By Dr. Amber Brody, Geriatrician and Family Medicine Physician, Western Connecticut Medical Group Wilton Primary & Specialty Care
- Cognitive health, including depression and dementia, is a primary concern for women in their 70s and older.
- Fall risk increases for women in this age group due to declining strength, balance, and range of motion.
- Exercise is important to prevent health issues such as depression, dementia, falls, high cholesterol, hypertension, and obesity.
- Women age 70 and beyond should ask their healthcare clinician if they should continue to receive cancer screening tests.
Many women in their 70s are busy working, traveling, pursuing hobbies, and running around with grandkids, which makes preventive health care critical to keeping up with their active lifestyle. Overall, health maintenance for women in their 70s is similar to when they were in their 50s and 60s, but a notable change is a focus on cognitive health.
Although some women may have postponed preventive care, screenings, and annual physicals during the COVID-19 pandemic, now is the time to get back on track and resume normal healthcare routines. All Nuvance Health facilities have implemented enhanced patient safety protocols, so there’s no reason to put off in-person appointments, tests, and screenings due to COVID-19 concerns. For more information, visit nuvancehealth.org/safecare.
Here’s a list of health screenings recommended for women in their 70s and beyond:
Women in their 70s and beyond often see their primary care clinician more than once a year for various screenings and health concerns. However, it’s still important for women in this age group to have an annual physical.
During an annual physical, a woman’s primary care clinician will review her personal medical history and family history to determine which tests and screenings she needs.
For example, women in their 70s should be screened for heart disease. Their clinician will calculate body mass index based on height and weight and will check blood pressure to make sure it’s within normal range. Electrocardiograms (EKGs) may also be a regular part of the annual exam for women in their 70s and beyond if they have any cardiac symptoms, hypertension (high blood pressure), or a history of cardiac conditions.
Blood work should be done to check for anemia, elevated cholesterol, kidney function, and liver function. Certain blood tests such as hemoglobin A1c to rule out diabetes, and thyroid function tests to rule out hypo- or hyperthyroidism, may not be routinely performed unless the patient has a personal or family history that places them at higher risk for these diseases. A urinalysis should also be done to assess for blood, protein, or signs of infection in the urine. Women over the age of 64 should also have a bone density test, also called a DEXA scan, to look for signs of osteoporosis.
Although an in-person exam is typically required during an annual physical, women in their 70s and beyond may be able to conveniently access follow-up or sick care services from the comfort of their home using Virtual Visits. For more information, to schedule an appointment, or to find a clinician, visit nuvancehealth.org/virtualvisits.
Cognitive Health: Depression and Dementia
Cognitive health is one of the main concerns for women in their 70s and older. Depression is common due to the losses of family and friends that older adults may begin to experience. Isolation due to family living far away, inability to drive, and fewer opportunities for social connections can also increase the risk of developing depression.
Depression can lead to poor self-care and “pseudo-dementia” — appearing to have dementia because of depression. If cognitive symptoms resolve after starting antidepressant medication, however, dementia may be ruled out.
Older adults should talk to their primary care clinician if they are experiencing signs of depression. Their primary care clinician may be able to refer them to a mental health professional for additional care.
Age-related dementia is the most common form of dementia. Women 65 and older can be screened for dementia with a mental status exam (MSE) at their annual physical, or more frequently if necessary. Exercising regularly and quitting smoking can reduce the risk of developing age-related dementia.
Getting older is not for the weak of heart. Arthritis is a widespread problem for women over the age of 70. The good news is there are medications that control arthritic pain and slow symptom progression. Pain management specialists are particularly helpful. Pain management specialists may be able to offer specialized treatment to get arthritis pain under control.
Strength, Balance, and Falls
Women in their 70s and older are at increased risk of falls; strength and balance tend to decrease as women reach their 70s, and range of motion decreases too. So it’s important to be proactive to prevent falls. I’ve had patients who have fallen and sustained injuries that could have been prevented.
Women can remove fall risks in their environment, such as area rugs, small tables, and unnecessary clutter. They should take their time going up and down stairs and avoid walking around their home in the dark.
This age group is lucky to have reached their 70s and beyond because there weren’t vaccines for diseases such as measles and polio when they were children.
Even in their 70s and beyond, there are still several vaccines women need to get to prevent infectious diseases, including:
- An annual high-dose flu vaccine
- Pneumonia vaccine, such as Pneumovax 23 for those 65 and older without comorbid conditions, or Prevnar 13 for those with comorbid conditions (healthcare clinicians may recommend a pneumonia booster every 10 years)
- One-time shingles vaccine after age 50; this includes the initial vaccine and then a booster
Hepatitis C Screening
The United States Preventive Services Task Force (USPSTF) recommends screening for hepatitis C virus infection (HCV) in adults aged 18 to 79 years. Baby boomers (people born between 1946 and 1964) are more likely to have Hepatitis C than other people. Hepatitis C is a liver infection caused by HCV.
Women in their 70s and beyond should exercise regularly. Regular exercise benefits heart health, boosts metabolism, reduces fall risk, and helps prevent high cholesterol, hypertension, and obesity.
It’s never too late to start exercising. Aerobic activity and weight-bearing exercises — such as walking or dancing — are both good options. The important thing is for women to get moving to get their heart rate up.
Women in their 70s and older should have their vision screened annually to detect cataracts, which can develop at this age. Cataracts progress slowly and impair vision, particularly at night.
People at this age may have difficulty driving at night due to cataracts so they tend to avoid going to events in the evening. This can lead to social isolation and depression. So it’s important to see an eye doctor at least annually because they may be able to detect cataracts before that start to cause vision problems.
The USPSTF recommends annual lung cancer screening for adults aged 55 to 80 if they currently smoke, have a history of smoking an average of a pack a day for 30 years (called “30 pack year”), or quit smoking within the last 15 years. Here’s more information about screening for lung cancer.
Women should continue to receive mammograms every one to two years until age 75. After that, women should talk to their healthcare clinician about whether to continue breast cancer screenings.
Most women can stop having Pap tests after age 65 to screen for cervical cancer, as long as they have no history of cancer or pre-cancer.
Like mammograms, women should continue to receive colonoscopies until age 75, and then speak to their healthcare clinician about whether they should continue to have colorectal cancer screenings.
Sexually transmitted infections (STIs), such as chlamydia and gonorrhea, are on the rise in older adults. I see patients who say things like, “I’m too old to get an STI,” or, “I made it through the 1960s, why would I be concerned about STIs now?”
Social factors like losing a spouse, having a spouse with dementia, or divorce can lead to women being sexually active with multiple partners as they age.
Women should talk with their healthcare clinician about their sex life as they age. They can simply say, “I’m sexually active, can I get an STI check?”
The Bottom Line
Women in their 70s and beyond need to be aware of changes in their cognitive health and physical strength, and stay on top of other issues such as arthritis and vision problems that are common for this age group. They should get recommended screenings and discuss any concerns they have with their primary care clinician.
This health checklist is a great starting point to prepare women for what they may expect health-wise when they’re in their 70s and beyond. But remember, everyone is unique. Women should speak with their healthcare clinician about their own personal health history, family health history, race/ethnicity, and lifestyle to know what types of screenings, tests, and support makes sense for them.
To schedule an appointment with a Western Connecticut Medical Group primary care clinician, visit our website or call (203) 739 4700.
Amy Forni, Manager, Public Relations
(203) 739 7478 | Amy.Forni@nuvancehealth.org