Key Takeaways
- Adults 65+ qualify for a free Annual Wellness Visit under Medicare, separate from a standard physical.
- USPSTF recommends several age-specific screenings including lung cancer, osteoporosis, and abdominal aortic aneurysm.
- Vaccination needs shift significantly at 65, with shingles, pneumococcal, and updated flu shots becoming priorities.
- Fall risk assessment and cognitive screening are important but often overlooked components of preventive care.
- Bring a complete medication list and prioritize your top questions before every preventive appointment.
Why Preventive Care Looks Different After 65
Preventive care at 65 and beyond is not simply more of the same — it reflects a deliberate shift in clinical priorities. As the body ages, certain conditions become significantly more prevalent, and the window for early intervention often narrows. At the same time, some screenings that were routine earlier in life may be discontinued or modified based on accumulated risk data and life expectancy considerations.
The U.S. Preventive Services Task Force (USPSTF), the Centers for Disease Control and Prevention (CDC), and other leading health bodies issue evidence-based recommendations that are specifically calibrated by age. Understanding which guidelines apply to you — and why — is the foundation of effective preventive care in later adulthood.
For readers who want to understand how screening priorities have shifted across earlier decades, our guide to screenings after 50 provides useful context for what leads into this life stage.
Before your Annual Wellness Visit, request your medical records from the past year so your provider can cross-check which screenings have already been completed versus which are still due.
Many older adults see multiple specialists, and preventive screenings can fall through the cracks when care is fragmented. Bringing a consolidated record reduces duplicate testing and missed gaps.
If you take five or more medications — a situation called polypharmacy — ask your provider or pharmacist for a medication review at least once a year to check for interactions and unnecessary prescriptions.
Polypharmacy is common among adults 65+ and is an independent risk factor for falls, cognitive side effects, and hospitalizations. Annual reviews are a recognized preventive strategy.
Essential Screenings for Adults 65+
The following screenings carry strong evidence support for this age group from the USPSTF and major clinical organizations:
- Blood pressure: Hypertension screening is recommended annually or more frequently depending on readings. High blood pressure is a leading modifiable risk factor for stroke and heart disease in older adults.
- Colorectal cancer: Screening is generally recommended through age 75; the decision for ages 76–85 should be individualized with a clinician.
- Lung cancer (low-dose CT): Recommended annually for adults aged 50–80 who have a 20 pack-year smoking history and currently smoke or quit within the past 15 years.
- Osteoporosis: Bone density screening (DEXA scan) is recommended for women 65 and older. Men should discuss risk factors with their provider to determine if screening is appropriate.
- Abdominal aortic aneurysm (AAA): A one-time ultrasound screening is recommended for men aged 65–75 who have ever smoked.
- Diabetes (type 2): Screening is recommended for adults aged 35–70 who are overweight or obese; your provider may continue or adjust this based on your individual profile.
- Lipid disorders: Cholesterol screening frequency should be discussed with your clinician, particularly if you are on or being considered for statin therapy.
- Vision and hearing: While not always covered under the same recommendations, age-related vision and hearing changes significantly affect quality of life and safety — raise these at every annual visit.
1 in 4
Older adults who fall each year
According to the CDC, approximately 14 million adults aged 65 and older report a fall annually in the United States.
50%
Hypertension prevalence in adults 65+
The American Heart Association estimates that more than half of adults in this age group have high blood pressure, many of whom are unaware or undertreated.
~33%
Eligible older adults who use their AWV
Studies have found that only about one-third of Medicare beneficiaries take advantage of the no-cost Annual Wellness Visit each year.
Vaccinations That Matter Most at This Stage
Immunity wanes with age — a process called immunosenescence — making vaccinations especially important for adults 65 and older. The CDC's Advisory Committee on Immunization Practices (ACIP) outlines several vaccines that carry heightened priority at this life stage:
- Influenza (flu): Annual vaccination is strongly recommended. High-dose or adjuvanted formulations are now specifically approved and preferred for adults 65+, as they generate a stronger immune response.
- COVID-19: Updated booster doses aligned with current variants are recommended; discuss current guidance with your provider as recommendations are periodically updated.
- Pneumococcal vaccines: Protection against pneumonia-causing bacteria is recommended; your provider can advise on the appropriate vaccine series based on your vaccination history.
- Shingles (Zoster, Shingrix): Two doses of the recombinant shingles vaccine are recommended for all immunocompetent adults aged 50 and older, including those who previously received an older formulation.
- Tdap/Td: A booster for tetanus and diphtheria is recommended every 10 years.
For a complete and organized view of the adult immunization schedule, see the U.S. Adult Immunization Schedule, decoded.
Cognitive Health and Fall Prevention
Two preventive areas that are frequently underaddressed — yet carry enormous consequences for older adults — are cognitive health screening and fall risk assessment.
Cognitive screening: Medicare's Annual Wellness Visit includes a cognitive impairment assessment. Tools used in clinical settings can help detect early signs of dementia or mild cognitive impairment, opening the door to earlier planning and intervention. If you or a family member have concerns, proactively raise them rather than waiting for a provider to initiate the conversation. Our Mind & Memory hub explores evidence-based strategies for brain health as you age.
Fall prevention: Falls are the leading cause of injury-related death among adults 65 and older, according to the CDC. USPSTF recommends that clinicians provide exercise interventions for community-dwelling adults 65+ who are at increased fall risk. Ask your provider about a formal fall risk assessment, which may evaluate gait, balance, vision, medications, and home environment. Staying physically active supports both fall prevention and overall longevity — our Active Aging hub covers movement strategies suited to this life stage.
How to Make Every Preventive Visit Count
Medicare covers an Annual Wellness Visit (AWV) at no cost to eligible beneficiaries — but many older adults either don't know about it or confuse it with a standard sick visit. The AWV is specifically designed for preventive planning, not for addressing new or acute symptoms. Understanding the distinction matters for both care quality and insurance coverage. Our article on annual physicals vs. preventive wellness visits explains this clearly.
To get the most from your appointment:
- Bring a complete, up-to-date list of all medications, supplements, and vitamins — including dosages.
- Write down your top two or three questions in advance. Providers can help you triage when time is limited.
- Share any changes in vision, hearing, mood, balance, or memory since your last visit.
- Request a summary of your current screening schedule and when each item is next due.
- Ask about referrals — some screenings require a specialist or separate appointment to complete.
For a deeper guide on preparing for and following through on preventive appointments, see getting the most out of a preventive care appointment.
This article provides general health information and education only. It is not a substitute for personalized medical advice, diagnosis, or treatment. Always consult a qualified healthcare professional about the screenings, vaccinations, and preventive interventions appropriate for your individual health history and circumstances.