Preventive Care: Ages 40 to 64

The following is a summary of the preventive health care schedules for adults ages 40 to 64 who have no risk factors for, or diagnosis of, a chronic disease or health condition. You should discuss the prevention steps listed with your health care provider. He or she will suggest a schedule that is tailored to your needs. The recommendations are derived from the U.S. Preventive Services Task Force, the Centers for Disease Control and Prevention (CDC) and the American Diabetes Association.

Listed with each prevention step is the recommended frequency of performing the step.

When to Schedule a Visit

Men should see their doctor every five years for a complete preventive care visit. Women should schedule a visit every three to five years. Each visit includes a height and weight check, blood pressure check, preventive counseling, health risk assessment and any other necessary screening tests or immunizations. Blood pressure checks, influenza vaccinations, clinical breast examinations and mammograms may need to be done more often.

Screening Tests and Immunizations

Men and Women

• Blood pressure check: every two years.

• Weight: Ask your health care provider to calculate your body mass index at each routine visit.

• Cholesterol check: men, every five years; women, every five years, beginning at age 45. Women who smoke, or have diabetes or a family history of heart disease should start having cholesterol checked at age 20.

• Screening for depression if you've felt "down," sad or hopeless, and have felt little interest or pleasure in doing things for two weeks straight.

• Diabetes screening: have your fasting blood glucose checked at least every three years.

• Colon cancer screening: begin at age 50; check with your doctor to find out how often you should have this screening.

• Influenza vaccine: every year, beginning at age 50.

• Diphtheria/tetanus/pertussis: adult tetanus/diphtheria/pertussis vaccine (Tdap) was approved in 2005 and is recommended every 10 years.

• Measles/mumps/rubella (MMR): one dose. The CDC recommends that adults born during or after 1957 receive one dose of MMR unless they have a medical reason not to do so, have medical records showing they already have been immunized or have other acceptable evidence of immunity. Some people may require a second immunization; talk to your health care provider to find out if you need one.

• Hepatitis B vaccine is available for people in this age group who are at risk for exposure to hepatitis B.  If you have any questions regarding risk, discuss them with your doctor.

• A vaccine to prevent shingles (Zostavax) was approved by the U.S. Food and Drug Administration in 2006.  It reduces the incidence of shingles by about half.  The vaccine is recommended for people 60 and older.

• Aspirin: Periodically discuss with your doctor whether you should take aspirin to prevent heart attack or stroke. Men should begin asking at age 40; women at age 50.

Men

• Prostate screening: at age 50, ask your health care provider if you should have tests to screen for prostate cancer. If your father or brother had prostate cancer before he was 65 years old, or if you are African American, you may need to begin screening at age 40 or 45. Talk to your health care provider about your risks.

Women

• Clinical breast examination: every year.

• Mammogram: every one to two years, beginning at age 40.

• Pap test and pelvic examination: every one to three years, depending on the type of test and past results.

Risk Factors That May Alter Preventive Care Schedule

• High blood pressure; elevated cholesterol, smoking; fat stored above or near waist.

• Residents of chronic care facilities such as nursing homes; people with diabetes or chronic lung or kidney disease; health care workers who see patients at high risk.

• Chronic heart, kidney, or lung disease; diabetes; alcoholism; Hodgkin's disease; cirrhosis; sickle cell disease.

• For men: smoking; high blood pressure; African American; diabetes; obesity; sedentary lifestyle; family history of heart disease.

• History of ulcerative colitis, severe dysplasia (abnormal changes in cells) or Crohn's disease; mother, father, sister or brother with colon cancer; obstruction in flow of urine.

• Having first intercourse before age 18; history of several sex partners or of a sexual partner who has had several other partners.

• A serious wound; a tetanus booster may be recommended if it has been more than five years since the last one.

• Mother, sister, or daughter with breast cancer; previous breast biopsy; personal history of cancer.

• Inadequate calcium and vitamin D intake for both genders, but especially women.

Lifestyle Habits

It is never too late to eat a healthier diet, get regular physical activity or stop using tobacco. If you have developed unhealthy habits over the years, do not give up hope. Slowly change your habits and set goals to improve the behaviors that can lead to a healthier lifestyle.