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Chronic Disease Screening and Health Promotion Strategies for Older Men

Published:December 14, 2022DOI:https://doi.org/10.1016/j.nurpra.2022.11.002

      Highlights

      • The study of older men has been overlooked in the research literature.
      • Advanced practice registered nurses (APRNs) need to be familiar with preventive and screening recommendations when caring for older male patients.
      • Centers for Disease Control and Prevention vaccine guidelines are an important resource for older male patients of APRNs.
      • APRNs must use current evidence-based resources to care for older male patients.

      Abstract

      The population of older men is increasing. Care of male patients has often been overlooked in practice and research. Older men have increased rates of cardiovascular disease, undiagnosed depression, and suicide, and avoid scheduling routine health visits or delay seeking health care. Nurse practitioners can use evidence-based screening recommendations to identify, treat, and manage chronic conditions in older men to improve their overall health and life expectancy. This report focuses on chronic conditions in older men with high rates of morbidity and mortality and provides updated guidelines to assist nurse practitioners to provide optimal care of their older male patients.

      Keywords

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      References

        • World Health Organization
        Ageing and health. WHO.
        • Sandman D.
        • Simantov E.
        • An C.
        • Fund C.
        • Harris L.
        Out of Touch: American Men and The Health Care System: Commonwealth Fund Men’s and Women’s Health Survey Findings The Commonwealth Fund.
        • Springer K.W.
        • Mouzon D.M.
        Macho men” and preventive health care: implications for older men in different social classes.
        J Health Soc Behav. 2011; 52: 212-227
        • Courtenay W.H.
        Constructions of masculinity and their influence on men’s well-being: a theory of gender and health.
        Soc Sci Med. 2000; 50: 1385-1401
        • Courtenay W.H.
        Key determinants of the health and well-being of men and boys.
        Int J Mens Health. 2003; 2: 1-30
        • Nuzzo J.L.
        Men’s health in the United States: a national health paradox.
        Aging Male. 2020; 23: 42-52https://doi.org/10.1080/13685538.2019.1645109
        • Case B.C.
        • Waksman R.
        Coronary heart disease: have we reached a plateau in primary prevention?.
        J Am Heart Assoc. 2020; 9e04963https://doi.org/10.1161/JAHA.120.016034
        • Lee S.J.
        • Kim C.M.
        Individualizing prevention for older adults.
        J Am Geriatr Soc. 2018; 66: 229-234https://doi.org/10.1111/jgs.15216
        • Shmerling R.H.
        Why men often die earlier than women. Harvard Health Blog.
        • Schlough M.
        Healthcare Maintenance for Older Adults. UNM Dept of Family and Community Medicine.
        • U.S. Preventive Services Task Force
        USPSTF Program Office. Grade Definitions.
        • Grossman D.C.
        • Curry S.J.
        • et al.
        • US Preventive Services Task Force
        Interventions to prevent falls in community-dwelling older adults.
        JAMA. 2018; 319: 1696-1704https://doi.org/10.1001/jama.2018.3097
        • Bergen G.
        • Shakya I.
        CDC STEADI: Evaluation Guide for Older Adult Clinical Fall Prevention Programs. National Center for Injury Prevention and Control of the Centers for Disease Control and Prevention.
        • Hestevik C.H.
        • Molin M.
        • Debesay J.
        • Bergland A.
        • Bye A.
        Older patients’ and their family caregivers’ perceptions of food, meals and nutritional care in the transition between hospital and home care: a qualitative study.
        BMC Nutr. 2020; 6: 11https://doi.org/10.1186/s40795-020-00335-w
        • Morley J.E.
        Decreased food intake with aging.
