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• Regular screenings are key for early disease detection.
• Health screenings are medical tests used in asymptomatic populations to assess the risk of developing a disease or disorder.
• Screenings are not diagnostic but identify a subset of the population for further diagnostic testing.
• Early detection through screenings improves treatment outcomes and reduces morbidity/mortality.
• Good screening tests target diseases that cause significant morbidity/mortality and are prevalent in the population.
• Recognizing patient advocacy focuses on the well-being of the patient.
• Patient have the right to be informed, involved, and supported when it comes to decisions regarding their health.
• The goal of patient advocacy is to focus on the well-being of the patient.

Common Diseases and Screenings

• Hypertension is a major risk factor for cardiovascular disease (CVD), the leading cause of death in the US.
• Long-term hypertension can lead to heart disease, kidney failure, stroke, and premature mortality.
• Cancer is one of the leading causes of death globally, second to heart disease in the US.
• There are roughly 20 million new cancer cases and 10 million cancer-related deaths worldwide annually.
• Many cancers grow slowly and may not show obvious symptoms until they have progressed significantly.
• Screenings are available to help detect breast, cervical, prostate, colon, and lung cancer.
• Diabetes affects more than 30 million people in the US.
• Type 2 diabetes may go undetected for years due to mild/vague symptoms in the early stages.
• Untreated diabetes can lead to severe complications like heart disease, kidney failure, and nerve damage.

Recommended Screenings

• Breast cancer screenings can include monthly self-exams, average risk screenings, and high-risk screenings.
• Average-risk individuals ages between 40-74 should undergo biennial mammography.
• Individuals 75+ should have shared decision-making with their provider.
• High-risk individuals should begin annual screening mammography beginning at 30.
• Colon cancer screenings can include average risk screenings, and high-risk screenings.
• People with Average-risk should have regular screenings between 45-75 years old
• Individuals 75+ should have shared decision-making with their provider.
• Frequency of screenings is based on the method chosen.
• Those with a 1st-degree relative with colon cancer should begin screening 10 years prior to the relative's diagnosis.
• Prostate cancer screenings can include annual exams for individuals ages between 55-69 and shared decision-making with a physician.
• Individuals 70+ can benefit from risk factors such as older age, African American descent, and family history.
• Hypertension screenings for individuals with average risk should be every 3-5 years for individuals between 18-39 and annually for those 40+.
• Individuals 40+ with high risk of Hypertension should get screened annually.
• All patients should confirm in office blood pressure measurement (OBPM) with non-clinical setting measurements
• Type I Diabetes screenings emphasize recognizing the need for screening and identifying the disease even before symptoms appear.
• Early consensus recommends screening between ages 2-6.
• Type I Diabetes is not exclusively a childhood diagnosis and is not exclusively familial.
• Type II Diabetes screenings includes Individuals between age 35-70 benefit from glucose testing every three years if overweight/obese, with normal glucose results.
• Weight-reduction interventions are key for the detection of pre-diabetes

Early Detection Importance

• Early detection screenings such as genetic testing can identify patients that have a high risk and allow proactive treatment
• Treatment for diseases such as breast cancer, colon cancer, hypertension, and diabetes are more effective when detected early.
• Survival rates increase with early detection that can be substantial in some cases.
• BRCA1 is a gene linked with breast and ovarian cancer.
• A family history of breast cancer or ovarian cancer could grant the need to have genetic testing performed for precautionary measures.
• Detection of this gene at an early stage allows one to act accordingly in regards to next-step treatment.
• BRCA1 detection with double mastectomy surgery can reduce the risk of breast cancer by 90-95%.

Barriers and Solutions

• Barriers may prevent access to regular health screenings can include financial, lack of awareness/education, geographic and linguistic, psychosocial, time/convenience, disabiity/ special needs.
• Possible solutions can include policy changes, access to public health programs, health education campaigns, telemedicine, and partnership with local organizations, accessible facilities, specialized screenings.
• Screening and adequate care for chronic conditions may not always be accessible, so timely intervention is key.
• Many diseases (such as cancer) do not show signs or symptoms until they are advanced, meaning more invasive and life-altering treatments.
• Assessing risk early on and making lifestyle changes can save patients millions of dollars in healthcare costs.

What can we do as providers?

