What are the items in the elderly health examination?

In fact, there is no unified "standard answer" for the elderly physical examination. The core is to first complete the basic required examination items with high cost performance, and then add targeted items based on your own chronic diseases, family medical history, and living habits. There is no need to blindly pursue "luxury packages" that cost tens of thousands.

I have worked in the community physical examination department for 6 years, and I have seen too many elderly people save money and choose ridiculously expensive packages. As a result, the items that should be checked are omitted. Last week, Aunt Zhang, who has 12 years of diabetes, chose a package worth more than 8,000 yuan. It included PET-CT and various rare tumor markers. As a result, it did not include even the most basic fundus examination and urine microalbumin. This means that the target organ damage that should be monitored for diabetes was not checked at all, and the money was wasted.

Don’t think that those basic items worth tens of dollars are useless. Routine hematuria, liver and kidney function, blood lipids, fasting blood sugar, electrocardiogram, ordinary chest X-ray, and abdominal ultrasound can really screen out big problems. Last month, there was a 73-year-old Uncle Wang who didn’t feel any discomfort at all. A routine blood test showed a low red blood cell count and a weak positive for fecal occult blood. We reminded him to go for a colonoscopy, and the result was that he had early-stage intestinal cancer. If he had minimally invasive surgery, he would be fine. If he missed this basic item, and symptoms of hematochezia and weight loss would appear, he would probably be in the middle and late stages.

The basic items are for all the elderly. If you have clear underlying diseases or lifestyle habits, you will need to add additional items. For example, if you are an old smoker who has been smoking for thirty or forty years and smokes a pack every day, don’t just take a chest X-ray. You must also add a low-dose spiral CT. This is several times more sensitive to early pulmonary nodules than a chest X-ray. I met a 69-year-old Uncle Li the year before last. Chest X-rays taken every year were normal. However, following our advice, a low-dose CT was added, and a 7mm ground-glass nodule was detected. There was no change after two years of follow-up. Now, annual re-examination is enough. If the abnormality can be found on chest X-rays, it has basically progressed to the point where it is difficult to deal with.

For elderly people with high blood pressure, it is recommended to perform carotid artery ultrasound and cardiac ultrasound to see if there are plaques in the blood vessels and whether the heart is thickened due to long-term high blood pressure.； Elderly people with diabetes need to check their fundus, urine microalbumin, and glycosylated hemoglobin. These can detect damage to target organs such as the retina and kidneys early. By the time you feel blurred vision or swollen feet, the damage is basically irreversible. There are also many elderly people who always feel pain all over the body and their hunched back is getting worse. Don’t always think that it is “normal as you age.” If you do a bone density test, you will know whether it is osteoporosis. Last year, an aunt fell and fractured her femoral neck. The preoperative bone density test showed that she had severe osteoporosis. If it had been diagnosed two or three years earlier and regular supplements of calcium and vitamin D, the fracture would not have occurred after a fall.

There are indeed different views in the industry regarding popular items such as tumor markers and genetic testing. Some institutions believe that the more complete the investigation, the better, so that risks can be detected early. However, more clinicians suggest that ordinary elderly people who do not have a clear family genetic history and no related discomfort symptoms really do not need to blindly do a full set of tumor markers. The false positive rate is very high, which can easily scare people away. As for the cancer gene test that costs several thousand dollars, unless there are several direct relatives in the family who have suffered from the same cancer, such as a mother or aunt who has suffered from breast cancer, or several grandparents who have colon cancer, otherwise it will have no reference value and is a complete waste of money.

Oh, by the way, there are also cognitive and emotional screenings that many people tend to ignore. Nowadays, many elderly people have not been found to have early-stage Alzheimer's disease or depression in the elderly. Spend ten minutes doing a simple scale assessment during the physical examination. Early intervention can greatly delay the course of the disease and improve the quality of life. In fact, to put it bluntly, there is really no need to be greedy for high prices when it comes to physical examinations for the elderly. When making the bill, tell the doctor clearly what underlying diseases you have, whether you are uncomfortable at ordinary times, and what serious illnesses your family members have suffered. The items provided will definitely be much more practical than those flashy package packages.