Older adults seeking health care are at risk of overtreatment and unnecessary tests. Many common medical tests are not recommended after a certain age or if there are no symptoms.
Certain examinations may be contraindicated in the elderly PHOTO Shutterstock
After age 65, many people see their doctor more often to get help managing a chronic disease or simply to keep their health under control, notes VeryWell Health.
Many older adults do not realize that some routine examinations and treatments may be unnecessary or even harmful to them.
A recent study highlighted the need for safeguards to avoid overtreatment of older adult patients, which may include unnecessary tests and screenings, particularly for prostate cancer (PSA test), urinary tract infections (UTIs), and diabetes.
Scheduling a simple screening or adjusting a treatment plan may not seem like a problem, but it can actually have negative health consequences for older adults. Unnecessary medical examinations can be both constitutive and stressful.
Many older women naturally have bacteria in their bladder that can cause a UTI test to come back positive. However, the presence of bacteria in the urinary tract does not mean that they are causing an active infection, especially if there are no symptoms.
False positive tests and the unnecessary use of antibiotics
When an asymptomatic patient receives a positive screening, this can lead to an antibiotic prescription that is unnecessary but could have side effects such as nausea, diarrhea, and dizziness. The big picture shows that prescribing antibiotics that patients don't need is contributing to antibiotic resistance – a growing problem.
Screenings for prostate cancer are another common example. A study found that PSA testing in men over the age of 69 often leads to false positives, leading to invasive procedures and side effects of treatment. This is part of the reason why the US Preventive Services Task Force (USPSTF) does not recommend PSA screenings for men age 70 and older.
Another risk for older adults is the negative health consequences of overtreating diabetes. While managing blood sugar levels is important, glycemic control must be modified as people age and their bodies change.
Katherine Ward, a board-certified geriatrician at Stanford Senior Care, told Verywell that diabetes management guidelines should be relaxed for older adults because they are at increased risk for hypoglycemia (low blood sugar), which maybe it can even put their lives in danger.
“There is a lot of awareness that some tests and treatments in medicine are used in clinical situations where they have not been shown to be beneficial”Purcell said.
Exams that should be modified for older adults—or avoided
Experts say there are other common medical tests that might be modified for older adults or even omitted for some patients. Medical providers must weigh the benefits against the potential harms in each case. The decision to have a test or not should be based on the patient's health history, current physical health, and life expectancy.
Common medical tests and examinations that older adults may not need include:
Colonoscopy;
Mammography;
Papanicolaou;
Anxiety screenings;
Detection of type 2 diabetes.
Tests and recommended treatments for older adults
While there may be some tests and exams that older adults don't need, that doesn't mean they should forego routine medical care. Routine screenings and vaccines that are recommended for the senior population include:
Blood pressure measurement;
Cholesterol level measurement;
Vision and hearing exam;
Bone density scan (DEXA scan);
Influenza vaccine;
Pneumococcal vaccine;
The RSV vaccine.
Patients should ask their doctor when they do not understand why a screening is recommended and always be informed about the risks and benefits.
