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Dorchester Center, MA 02124

Health Maintenance: Ages 65 Years And Older


Important Considerations (Physiologic Changes)

This age group is notable for maturity, leisure, and age-related health changes. Healthcare is still directed toward prevention; however, it becomes more and more occupied by the management of general medical and age-related illness. While reproductive health issues no longer are the focus of well-women visits, the women’s healthcare provider is often still the patient’s primary entry point for healthcare.

Leading Causes of Death

  • Cardiovascular disease

  • Coronary artery disease

  • Colorectal, lung, and breast cancer

  • Alzheimer disease

  • Cerebrovascular disease

  • Obstructive lung disease

  • Pneumonia/influenza

  • Diabetes mellitus and its complications

  • Accidents

  • Renal disease

Leading Causes of Morbidity

  • Nose, throat, and upper respiratory conditions

  • Osteoporosis

  • Arthritis

  • Hypertension

  • Urinary and fecal incontinence

  • Heart disease

  • Musculoskeletal and soft tissue injuries

  • Hearing and vision impairment

  • Colon disease (diverticulitis, etc.)

Screening

History

  • Reason for visit

  • Health status: Medical, surgical, family

  • Dietary/nutritional assessment

  • Physical activity and activities of daily life

  • Tobacco, vaping, alcohol, and other drugs (concurrent medications including complementary and alternative medicines)

  • Abuse/neglect (Two-thirds of the victims of elderly abuse are women, with almost 90% of abuse cases occurring in the home.)

  • Sexual practices/activity

  • Urinary and fecal incontinence (These issues become more common with childbearing and age, but patients seldom volunteer these complaints.)

Physical

  • Height

  • Weight (body mass index [BMI])

  • Blood pressure

  • Oral cavity

  • Neck: Adenopathy, thyroid

  • Breasts

  • Abdomen

  • Pelvic and rectovaginal examination

  • Skin

  • Hearing and vision screening (including glaucoma)

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