Health Maintenance: Ages 40–64 Years

Chapter 5 Health Maintenance: Ages 40–64 Years



IMPORTANT CONSIDERATIONS (PHYSIOLOGIC CHANGES)


The 40- to 64-years age group is notable for the transitions from reproductive function to maturity, from rhythmic menstrual function to menopause, and from robust health to the emergence of age-related health changes.



Leading Causes of Death



• Breast, lung, colorectal, and ovarian cancer

• Coronary artery disease

• Cerebrovascular disease

• Obstructive pulmonary disease

• Accidents

• Diabetes mellitus and its complications


Leading Causes of Morbidity



• Nose, throat, and upper respiratory conditions

• Osteoporosis

• Arthritis

• Hypertension

• Depression

• Orthopedic deformities, including back and upper and lower extremities

• Obesity

• Heart disease

• Hearing and vision impairments


SCREENING



History



• Reason for visit

• Health status: medical, surgical, family

• Dietary/nutritional assessment

• Physical activity

• Tobacco, alcohol, other drugs (including complementary and alternative medicines)

• Abuse/neglect

• Sexual practices

• Urinary and fecal incontinence (These issues become more common with childbearing and age, but patients seldom volunteer these complaints.)


Physical



• Height

• Weight (body mass index)

• Blood pressure

• Oral cavity

• Neck: adenopathy, thyroid

• Breasts

• Abdomen

• Pelvic and rectovaginal examination

• Skin


Laboratory



Periodic



• Pap test (physician and patient discretion after three consecutive normal test results if low risk)

• Cholesterol, high-density lipoprotein cholesterol (every 5 years, starting at age 45 years)

• Fecal occult blood test (Testing requires the collection of two to three samples of stool collected by the patient at home to be valid. A single stool sample collected at the time of digital rectal examination is not sufficient to adequately screen for colon cancer.)

• Sigmoidoscopy (every 3 to 5 years after age 50 years; double-contrast barium enema study may be substituted or a complete colonoscopy may be performed every 10 years)


As Indicated by Risk Factors



• Bacteriuria testing

• Colonoscopy

• Fasting glucose test

• Hemoglobin

Related posts:

  1. Health Maintenance: Ages 65 Years and Older
  2. Urinary Incontinence: Bypass, Overflow
  3. Acne Inversa (Hidradenitis Suppurativa)
  4. Breast: Intraductal Papilloma

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Jun 6, 2016 | Posted by in GYNECOLOGY | Comments Off on Health Maintenance: Ages 40–64 Years

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