Written by Tina Sindwani, MD and Louis DePalo, MD 

Studies show genes determine only 20% of a person’s life expectancy, therefore lifestyle choices and disease prevention are extremely important factors in leading a long and healthy life.

Each stage of adult life also presents different health challenges or risks. See the below guidance on the vaccines, screenings, and general health tips for men and women to be aware of as they age. 

Jump to the Men’s Health Checklist

Jump to the Women’s Health Checklist

Please note: These checklists are for guidance and not comprehensive of all situations and needs. It’s important to speak with your provider about your family history and specific health concerns.

Tests, Vaccines, and Tips for Adult Women of All Ages

In May, for National Women’s Health Month, we discussed a few of the top health concerns facing women; heart disease, anemia, and irritable bowel syndrome. These are excellent examples of health risks or issues that women face and in many cases, don’t know to be concerned about or even how to treat them.

Since women are more likely to seek medical care at an earlier age, they are more likely to have routine physical exams and regular discussions about contraception and how to prevent disease. This may lead them to be more comfortable seeking care when health issues arise.

However, if women start to build families and care for children, their personal health can often take a back seat to others. This checklist is to remind women to prioritize their own health, including such things as vaccines, screenings and other health risks to be aware of as they age. 

Please note: This checklist does not include recommendations for pregnant women. For information about pregnancy and childbirth, consult your provider. 

Young adulthood: 20-40 years

This is a time when you are at your peak for physical and mental health, however it is also a time when child bearing/pregnancy becomes an issue for some women.

Developing healthy exercise, eating, and self care habits at this stage of life is crucial for sustaining long term well-being. Consult with your doctor on diet, exercise, sleep, smoking, STI screening and prevention, and alcohol consumption. Understanding the best contraception options is also important. These years can bring added stress with balancing careers and building a family. The USPSTF recommends screening for depression in the general adult population, including pregnant and postpartum women. Screening should be implemented with adequate systems in place to ensure accurate diagnosis, effective treatment, and appropriate follow-up. The coping mechanisms you develop at this stage will help you to endure through difficult periods later in life as well. 

Additionally, be sure to wear sunscreen when outside for prolonged periods, as well as sun protective clothing. The number of sunburns you have in your lifetime is cumulative, and can increase your risk of skin cancer long term.

Middle years: 40-60 years

Combination of lifestyle choices we made when we were younger mixed with genetic risk factors from our parents. 

Many women experience menopause during this stage. Talk with your doctor if you are experiencing increasingly painful, heavy, or unpredictable periods, hot flashes, or mood lability which can occur as you approach menopause. 

Heart health, high blood pressure and weight gain are all areas to watch during these years of life. Metabolism naturally slows with age, so maintaining an active lifestyle and healthy dietary habits will help to offset this. Adults should get 30 minutes of aerobic exercise per day, five days a week and two days per week of strength training. The Mediterranean diet has been studied as one of the best diets to follow to promote longevity and to reduce the risk of coronary artery disease and cancer. And remember to take care of your skin, your largest and most visible organ! Talk with your healthcare provider if you notice any skin changes, unusual moles, or if you have a family history of skin cancer.

Later years: 60+ years

A time when you need to be regularly on top of your health.

Chronic conditions such as arthritis and diabetes may become bigger concerns during these years, as well as falls that can lead to bone fractures. This makes maintaining muscle mass through strengthening exercises all the more important. Squats, pushups, and lifting hand weights are a good start. 

Grieving is also more prevalent in these years, with many people experiencing the loss of a partner, family, or friends. Staying socially involved and physically active are important for your mental health. You also want to engage in activities that stimulate your brain and cognition. 

Schedule routine consultations with your doctor to stay on top of any changes in health.

Vaccinations

• Flu shot every year
• Tetanus booster every 10 years
• Whooping cough vaccine (Tdap booster) once in adulthood (unless you had one as a preteen or teenager)
• Human papillomavirus (HPV) vaccine: If you’re 26 or younger and haven’t received it yet (catch up vaccination is now approved for adults up until the age of 45): 3 doses
• Shingles vaccine at age 50: 2 doses
• Two pneumonia vaccines starting at 65 

Screening Tests

Cholesterol

Starting at age 20, have your cholesterol tested every four to six years. If you have high blood pressure, a family history of heart disease, or other cardiac risk factors, you may need to be screened more often.

Blood Pressure

Starting at age 20, have your blood pressure checked at least every two years. If your blood pressure is above 120/80, you may need to be screened more often.

Type 2 Diabetes

Starting at age 45, this screening is usually done every 3 years. If you’re overweight, have a family history of diabetes, or have high blood pressure or high cholesterol, screening may begin earlier.

Sexually Transmitted Disease

If you’re sexually active with more than one partner, get screened at least once a year or more often if applicable.

HIV

All women between the ages of 13 and 64 should be screened at least once. Talk with your provider about how often you should be tested after the initial screening.