• Emphasize Education
• Offer support systems
• Offer encouragement

Patient Advocacy

• Any person who receives health care is entitled to patient advocacy
• It ensures that patients' rights such as privacy are protected in healthcare
• It helps patients' voices be heard, patients understand their diagnosis, and respects their autonomy
• Assists with insurance and billing, ensures patients are receiving proper care and avoids patient discrimination
• This improves patient outcomes by increasing patient adherence to the treatment plan
• As shown in a 2022 study involving 188 patient and caregivers, 262 advocates, and 91 providers 92% of patients felt a positive impact on their health care
• 98% of providers felt a positive impact on patient outcome
• 92% of providers felt advocates decreased staff burden
• Effective communication, clear listening skills, empathy, compassion, and medical knowledge are required for a patient advocate to succeed
• Duties include everything from scheduling appointments, assessing financial and legal resources, ensure medical bills are accurate, and connecting patients
• Health professionals should always actively support patient rights, ensure access to necessary care, and help patients navigate health system Strategies for helping patients can vary based on how they can impact patients individually, or as a group/organisation.

Individual Strategies:

• Build strong relationships with patients
• Teach patients to advocate for themselves
• Ensure they understand their rights
• Thoroughly document all interactions
• Follow up with patients after appointments
• Advocate for policy changes

Organizational Strategies:

• Train healthcare staff in patient advocacy
• Implement patient centered policies
• Offer patient assistant programs and group collaboration
• Monitor and evaluate Advocacy efforts

Healthy Aging Concepts

• WHO defines healthy aging "the process of developing and maintaining the functional ability that enables wellbeing in older age.
• It is important to maintain & promote health, reduce risk factors, early diagnosis, & complication prevention
• This includes cancer, hearing loss, vision loss, blood pressure screenings and blood pressure screenings,
• Benefits of screenings outweigh the risks of complications associated with aging.
• Breast cancer can be diagnosed earlier, allowing for greater treatment possibilities, increases survival rates, reduced treatment intensity & improves quality of life
• This is especially true when women start screening at age 40

Hearing Screenings

• Childhood screenings are a crucial component of wellness visits where where Undetected hearing loss can lead to speech, language and social skill development
• It is important to express any concerns or display any concerning signs
• Hearing loss in adults can lead to a decreased quality of life
• Behavioral Audiometry is used to evaluate patient's response to sound
• Medicare mandate inquiring about hearing loss at wellness visits to ensure patient knowledge

Vision Screenings

• Vision loss tests can detect & diagnose glaucoma
• Measure eye pressure, inspect drainage angle, optic nerve, peripheral vision, measure cornea
• American Academy of Ophthalmology Recommendations
• Adults get screened
• Once in 20s & twice in 30s
• 40 = complete eye examination

• 65 years old checked every

Blood Pressure Screenings

• Blood pressure is tested to reduce risks of heart attack, stroke & death
• High blood pressure rarely show symptoms until there's an adverse outcome
• Most often diagnosed with screenings
• For those 18 & older without previous diagnosis of HTN
• Age 18-39 every 3-5 years

• 40 years old annual screenings

Managing Chronic Conditions in Aging Populations

• Diabetes: Focus on Glucose management and monitoring, weight reduction, A heart-healthy diet (DASH), exercise, sufficient sleep and medication as prescribed.
• Diabetes involves tracking HbA1c, (percentage of total hemoglobin that is "glycated" which estimates blood glucose over three months), and weight loss of 10-15% to maintain normal blood glucose levels

Conditions

• Type 2 Diabetes focus on Mediterranean, vegetarian, and vegan diets for the best long term effect (+gt; 6 months on controlling weight and blood sugar.
• Consistent good sleep hygiene (greater than 8 hours), reduce stress, and medication is important for regulating sugar and blood pressure.
• Arthritis routine of low impact exercises focusing on strength and balance

Hypertension

• Heart healthy diet with fruits, vegetables, whole grains, lean meat/proteins,
• Focus diet for Hypertension is is DASH.
• Reduced sodium, alcohol, smoking and increase sleep and water intake is beneficial for the treatment of hypertension.
• Regular moderate exercise for at least 2.5 hours a week to maintain blood pressure
• Get plenty of sleep and treat sleep apnea
• Physicians may prescribe the need for medication to regulate blood pressure.

Maintain Functional Ability

• Mental health is an important component of healthy aging.
• Longitudinal studies show that as self health perception declines, mortality rates decrease

Prevention

• Social engagement through community activities has shown correlation with decreased development of Dementia.
• Studies show that the the correlation is seen based on social activity such as community projects with those that are older in age.

Cognitive decline prevention

• Nutrition is important to eat from the earth (Type 3 diabetes (inflammation of sugar results to Alzheimer's)
• Take antioxidants as prescribed
• Exercise to increase blood flow to vascularization muscles, as balance and flexibility are important to stimulate motor function.
• Activate sensory nerves to the feet to help with propitiations and active foot muscles
• Reduce stress on body and mind to function as an important component for all aging adults to maintain overall health by stimulation body and function.
• Educate patients, family and community on overall needs of the patient to improve patient compliance.