        J Gerontol A Biol Sci Med Sci. 2001; 56 Spec: 81-88https://doi.org/10.1093/gerona/56.suppl_2.81
        • Coll P.P.
        • Roche V.
        • Olsen J.S.
        • Voit J.H.
        • Bowen E.
        • Kumar M.
        The prevention of cardiovascular disease in older adults.
        J Am Geriatr Soc. 2020; 68: 1098-1106https://doi.org/10.1111/jgs.16353
        • World Health Organization
        The injury chart book: a graphical overview of the global burden of injuries.
        World Health Organization, 2002
        • Liddle J.L.M.
        • Lovarini M.
        • Clemson L.M.
        • et al.
        Masculinity and preventing falls: insights from the fall experiences of men aged 70 years and over.
        Disabil Rehabil. 2019; 41: 1055-1062https://doi.org/10.1080/09638288.2017.1419381
        • Dellinger A.
        Older adult falls: effective approaches to prevention.
        Curr Trauma Rep. 2017; 3: 118-123https://doi.org/10.1007/s40719-017-0087-x
        • Loonlawong S.
        • Limroongreungrat W.
        • Jiamjarasrangsi W.
        The stay independent brochure as a screening evaluation for fall risk in an elderly Thai population.
        Clin Interv Aging. 2019; 14: 2155-2162https://doi.org/10.2147/CIA.S233414
        • Owens D.K.
        • Davidson K.W.
        • et al.
        • US Preventive Services Task Force
        Screening for HIV infection: US Preventive Services Task Force Recommendation Statement.
        JAMA. 2019; 321: 2326-2336https://doi.org/10.1001/jama.2019.6587
        • Owens D.K.
        • Davidson K.W.
        • et al.
        • US Preventive Services Task Force
        Screening for hepatitis C virus infection in adolescents and adults: US Preventive Services Task Force Recommendation Statement.
        JAMA. 2020; 323: 970-975https://doi.org/10.1001/jama.2020.1123
        • The International Society for Clinical Densitometry
        Indications for Bone Mineral Density (BMD) Testing.
        • Rinonapoli G.
        • Ruggiero C.
        • Meccariello L.
        • Bisaccia M.
        • Ceccarini P.
        • Caraffa A.
        Osteoporosis in men: a review of an underestimated bone condition.
        Int J Mol Sci. 2021; 22: 2105https://doi.org/10.3390/ijms22042105
        • Watts N.B.
        • Adler R.A.
        • Bilezikian J.P.
        • et al.
        Osteoporosis in men: an Endocrine Society clinical practice guideline.
        J Clin Endocrinol Metab. 2012; 97: 1802-1822https://doi.org/10.1210/jc.2011-3045
        • U.S. Preventive Services Task Force
        A & B Recommendations.
        • Rodgers J.L.
        • Jones J.
        • Bolleddu S.I.
        • et al.
        Cardiovascular risks associated with gender and aging.
        J Cardiovasc Dev Dis. 2019; 6: 19https://doi.org/10.3390/jcdd6020019
        • Benjamin E.J.
        • Muntner P.
        • Alonso A.
        • et al.
        American Heart Association Council on Epidemiology and Prevention Statistics Committee and Stroke Statistics Subcommittee. Heart disease and stroke statistics–2019 update: a report from the American Heart Association.
        Circulation. 2019; 139 (Published correction appears in Circulation. 2020;141(2):e33): e56-e528https://doi.org/10.1161/CIR.0000000000000659
        • Kulkarni A.
        • Mehta A.
        • Yang E.
        • Parapid B.
        Older Adults and Hypertension: Beyond the 2017 Guideline for Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults. American College of Cardiology.
        (February 26)
        • Dehmer S.P.
        • O’Keefe L.R.
        • Evans C.V.
        • Guirguis-Blake J.M.
        • Perdue L.A.
        • Maciosek M.V.
        Aspirin use to prevent cardiovascular disease and colorectal cancer: updated modeling study for the US Preventive Services Task Force.
        JAMA. 2022; 327: 1598-1607
        • Moreno G.
        • Mangione C.M.
        • Kimbro L.
        • Vaisberg E.
        American Geriatrics Society Expert Panel on Care of Older Adults with Diabetes Mellitus. Guidelines abstracted from the American Geriatrics Society guidelines for improving the care of older adults with diabetes mellitus: 2013 update.