Learn more about HIV from our interview with Dr. Michael Mullen, a pioneer in HIV treatment, Director for the Institute of Advanced Medicine and a Professor of Medicine and Infectious Diseases at Mount Sinai Hospital in New York.

Breast Cancer

• Breast cancer is the most common cancer in women outside of skin cancer, with 1 in every 8 women developing breast cancer in their lifetime. Breast cancer is also the second most deadly cancer for women claiming 40,000 lives each year. 
• Women aged 20-39: your provider may perform a clinical breast exam every 1 to 3 years. 
• Women prior to 50 years: the decision to start screening mammography should be an individual one. There is much discussion on when to start screening. Women who place a higher value on the potential benefit than the potential harms may choose to begin biennial screening between the ages of 40 and 49 years. Our own Dr. Port has championed for women to start screening at age 40.  Other organizations argue that while screening mammography in women aged 40 to 49 years may reduce the risk for breast cancer death, the number of deaths averted is smaller than that in older women and the number of false-positive results and unnecessary biopsies is larger. The balance of benefits and harms is likely to improve as women move from their early to late 40s.
• Women with a parent, sibling, or child with breast cancer are at higher risk for breast cancer and thus may benefit more than average-risk women from beginning screening in their 40s or earlier.
• For women who are at average risk for breast cancer, most of the benefit of mammography results from biennial screening during ages 50 to 74 years. 
• Of all of the age groups, women aged 60 to 69 years are most likely to avoid breast cancer death through mammography screening. 
• At age 75: talk with your doctor about whether you should continue having regular mammograms.

Cervical Cancer

• Starting at 21 years, have a Pap smear every three years. 
• For women aged 30 to 65 years, the USPSTF recommends screening (Pap smear) every 3 years with cervical cytology alone, every 5 years with high-risk human papillomavirus (hrHPV) testing alone, or every 5 years with hrHPV testing in combination with cytology (cotesting).
• At age 65, most women can stop having regular Pap smears. Talk with your doctor about whether you should continue.

Eyes

• Annual exams are recommended for individuals with existing vision correction prescriptions.
• At age 40, all adults should receive an eye evaluation. 
• Women 65 and over with no risk factors should be examined every 1 to 2 years. This should include having your eyes checked for signs of cataracts, age-related macular degeneration, and glaucoma.

Ears

Talk with your provider about a hearing test if you are having any issues with your hearing.

Hepatitis C

The USPSTF recommends screening for hepatitis C virus (HCV) infection in adults aged 18 to 79 years.

Colon Cancer

At age 45, talk to your doctor about having either a colonoscopy every 10 years, or other colon cancer screening options are available. Screenings should take place until 75 years of age. If you have a family history of certain genetic conditions or one or more first degree relatives with colon cancer or colon polyps, then you may need to have a colonoscopy earlier. Also, there are some alternatives for colon cancer screening also available including FIT testing and Cologuard. Talk to your doctor to learn more about the options.

Lung Cancer

The USPSTF recommends annual screening for lung cancer with low-dose computed tomography (LDCT) in adults aged 50 to 80 years who have a 20 pack-year smoking history and currently smoke or have quit within the past 15 years. Screening should be discontinued once a person has not smoked for 15 years or develops a health problem that substantially limits life expectancy or the ability or willingness to have curative lung surgery.

Osteoporosis

At age 65, have a bone density test and be screened again every two to three years. You may want to talk to your doctor about screening earlier if you have certain risk factors, such as family history, low body weight, smoking, thyroid disease, certain medical conditions, early or surgical menopause, a history of taking prednisone, or a history of fractures.

Tests, Vaccines, and Tips for Adult Men of All Ages

For Men’s Health month in June, we published an article on men dispelling fear and developing interest in their health. Unlike women, men are less likely to visit their physician for routine exams and preventive consultations, leaving many men without a trusted doctor to consult with when health concerns arise. 

For adult men of all ages, it is very important to develop a relationship with a primary care provider. They can educate and steer you down the best path for optimal health as well as serve as a reliable source for keeping you on top of your health as you age. Decisions you make in early adulthood impact the longevity of your health, therefore, the sooner you get attuned to your body, family history, and health goals, the better your outcomes. 

This checklist is meant to help guide you on the vaccines, screenings and other health risks to be aware of as you age.

Young adulthood: 20-40 years

Considered the honeymoon of health, this is a time when you are achieving physical and mental prowess.

Facing health concerns or discussing them with your physician can feel uncomfortable, but it is important to address concerns when they arise. You never want to ignore symptoms. For example, if you discover a lump or have pain in a testicle, it’s important to tell your doctor. Testicular cancer is the most common cancer among men ages 15 to 34. 

