in older adults.
From the Research
Preventative Care for 80-Year-Old Female at Annual Wellness Visit
At an annual wellness visit, an 80-year-old female should receive the following preventative care:
- Review of medications to minimize polypharmacy and potential drug-drug interactions, as polypharmacy is associated with increased risk of adverse events 2, 3, 4
- Screening for geriatric syndromes, such as cognitive impairment, falls, and functional decline 5
- Assessment of the patient's medication regimen to identify potential drug-drug interactions and anticholinergic burden, which can affect cognitive function 3, 4, 6
- Discussion of preventive health recommendations, such as vaccinations, cancer screenings, and healthy lifestyle habits 5
- Review of the patient's medical history, including cardiovascular disease, to identify potential risks and develop strategies for prevention and management 4
Medication Management
Medication management is a critical component of preventative care for older adults, as polypharmacy and potential drug-drug interactions can have serious consequences. The patient's medication regimen should be reviewed to:
- Identify potential drug-drug interactions and anticholinergic burden 3, 4, 6
- Minimize the use of unnecessary medications and reduce the risk of adverse events 2, 3, 4
- Ensure that the patient is taking medications as prescribed and is aware of potential side effects and interactions 2, 3, 4
Health Screenings
The patient should receive the following health screenings:
- Cognitive screening to assess for mild cognitive impairment or dementia 6
- Functional assessment to evaluate the patient's ability to perform daily activities and identify potential risks for falls or other adverse events 5
- Cardiovascular risk assessment to identify potential risks for cardiovascular disease and develop strategies for prevention and management 4