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Preventive examinations after the age of 60 should be performed by every senior. With age, the biological processes of aging irreversibly occur, causing many chronic diseases. Check what tests should be performed after the age of 60.

Whatpreventive examinationsshould be doneafter the age of 60 ? The list goes on and on. With age, the efficiency of many organs, such as the kidneys and liver, which are responsible for detoxifying the body and removing harmful substances, declines. The endocrine glands, such as the pancreas and thyroid, begin to produce less and less hormones. DNA repair mechanisms are also starting to fail, which increases the risk of cancer. For this reason, people over 60 years of age should receive special medical care.

The most common diseases and ailments of Poles over 60

The table below presents the nine most common diseases and ailments occurring in Poles over 60:

MenWomen
High blood pressure 47.2%High blood pressure 56.3%
Lower back pain 36.2%Osteoarthritis 47.3%
Osteoarthritis 29%Lower back pain 45.5%
Coronary artery disease 24.8%Neck pain or other chronic neck discomfort 33.9%
Middle back pain 24%Middle back pain 32.4%
Neck pain or other chronic neck ailments 23.7%Coronary artery disease 28%
Prostate diseases 22.5%Diabetes 17.6%
Diabetes 17.7%Thyroid diseases 17.2%
Myocardial infarction and its complications 13%Urinary incontinence 15.4%

Unfortunately, there are currently no preventive programs in Poland dedicated to people over 60 years of age. As part of the National He alth Fund, sixty-year-olds can take advantage of preventive examinations available for other age groups upon presentation of an appropriate referral from a doctor. Programs organized by the Ministry of He alth, among others, are available without referral. breast cancer and colorectal cancer early detection program.

Research after the age of 60 -peripheral blood count

Blood morphology is one of the basic laboratory tests that allow the detection of various pathologies at an early stage. Thanks to it, it is possible to detect dangerous infections, which in people over 60 years of age may have a more intense course than in younger people, as the body's immunity decreases with age. In addition, the morphology will allow the diagnosis of anemia, the cause of which may be nutritional deficiencies or blood cancers (their frequency increases with age).

Blood morphology consists of three systems:

  • white blood cell (total and percentage of neutrophils, monocytes, basophils, eosinophils, lymphocytes)
  • red cell (red blood cell count, hemoglobin, hematocrit, MCV, MCH, MCHC, RDV)
  • platelet (platelet count, MPV)

Along with the morphology, it is worth determining the markers of inflammation: Biernacki's test (ESR) and highly sensitive C-reactive protein (hsCRP). The above tests should be performed in people over 60 at least once a year.

Research over 60 and cardiovascular diseases

Cardiovascular diseases, such as hypertension, myocardial infarction or ischemic stroke, are closely related to aging. One in four people over 60 suffers from coronary heart disease, and over 80% of deaths in this age group are caused by diseases of the circulatory system.

In Poland, according to GUS data, arterial hypertension is the most common in 60-year-olds, which is found in more than half of people. Control of arterial hypertension is very important as it may lead to the development of further diseases, e.g. kidney diseases.

A single blood pressure reading is usually unreliable. Therefore, it is recommended that you regularly check your blood pressure with a blood pressure monitor at home or in a he althcare facility. Remember that mercury manometers are the most accurate and it is on the basis of their measurement that you should diagnose arterial hypertension. In people with hypertension, it is also worth assessing the concentration of sodium, potassium, calcium and magnesium in the blood, because their abnormal levels may cause high blood pressure.

In order to prevent coronary heart disease, you should regularly test total cholesterol and its individual LDL, HDL and non-HDL fractions, and triglycerides. Old age itself is a factor that increases the risk of cardiovascular disease, therefore the test should be performed once a year in this group of people. In order to monitor the effectiveness of treatment, the test should be performed approximately every 3 months.

Additionally, it is worth measuring homocysteine ​​and hsCRP in the blood.Increasing these two ratios further increases the risk of cardiovascular disease.

Research after the age of 60 and the locomotor system

The musculoskeletal system is the second most common cause of dysfunction in people over 60. About 40% of them complain of lower back pain and osteoarthritis (especially in women). Osteoarthritis and spine degeneration can manifest itself in, among others. joint pain, swelling and crackling, and morning stiffness.