Developing healthy exercise, eating, and self care habits at this stage of life is crucial for sustaining long term well-being. Consult with your doctor on diet, exercise, sleep, smoking, STI screening and prevention, and alcohol consumption. These years can bring added stress with balancing careers and building a family. The USPSTF also recommends screening for depression in the general adult population. Screening should be implemented with adequate systems in place to ensure accurate diagnosis, effective treatment, and appropriate follow-up. The coping mechanisms you develop at this stage will help you to endure through difficult periods later in life as well. 

Middle years: 40-60 years

Combination of lifestyle choices we made when we were younger mixed with genetic risk factors from our parents. 

Heart health, high blood pressure and weight gain are all areas to watch during these years of life. Metabolism naturally slows with age, so maintaining an active lifestyle and healthy dietary habits will help to offset this. Adults should get 30 minutes of aerobic exercise per day, five days a week and two days per week of strength training. The Mediterranean diet has been studied as one of the best diets to follow to promote longevity and to reduce the risk of coronary artery disease and cancer. And remember to take care of your skin, your largest and most visible organ! Talk with your healthcare provider if you notice any skin changes, unusual moles, or if you have a family history of skin cancer. Additionally, talk with your doctor about your personal risk profile for prostate cancer.

Later years: 60+ years

A time when you need to be regularly on top of your health.

Grieving is more prevalent in these years, experiencing the loss of a partner, family, or friends. Staying socially involved and physically active are important for your mental health. You also want to engage in activities that stimulate your brain and cognition. Continue 30 minutes of aerobic exercise per day five days a week and two days per week of strength training. 

Schedule routine consultations with your doctor to stay on top of any changes in health.

Vaccinations

• Flu shot every year
• Tetanus booster every 10 years
• Whooping cough vaccine (Tdap booster) once in adulthood (unless you had one as a preteen or teenager)
• Human papillomavirus (HPV) vaccine: If you’re 26 or younger and haven’t received it yet (catch up vaccination is now approved for adults up until the age of 45): 3 doses
• Shingles vaccine at age 50: 2 doses
• Two pneumonia vaccines starting at 65 

Screening Tests

Cholesterol

Starting at age 20, have your cholesterol tested every four to six years. You may need to test more often if you have heart disease or a family history of heart disease, diabetes, or other cardiac risk factors.

Blood Pressure

Starting at age 20, have your blood pressure checked at least once every two years. If your blood pressure is higher than normal (120/80), you may have it checked more often.

Type 2 Diabetes

Screenings usually start at age 45 and are done every 3 years. If you’re overweight and have one or more other risk factors, such as a family history of diabetes or high blood pressure or cholesterol, you may start screening at a younger age or more frequently.

Hepatitis C

The USPSTF recommends screening for hepatitis C virus (HCV) infection in adults aged 18 to 79 years.

Sexually Transmitted Disease

If you’re sexually active with more than one partner, get screened at least once a year or more often if applicable.

HIV

All men between the ages of 15 and 65 should be screened at least once. Talk with your provider about how often you should be tested after the initial screening.

Learn more about HIV from our interview with Dr. Michael Mullen, a pioneer in HIV treatment, Director for the Institute of Advanced Medicine and a Professor of Medicine and Infectious Diseases at Mount Sinai Hospital in New York.

Eyes

• Annual exams are recommended for individuals with existing vision correction prescriptions.
• At age 40, all adults should receive an eye evaluation. 
• Men 65 and over with no risk factors should be examined every 1 to 2 years. This should include having your eyes checked for signs of cataracts, age-related macular degeneration, and glaucoma.

Ears

Talk with your provider about a hearing test if you are having any issues with your hearing.

Prostate Cancer

At age 45, be sure to talk to your doctor about the risks and benefits of testing for prostate cancer. Prostate cancer affects 3 million men in the United States, claiming roughly 30,000 lives each year, but if detected early, is curable. See our interview with Ash Tewari, MD, urologist and prostate cancer specialist at the Icahn School of Medicine at Mount Sinai to learn more about screening for prostate cancer.

Colon Cancer

At age 45, talk to your doctor about having either a colonoscopy every 10 years, or other colon cancer screening options are available. Screenings should take place until 75 years of age. If you have a family history of certain genetic conditions or one or more first degree relatives with colon cancer or colon polyps, then you may need to have a colonoscopy earlier. Also, there are some alternatives for colon cancer screening also available including FIT testing and Cologuard. Talk to your doctor to learn more about the options.

Lung Cancer

The USPSTF recommends annual screening for lung cancer with low-dose computed tomography (LDCT) in adults aged 50 to 80 years who have a 20 pack-year smoking history and currently smoke or have quit within the past 15 years. Screening should be discontinued once a person has not smoked for 15 years or develops a health problem that substantially limits life expectancy or the ability or willingness to have curative lung surgery.

Osteoporosis

At age 70, have a bone density test and be screened again every two to three years. You may want to talk to your doctor about screening earlier if you have certain risk factors, such as family history, low body weight, smoking, thyroid disease, certain medical conditions, a history of taking prednisone, or a history of fractures.