Amy Isler, RN, MSN, CSN, is a registered nurse with over six years of patient experience. She is a credentialed school nurse in California.
Nick Blackmer is a librarian, fact-checker, and researcher with more than 20 years’ experience in consumer-oriented health and wellness content.
When was the last time you had your cholesterol checked? Or a Pap smear completed? Have you ever had the shingles vaccine or a bone density scan?
Many Americans don’t know the answer to these questions—and they don’t know when they’re even supposed to be asking.
According to the results of a national questionnaire used by the U.S. Department of Health and Human Services (HHS), only 8.5% of adults over 35 received all of the priority preventive services recommended for them in 2015, such as the ones mentioned above. By 2018, that percentage dropped to 6.9%—a figure that has likely worsened as a result of decreased access to health care during the pandemic.
As a result, HHS is focusing on increasing preventive care as part of its Healthy People 2030 campaign. On an individual level, you can take preventive health into your own hands every single year.
The first step? Knowing what to expect for your age group. The second step? Understanding what to ask about it.
We spoke with two primary care physicians on health changes and recommendations most people can expect in their 40s and beyond, as well as what they wished patients knew to ask about decade by decade.
“Asking how you can optimize your health should be part of the conversation with your PCP [] at every visit, at every age,” Malathi Srinivasan, MD, clinical professor of medicine at Stanford University, told Verywell via email. “This question will open a conversation that will help your physician understand your individual health risks and personalize your care.”
If you don’t have a PCP, Danielle Carter, MD, FAAFP, a family physician in Jacksonville, Florida, says it’s never too late to get one. And it’s essential to healthy aging and maintaining your independence over time.
“If you don’t already have an established relationship with a family physician or primary care doctor, don’t delay,” Carter told Verywell via email. “It’s important to take good care of yourself as you age. You’re worth it!”
If you think you notice some physical changes after turning 40, you’re not alone. Srinivasan explains that habits such as drinking, smoking, recreational drugs, and lack of exercise catch up with us in our 40s, as do decades of sun exposure.
In addition, your 40s can mark the onset of several common chronic conditions.
“At age 40, we begin additional recommended screenings,” Carter said. “During middle age, we are more likely to be diagnosed with ‘silent’ conditions like high blood pressure, high cholesterol, or diabetes that need to be treated to prevent complications later in life.”
Beyond annual blood tests, there are a number of recommended screenings that should happen in your 40s, including:
In addition to going over family history, Srinivasan recommends asking your PCP the following important questions after turning 40:
Bone health, weight gain, and sexual health are important health factors to consider as we turn 50, Srinivasan says.
In this decade of life, bone starts to break down in the absence of weight-bearing exercises, calcium, and vitamin D. At the same time, metabolism tends to slow, and menopause may be linked to decreased libido.
Exercise and proper nutrition will help you optimize your lifestyle, as well as continued monitoring of any chronic diseases and general cardiovascular health.
While many of the recommended screenings for people in their 50s are the same as for people in their 40s, Carter emphasizes one unique screening that should enter the rotation: Current and former smokers should start getting annual low-dose CT scans of the chest in their 50s to look for lung cancer.
In addition routine blood work and blood pressure screenings, recommended screenings during your 50s include:
Talk to your PCP about the pros and cons of getting a prostate-specific antigen (PSA) test to screen for prostate cancer.
Srinivasan recommends asking your PCP the following important questions after turning 50:
According to Srinivasan, many people need to work harder to maintain their physical health in their 60s, especially if they’re experiencing a series of life transitions, like retirement.
Along with a reduction in muscle and bone mass, many people start to notice changes in cognitive functioning and a decline in immune function, putting them at an increased risk of infections.
For women in their 60s, in particular, bone density screening is a priority. That’s because, according to Srinivasan, 22% of women in their 60s have lost enough bone mass to increase their rate of fracture.
Men over age 65–75 with any history of smoking should be screened for an abdominal aneurysm.
In tandem with routine blood work and blood pressure screenings, people in their 60s should undergo:
Talk to your PCP about the pros and cons of getting a prostate-specific antigen (PSA) test to screen for prostate cancer.
“Check with your family physician, but based on prior history, you may be eligible to stop getting Pap smears at age 65,” Carter said. “Before discontinuing the screening, you should have two consecutive normal Pap smears.”
Srinivasan recommends asking your PCP the following important questions after turning 60:
Experts suggest taking the time to evaluate your household for any fall risks in your 60s and 70s.
While she describes your 70s as a vibrant decade, Srinivasan adds it’s especially important to focus on three things to avoid a slide into disability:
Depending on family history and risk factors, you may be able to stop a few screenings in your 70s.
“Discuss with your family physician the risks and benefits of discontinuing screening for colon cancer and breast cancer at age 75,” Carter said. “Women should continue bone density screening every two years, which is also sometimes recommended for men 75 and older.”
Recommended screenings in your 70s include:
Talk to your PCP about the pros and cons of getting a prostate-specific antigen (PSA) test to screen for prostate cancer.
Srinivasan recommends asking your PCP the following important questions after turning 70:
Preserving independence and focusing on physical, cognitive, and emotional wellbeing is important for people entering their 80s and beyond, Srinivasan says. Above all, she recommends preventing social isolation and monitoring for signs of cognitive impairment, also called dementia.
Part of aging tends to mean more medications. Carter adds that managing your prescriptions is of the utmost important in your 80s.
“I recommend having your medications reviewed at each primary care visit to ensure all medications are still necessary, dosed properly, and not causing any side effects or interactions,” she said.
Since the risk of some cancers, such as cervical cancer, declines as people age, many routine screenings are not recommended in your 80s and beyond. This is decided based on your overall health status.
“Being open about issues like problems with hearing, vision, mobility, balance, and thinking make a world of difference in getting early interventions in place to improve independence, healthspan, and lifespan,” Srinivasan said.
In addition to screening for high blood pressure and diabetes, and obtaining routine blood work, recommended screenings in our 80s include:
Srinivasan suggests asking your PCP the following important questions after turning 80:
Department of Health and Human Services. Healthy People 2030: Increase the proportion of adults who get recommended evidence-based preventive health care — AHS-08.
American Academy of Family Physicians. Adult preventive health schedule: recommendations from the USPSTF.
American Cancer Society. Guideline for colorectal cancer screening.
U.S. Preventive Services Task Force. Final recommendation statement—cervical cancer: screening.
Centers for Disease Control and Prevention. Breast cancer screening guidelines for women.
U.S. Preventive Services Task Force. Final recommendation statement—prediabetes and type 2 diabetes: screening.
Centers for Disease Control and Prevention. Adult immunization schedule: recommendations for ages 19 years or older, United States, 2022.
U.S. Preventive Services Task Force. Final recommendation statement—colorectal cancer: screening.
U.S. Preventive Services Task Force. Final recommendation statement—prostate cancer: screening.
Centers for Disease Control and Prevention. Shingles vaccination.
U.S. Preventive Services Task Force. Final recommendation statement—abdominal aortic aneurysm: screening.
By Amy Isler, RN, MSN, CSN Amy Isler, RN, MSN, CSN, is a registered nurse with over six years of patient experience. She is a credentialed school nurse in California.
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