Another disease of old age is osteoporosis, which most often affects postmenopausal women, which is associated with a reduction in the level of hormones that protect the bones. Osteoporosis also affects men over the age of 70. The consequence of osteoporosis is a reduction in bone mass and an increased risk of bone fractures.

In the case of chronic pain in the spine and joints in the elderly, an X-ray examination of the joints and / or the spine should be performed. Joint pain can also be caused by gout or rheumatoid arthritis. If gout is suspected, a blood uric acid test should be performed, the synovial fluid should be microscopically assessed and sodium urate crystals should be found.

Later onset rheumatoid arthritis or EORA (elderly-onset rheumatoid arthritis) is characterized by a sudden and acute onset and involvement of mainly large joints. Laboratory tests that should be performed when rheumatoid arthritis is suspected are the determination of anti-CCP and anti-RF antibodies in the blood.

  • RHEUMATIC PROFILE - tests to detect rheumatic diseases

The basic test for the diagnosis of osteoporosis is the assessment of bone mineral density by densitometry. This examination should be performed once after the age of 60. Other tests that should be performed when osteoporosis is suspected include the determination of calcium, inorganic phosphorus and vitamin D in the blood.

Research after the age of 60 and diabetes

The incidence of type 2 diabetes mellitus incidents increases with age and affects approximately 18% after the age of 60. Undiagnosed or improperly controlled diabetes leads to many serious complications, such as limb amputations or visual disturbances (diabetic retinopathy, cataracts). Symptoms of diabetes include, among others. excessive thirst, frequent urination, fatigue.

One of the causes of type 2 diabetes is overweight and obesity, which affects nearly 70% of people over 60, and every fourth person in this age group is obese.

Basic assessment researchcarbohydrate metabolism is the concentration of glucose in the blood (fasting norm: 70-99 mg / dl) and insulin. These tests should be performed at least once a year. In the case of abnormal fasting blood glucose levels, when the glucose value is between 100 and 125 mg / dL, the so-called glucose curve. This test involves measuring fasting blood glucose and administering 75 g of glucose in the first and second hours after its administration.

In people diagnosed with type 2 diabetes, a useful marker for monitoring blood glucose levels is the determination of glycosylated hemoglobin (HbA1c). This parameter reflects the average blood glucose concentration in the last 3 months.

The BMI index is used to assess the body weight.

Research over 60 and cancer

Malignant neoplasms are another common disease among the elderly. They are the second most common cause of death in this age group. In Poland, the most common malignant neoplasms in men over 60 are lung cancer, prostate cancer and colorectal cancer. In women, however, cancer of the breast, colon and lung. Due to this fact, preventive examinations aimed at detecting cancers at an early stage of development are extremely important.

  • Colorectal cancer

Colorectal cancer screening is a colonoscopy and a fecal occult blood test. The Ministry of He alth finances a colon cancer prevention program through colonoscopy. Men and women aged 55-64 can apply for the tests. Colonoscopy after the age of 60 should be performed every 5-10 years depending on the test results. Fecal occult blood testing is performed every 1-2 years.

  • Lung cancer

People over 60 who smoke or have smoked in the past should have a chest X-ray. A screening project for the early detection of lung cancer is also planned in 2022. Screening will be performed using low-dose computed tomography for smokers and ex-smokers between the ages of 50 and 74.

  • Breast cancer

The prevention program of the Ministry of He alth for the early detection of breast cancer using mammography is aimed at women between 50 and 69 years of age. Therefore, people over 60 years of age can use it without a doctor's referral.

  • Prostate cancer

It is estimated that about 50% of men over the age of 60 develop prostate enlargement. However, it is not always associated with the presence of a malignant tumor. In order to diagnose prostate cancer, an examination should be performedtransrectal and determination of the prostate antigen (PSA) in the blood.

Tests after the age of 60 - kidneys

Aging also causes permanent changes in the structure of the kidneys, including reduction of the number of active nephrons and blood vessel fibrosis. In turn, structural changes will directly affect kidney function. People over 60 are the most numerous group with newly diagnosed chronic kidney disease. This disease is very insidious as it does not give any symptoms for a long time.

