List of health check-up items for the elderly

For ordinary elderly people over 60 years old without serious underlying diseases, routine health check-ups with 11 mandatory items clearly required by the state can cover most risks.； For those with chronic diseases, family medical history or high-risk lifestyle habits, it is enough to add 3-6 optional items in a targeted manner. There is no need to choose a "full set of high-end physical examination packages" that often cost tens of thousands of yuan. Over-examination may cause unnecessary radiation damage and psychological anxiety.

I have been involved in physical examinations for the elderly in a community health service center for almost five years. I have helped thousands of elderly people adjust their physical examination plans. I have seen too many situations where key items were missed and the condition was delayed, or a bunch of useless items were spent in vain. Today I will clarify my practical experience for everyone.

First, let’s talk about the must-check items that everyone can do for free in the community. Don’t think that the free ones are not good. These are all determined by the National Health Commission based on the incidence data of the elderly population in China, and they are very practical. Needless to say, conventional height, weight, blood pressure, and waist circumference need not be mentioned in detail. As a reminder, if the waist circumference exceeds 90cm for men and 85cm for women, even if the weight is normal, the risk of metabolic syndrome will be 2-3 times higher than that of ordinary people. Don’t take it seriously. Next are the three major routines of hematuria and stool, especially fecal occult blood. Many elderly people find it troublesome and do not want to keep it. This is the most basic method for early screening of gastrointestinal bleeding and colorectal cancer. Last year, we screened out three cases of early-stage intestinal cancer through fecal occult blood. Because it was discovered early, the surgery basically did not affect their lives. Then there are four items including liver function, kidney function, fasting blood sugar, and blood lipids, as well as electrocardiogram and abdominal B-ultrasound (liver, gallbladder, pancreas, spleen, and kidneys). These are standard for checking basic chronic diseases. The remaining two are easily overlooked by many people. One is fundus examination, which does not require dilation. It can not only check for cataracts and glaucoma, common eye diseases in the elderly, but also directly see the degree of hardening of retinal blood vessels and predict the risk of cardiovascular and cerebrovascular accidents. It is more effective than many expensive examinations. ； The other is cognitive function and fall risk screening. Both are free. Just do a few small tests. Early detection of cognitive decline and poor balance ability can greatly reduce the probability of Alzheimer's disease and falls and fractures through early intervention.

Having said this, someone must ask, among the various extras recommended by the physical examination center, which ones are really useful? You really don’t need to add randomly, just pick according to your own situation. For example, if you have smoked for 20 to 30 years, or if you have a direct relative in your family who has suffered from lung cancer, you can add a low-dose spiral CT, which is several times clearer than an ordinary chest X-ray, and the radiation dose is only 1/3 of a conventional CT, which is completely sufficient. If you have high blood pressure, add homocysteine ​​and carotid artery B-ultrasound. If the former is high, it is easy to have a stroke, and supplementing with folic acid can reduce it. The latter can look at the carotid artery plaque and know in advance whether the blood vessel is blocked or not. If you have diabetes, add glycated hemoglobin and urine microalbumin. The former reflects the average blood sugar in the past three months, which is much more accurate than a single fasting blood sugar test. The latter is to see if there is early diabetic nephropathy, which can be reversed if detected early. If you often suffer from back pain and are more than 3cm shorter than when you were young, get a bone density test to check for osteoporosis and take vitamin D and calcium supplements early to avoid fractures after a fall. It is best for postmenopausal women to have gynecological B-ultrasound, TCT, and HPV examinations every three years. Don’t think that you don’t need to check as you get older. Last year, we screened out 2 cases of cervical precancerous lesions in postmenopausal women. Early treatment will not develop into cancer at all.

Here I have to talk about two types of projects that are particularly controversial right now. I am not biased towards either camp, I will explain it to you objectively. One is tumor markers. Nowadays, there is a school of thought that routine physical examinations are completely unnecessary. False positives are too high. For example, if you have some inflammation recently or have not slept well, it may cause the markers to rise, which will scare you half to death. ； The other group believes that people with high-risk factors can be targeted for investigation. My own experience is that if there is no family history of cancer and no discomfort, there is really no need to do a full set of tests. If there are related high-risk factors, such as a family history of gastric cancer, just check for CA72-4. If you are a regular smoker, just check for CEA and CYFRA21-1. Don't do a full set of more than ten items at the beginning. It is a waste of money. The other one is PET-CT, which the physical examination center likes to recommend, saying it can detect cancer throughout the body. To be honest, unless you are highly suspected of having cancer and want to check for metastasis, there is no need to do a routine physical examination. The radiation dose per session is equivalent to 10 chest CT scans. It is also expensive, costing more than 10,000 yuan, so it is really not worth it.

Oh, by the way, there are a few small things to note before the physical examination. Don’t take them seriously, otherwise the examination will be in vain. Don’t believe it, I met an old man last time. He ate half a catty of soy pork elbows the night before the physical examination. The next day it was found that his triglycerides were twice as high. He thought he had hyperlipidemia. He was scared for several days. Later, the reexamination came back normal, so he suffered in vain. Therefore, don’t eat too much food 3 days before the physical examination, and don’t deliberately go on a vegetarian diet. Just eat normally. Don’t eat after 8 pm the night before. It’s okay to drink less water. If you usually take antihypertensive or hypoglycemic drugs, you should take them normally without stopping. Otherwise, your blood pressure and blood sugar will rise and it will be dangerous. Just tell the doctor what medicines you take when you go for a physical examination. When retaining urine, leave the middle section and do not leave the beginning, otherwise it is easy to be contaminated and the results will be inaccurate.

In fact, there is really no need to think about physical examinations being too complicated, and there is no need to pursue as many items as possible. Expensive ones are not necessarily the right ones. If you are really not sure what items you should add, take your previous medical records and the medicines you usually take, and go to the community to find a family doctor to ask. It only takes less than 5 minutes and is much more reliable than searching for random package recommendations online. After all, everyone’s physical condition is different, and the one that suits you is the best.