Prevention Guidelines for Men 65+

Screening tests and vaccines are an important part of managing your health. A screening test is done to find diseases in people who don’t have any symptoms. The goal is to find a disease early so lifestyle changes and checkups can reduce the risk of disease. Or the goal may be to find it early to treat it most effectively. Screening tests are not used to diagnose a disease. But they are used to see if more testing is needed. Health counseling is important, too. Below are guidelines for these, for men ages 65 and older. Talk with your healthcare provider to make sure you’re up to date on what you need.

ScreeningWho needs itHow often
Abdominal aortic aneurysmMen ages 65 to 75 who have ever smoked1 ultrasound
Alcohol misuseAll adultsAt routine exams
Blood pressureAll adultsYearly checkup if your blood pressure is normal*Normal blood pressure is less than 120/80 mm Hg*If your blood pressure is higher than normal, follow the advice of your healthcare provider.
Colorectal cancerAll men at average risk in this age group through age 75 who are in good health. For men ages 76 to 85, talk with your healthcare provider to see if you should continue screening. For men 85 and older, screening is not advised.Several tests are available and are used at different times.For tests that find polyps and cancer:Flexible sigmoidoscopy every 5 years, orColonoscopy every 10 years, orCT colonography (virtual colonoscopy) every 5 yearsFor tests that mainly find cancer:Yearly fecal occult blood test, orYearly fecal immunochemical test, orStool DNA test every 3 yearsYou will need a colonoscopy if you choose a different test and have an abnormal test result, Screening advice varies among expert groups. Talk with your healthcare provider about which tests are best for you.Some people should be screened using a different schedule because of their personal or family health history. Talk with your healthcare provider about your health history.
DepressionAll men in this age groupAt routine exams
Type 2 diabetes or prediabetesAll men starting at age 45 and men without symptoms at any age who are overweight or obese and have 1 or more extra risk factors for diabetesAt least every 3 years (annual testing if your blood sugar has begun to rise)
Type 2 diabetesAll men with prediabetesEvery year
Hepatitis CAnyone at increased risk for infectionAt routine exams
High cholesterol and triglyceridesAll adultsAt least every 5 years
HIVAnyone at increased risk for infectionAt routine exams
Lung cancerAdults ages 55 to 80 who have smokedYearly screening in smokers with 30 pack-year history of smoking or who quit within 15 years
ObesityAll adultsAt routine exams
Prostate cancerAll men in this age group, talk to healthcare provider about risks and benefits of digital rectal exam (DRE) and prostate-specific antigen (PSA) screening***At routine exams
SyphilisAnyone at increased risk for infectionAt routine exams
TuberculosisAnyone at increased risk for infectionCheck with your healthcare provider
VisionAll adults1Every 1 to 2 years. If you have a chronic disease, ask your healthcare provider how often you need an exam.
CounselingWho needs itHow often
Aspirin for primary prevention of cardiovascular eventsMen ages 45 to 69 when potential benefits from a decrease in heart attacks outweigh the harm or risks from an increase in gastrointestinal bleedingWhen diagnosed with a risk for cardiovascular disease. Check with your healthcare provider before starting
Diet and exerciseAdults who are overweight or obeseWhen diagnosed and at routine exams
Fall prevention (exercise, vitamin D supplements)All men in this age groupAt routine exams
Sexually transmitted infection preventionAnyone at increased risk for infectionAt routine exams
Tobacco use and tobacco-related diseaseAll adultsEvery visit
ImmunizationWho needs itHow often
Tetanus/diphtheria/pertussis (Td/Tdap) boosterAll adultsEvery 10 years. Tdap is advised if you have contact with a child younger than 12 months. Either Td or Tdap can be used if you have no contact with infants.
Chickenpox (varicella)All adults ages 65 and older who have no previous infection or vaccine**2 doses. The second dose should be given at least 4 weeks after the first dose.
Flu (seasonal)All adultsYearly, when the vaccine is available
 Haemophilus influenzae type B (HIB)People at risk1 to 3 doses
Hepatitis APeople at risk, such as travelers2 doses given at least 6 months apart. These should give long-lasting protection
Hepatitis BPeople at risk, such as travelers and those with chronic liver disease3 doses; the second dose should be given 1 month after the first dose, and the third dose should be given at least 2 months after the second dose (or at least 4 months after the first dose)
Pneumococcal conjugate vaccine (PCV13) and pneumococcal polysaccharide vaccine (PPSV23)All adults ages 65 and older1 dose of each vaccine
ZosterAll men ages 60 and older2 doses of the Recombinant Zoster Vaccine (RZV), 2-6 months apart. RZV is advised even for people who have had the live shingles vaccine called Zostavax. There is no live virus in RZV.

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