In order to assess the condition of the kidneys, it is recommended to perform an ultrasound examination. In addition to assessing kidney function in the blood, urea (sometimes replaced by BUN), creatinine and uric acid should be tested. These parameters are elevated when the kidneys are not working properly. It should be remembered that in elderly people with kidney damage, the creatinine concentration increases much slower than in young people.

That is why many specialists advise against the use of creatinine as a marker of kidney damage. More useful for assessing kidney function in people over 60 is the creatinine clearance.

Once a year, it is worth performing a general urine test in people over 60 years of age, which can be a source of information about pathologies starting. In addition to testing the color, pH, and weight of the urine, you can test the amount of protein in the urine (which may indicate renal failure) and the presence of glucose and ketone bodies (which may indicate diabetes).

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Research after the age of 60 - the liver

The liver is the body's main detox center. The lifestyle we led - how much alcohol we consumed, what medications we took or whether we ate he althy - had a great influence on her condition in old age. Symptoms of a poorly functioning liver are nausea, lack of appetite, indigestion, gas.

As in the case of kidneys, liver ultrasound should be performed to assess structural changes in the liver parenchyma. However, in order to assess its function, tests for alanine aminotransferase (ALT) and asparagine aminotransferase (AST) and glutaryltranspeptidase (GGTP) in the blood should be performed. They are the so-called liver tests, elevated levels of which may indicate abnormal liver function.

Tests after the age of 60 - thyroid

Thyroid dysfunction (hyperthyroidism or hypothyroidism) is more common in older populations than inyoung people and concern mainly women. At the same time, they are more difficult to diagnose, as in the elderly they may be asymptomatic or with poorly expressed symptoms. Both hyperthyroidism and hypothyroidism are associated with a higher cardiovascular risk.

The determination of TSH, fT4 and fT3 in the blood is used to assess thyroid function. However, we should remember that in the elderly the levels of TSH and fT3 may be higher than in young people, with relatively low levels of fT4.

Additionally, it is worth performing an ultrasound of the thyroid gland and the determination of anti-thyroid antibodies in the blood (anti-TG and anti-TPO). However, it is estimated that anti-thyroid antibodies may be present in up to half of people over the age of 60 without clinical symptoms of thyroid dysfunction. This suggests that the detection of anti-thyroid autoantibodies in the elderly is of less clinical and diagnostic importance than in younger people,

Research after the age of 60 - eyesight

As the years go by, the efficiency of the sense organs, especially the eyesight, decreases. Only every sixth elderly person does not use glasses or contact lenses. Cataracts, glaucoma, age-related macular degeneration and diabetic retinopathy are the most common causes of blindness in people over 60.

Although most age-related eye diseases are incurable, regular ophthalmological examinations slow down the disease process and protect the elderly from premature vision loss.

People over 60 who begin to have vision problems should be under the constant supervision of an ophthalmologist. The specialist examinations performed by an ophthalmologist include: measurement of intraocular pressure (tonometry), stereoscopic evaluation of the II nerve disc, examination of the drainage angle (gonioscopy), measurement of the corneal thickness (pachymetry) and examination of the visual field (perimetry).

About the authorKarolina Karabin, MD, PhD, molecular biologist, laboratory diagnostician, Cambridge Diagnostics Polska A biologist by profession, specializing in microbiology, and a laboratory diagnostician with over 10 years of experience in laboratory work. A graduate of the College of Molecular Medicine and a member of the Polish Society of Human Genetics. Head of research grants at the Laboratory of Molecular Diagnostics at the Department of Hematology, Oncology and Internal Diseases of the Medical University of Warsaw. She defended the title of doctor of medical sciences in the field of medical biology at the 1st Faculty of Medicine of the Medical University of Warsaw. Author of many scientific and popular science works in the field of laboratory diagnostics, molecular biology and nutrition. Every day as a specialist in the field of diagnosticslaboratory, runs the substantive department at Cambridge Diagnostics Polska and cooperates with a team of dieticians at the CD Dietary Clinic. He shares his practical knowledge on diagnostics and diet therapy of diseases with specialists at conferences, training sessions, and in magazines and websites. She is particularly interested in the influence of modern lifestyle on molecular processes in the body.

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Geriatrics