Want to be healthy over 50? Get these tests, exams

Bone Density Test
This is an x-ray, also called the DXA scan, which measures your bone density.  The lower your bone density, the greater your risk for bone fractures.  (There is also a much less accurate heel ultrasound test that does NOT diagnose osteoporosis but merely tells your doctor whether you are at risk and should have the more complete x-ray DXA scan test.)  The DXA scan is considered the gold standard for the diagnosis of osteoporosis.  The most important score or result to check is your T-score.  The T-score tells you how your bones compare to that of a healthy 35 year old woman.  If your T-score falls between -1 and -2.5 then you have mild bone loss called osteopenia.  If your T score is -2.5 or lower, than you have osteoporosis and a significant increased risk of fractures.

You can also look at your Z-score, which tells you how you compare to a similarly matched group of women your age and ethnic background.  It is not unusual for an 80 year old woman to have a normal (for her age) Z-score but have severe osteoporosis (her T-score could be much lower than -2.5).  I often hear women tell me their DXA scan is normal yet when I got the actual report I found that their Z-score was normal for their age but their T-score was low and they needed counseling about prevention for further bone loss.  I can’t say it enough, “Get a copy of your report and learn what your results mean for you.”

Mammogram
A mammogram is an x-ray that can detect breast cancer early; often before a lump can be felt.   It is best to schedule this test a week after your period, a time when your breasts will be least tender and glandular.  If you are taking Hormone therapy after menopause your breasts may appear more glandular or dense from the hormones.  Ask your doctor about stopping the hormones a few weeks before the scheduled test.  Women over 50 should have this test yearly.  Women at high risk for breast cancer should ask about a digital mammogram and an MRI.

Colon cancer screening:
Talk to your doctor about colon cancer screening at the age of 50 – or sooner if colon cancer, colon polyps, inflammatory bowel disease or other cancers such as breast, ovarian, endometrial or prostate run in your family.  At the least, you should have an annual rectal exam and check of the stool for occult or hidden blood.  Ideally you should also have a look inside of your entire colon once at age 50 (called a colonoscopy) and if it is normal, perhaps this test could be repeated no more often that once every 5-10 years depending on your history. 

Dental
A dental exam checks for decay and plaque buildup and to look for signs of inflammation and infection.  Women at risk for heart disease, metabolic syndrome or diabetes (women with waist circumference over 35 inches or apple-shaped women) should be particularly concerned about regular every 6 month checkups.

Vision
Everyone should have their eyes checked on a regular basis.  This exam can check for vision, cataracts and even glaucoma.  Patients with metabolic syndrome or diabetes should also have an annual opthalmology exam by an opthalmologist to check the retina as well (see below for apples).

Total skin exam
Melanoma, the most serious form of skin cancer, is reaching epidemic levels thanks to excessive sun exposure and loss of the protective ozone layer.  It is important that you get a head-to-toe check of your skin on an annual basis.

EKG 
A baseline EKG to assess your heart’s electrical activity should be done by age 50.  IF you are at increased risk for heart disease, ask for a special CT scan, stress test using a heart ultrasound or special dye to get more accurate pictures of your heart.

Note: Ask your doctor to reduce the size of your printout on a copy machine. Then carry it with you in your wallet along with your emergency health card. Also keep a copy in your binder or folder for future reference. If you need emergency care, a copy of your old EKG compared to a new one will help your doctors decide how best to treat you.

Make sure you understand the purpose of every exam or test your doctor orders for you. Because everyone is different you must be sure to talk with your doctor about your specific treatment goals.

In addition, keeping an ongoing log of any tests or procedures you’ve had and recording the information in your calendar will help remind you to schedule regular checkups such as mammograms and a cholesterol check.

Immunizations
Don’t forget your annual flu shot starting at age 50 AND at age 65 get a pneumonia vaccine once only.  Also every 10 years tetanus/diphtheria shot.

You know you are healthy at 50–60 if you have…

• Waist circumference under 35 inches
• Blood pressure <120/80
• Blood lipids: LDL cholesterol <100, HDL > 50, TG (triglycerides) <150
• Fasting blood glucose <100
• EKG: baseline and CRP blood test if WC over 35 inches
• Sleep 7-8 hours at night
• Eat fruits, veggies, grains and healthy fats
• Don’t smoke
• Reduce stress in your life
• <1 glass wine daily
• Exercise/walk 30 minutes or more daily
• Discuss daily baby aspirin and multivitamin (silver or no iron variety) with doctor

Cancer risk

• Negative PAP and HPV test (repeat every 3 years)
• Normal rectal exam and colonoscopy (repeat in 5-10 years)
• Normal breast exam and mammogram yearly

Osteoporosis

• Bone density test: T-score of lumbar spine and hip <2.0
• Consume 1200 mg Calcium and 600 IU of Vitamin D daily
• Walk 30 minutes daily and lift weights 3 x’s/week

Mental health

• Strong friendships
• Sleep 7-8 hours at night
• Relaxation/reduce stress      

Menopause assessment

• Weigh pros and cons of hormone therapy
• Assess menopausal status and risk with practitioner

Make sure you ask for copies of all your test results and keep them in chronologic order in your health record.  For more information or to download Dr. Savard's special health form titled “test results at-a-glance (for women),” visit www.DrSavard.com.

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