Topics

• History
• Functional Assessment
• Immunizations, Screenings and Health Promotion
• Physical Exam

NDNP 819: Advanced Health Assessment Across the Lifespan

Module: Geriatrics

Immunizations, Screenings and Health Promotion

For immunizations, make sure to ask about influenza, pneumococcal, tetanus and herpes zoster. Older adults’ health screening includes colon cancer screening (fecal occult blood, sigmoidoscopy, or colonoscopy), breast cancer screening for women (mammograms), and alcohol misuse. Health promotion opportunities include exercise, nutrition, and social system development to reduce isolation. Do not assume older adults do not have sexuality issues, alcohol or other drug use. Ask the questions just as you would with other age groups.

These are current recommendations from the US Preventive Services Task Force (2016) for older adults:

Screening	Gender/Age Group	Type
Abdominal Aortic Aneurysm	Men Ages 65 to 75 Years who Have Ever Smoked	One-time screening with ultrasonography
Blood Glucose	Adults aged 40 to 70 years who are overweight or obese	As part of cardiovascular risk assessment- offer or refer patients with abnormal blood glucose to intensive behavioral counseling interventions
Colorectal cancer	Adults aged 50 to 75 years	Starting at age 50 years and continuing until age 75 years
HTN	Adults aged 18 years or older	Recommends obtaining measurements outside of the clinical setting for diagnostic confirmation before starting treatment
TB	Asymptomatic adults at increased risk for infection	Screening for latent tuberculosis infection (LTBI) in populations at increased risk.
Lipids	Men 35 and Older Women 45 and older at increased risk for CHD	Screening men aged 35 and older for lipid disorders. Screening women aged 45 and older for lipid disorders if they are at increased risk for coronary heart disease.
Osteoporosis	Women, 65 and Older	In younger women whose fracture risk is equal to or greater than that of a 65-year-old white woman who has no additional risk factors.

Immunization schedule

The most important vaccines for older adults are: shingles, influenza, TD/Tdap, and pneumonia. For more information click the links below:

Lay person: https://www.vaccines.gov/who_and_when/adults/seniors/index.html

CDC chart by age Adult Immunization Schedule 2020.pdf