Barbara Resnick, PhD, CRNP, FAAN, FAANP


Topics in Advanced Practice Nursing eJournal. 2001;1(1) 

In This Article

Guidelines for Primary and Secondary Prevention

With regard to primary prevention, all older adults should receive influenza, pneumonia, and tetanus/diphtheria prophylaxis.[7] Current recommendations for secondary prevention suggest that older adults should at least have a yearly fecal occult blood test and prostate exam.[8]

There is uncertainty and ambivalence about breast cancer screening for older women, and recommendations for screening vary based on the source. The US Preventive Services Task Force does not recommend routine screening for women older than age 69 years,[9] while the American Medical Association[10] and the American Cancer Society[11] recommend annual screening mammograms for all women ages 50 years and older. The Medicare program, despite the lack of professional consensus, provides coverage for a yearly screening mammogram for all women over the age of 40 years [Social Security Act 1833 (b), 1834(c)(2)(a)].

There is some evidence to suggest that seniors benefit just as much from primary and secondary health promotion activities as do the middle-aged.[7] Exercising, reducing cholesterol levels, and monitoring blood pressure improve overall health status and physical fitness of older adults. Specifically, these benefits include increased aerobic power, strength, balance, flexibility, and the prevention of acute medical problems such as fractures, myocardial infarctions, and cerebral vascular accidents.[7,12,13]

Screening with mammography, a Pap test, digital exam for monitoring prostate size, and yearly evaluation of stool specimens for occult blood can help reduce mortality and morbidity among older adults.[14,15,16] For example, McCarthy and colleagues[15] recently reported a study of nearly 10,000 older women, which showed that regular mammography reduced the risk for breast cancer mortality, even for those ages 85 years and older.


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