        J Am Geriatr Soc. 2013; 61: 2020-2026
        • Zhou B.
        • Perel P.
        • Mensah G.A.
        • Ezzati M.
        Global epidemiology, health burden and effective interventions for elevated blood pressure and hypertension.
        Nat Rev Cardiol. 2021; 18: 785-802https://doi.org/10.1038/s41569-021-00559-8
        • Guirguis-Blake J.M.
        • Evans C.V.
        • Webber E.M.
        • Coppola E.L.
        • Perdue L.A.
        • Weyrich M.S.
        Screening for hypertension in adults: updated evidence report and systematic review for the US Preventive Services Task Force.
        JAMA. 2021; 325: 1657-1669https://doi.org/10.1001/jama.2020.21669
        • Choi H.M.
        • Kim H.C.
        • Kang D.R.
        Sex differences in hypertension prevalence and control: analysis of the 2010-2014 Korea National Health and Nutrition Examination Survey.
        PLoS One. 2017; 12e0178334https://doi.org/10.1371/journal.pone.0178334
        • Kahwati L.C.
        • Asher G.N.
        • Kadro Z.O.
        • et al.
        Screening for atrial fibrillation: updated evidence report and systematic review for the US Preventive Services Task Force.
        JAMA. 2022; 327: 368-383https://doi.org/10.1001/jama.2021.21811
        • US Preventive Services Task Force
        Screening for Atrial Fibrillation: US Preventive Services Task Force Recommendation Statement.
        JAMA. 2022; 327: 360-367
        • Passman R.
        • Freedman B.
        Updated USPSTF guidelines for screening for atrial fibrillation: same as it ever was?.
        JAMA Cardiol. 2022; 7: 247-249https://doi.org/10.1001/jamacardio.2021.5873
        • Gazova A.
        • Leddy J.J.
        • Rexova M.
        • Hlivak P.
        • Hatala R.
        • Kyselovic J.
        Predictive value of CHA2DS2-VASc scores regarding the risk of stroke and all-cause mortality in patients with atrial fibrillation (CONSORT compliant).
        Medicine. 2019; 98e16560https://doi.org/10.1097/MD.0000000000016560
        • Davidson K.W.
        • Barry M.J.
        • Mangione C.M.
        • et al.
        Screening for atrial fibrillation: US Preventive Services Task Force recommendation statement.
        JAMA. 2022; 327: 360-367
        • American College of Cardiology
        Updated AFib Guidelines Recommend NOACs to Prevent Stroke in AFib Patients.
        • Owens D.K.
        • Davidson K.W.
        • et al.
        • US Preventive Services Task Force
        Screening for abdominal aortic aneurysm: US Preventive Services Task Force Recommendation Statement.
        JAMA. 2019; 322: 2211-2218https://doi.org/10.1001/jama.2019.18928
        • Guirguis-Blake J.M.
        • Beil T.L.
        • Senger C.A.
        • Coppola E.L.
        Primary care screening for abdominal aortic aneurysm: updated evidence report and systematic review for the US Preventive Services Task Force.
        JAMA. 2019; 322: 2219-2238https://doi.org/10.1001/jama.2019.17021
        • Bibbins-Domingo K.
        • Grossman D.C.
        • et al.
        • US Preventive Services Task Force
        Statin use for the primary prevention of cardiovascular disease in adults: US Preventive Services Task Force Recommendation Statement.
        JAMA. 2022; 316 (Published correction appears in JAMA. 2020;323(7):669-670. https://doi.org/10.1001/jama.2016.15450): 1997-2007
        • American College of Cardiology
        ASCVD Risk Estimator Plus.
        • Mangione C.M.
        • Barry M.J.
        • et al.
        • U.S. Preventive Services Task Force
        Statin use for the primary prevention of cardiovascular disease in adults: US Preventive Services Task Force Recommendation Statement.
        JAMA. 2022; 328: 746-753https://doi.org/10.1001/jama.2022.13044
        • Chou R.
        • Dana T.
        • Blazina I.
        • Daeges M.
        • Jeanne T.L.
        Statins for prevention of cardiovascular disease in adults: evidence report and systematic review for the US Preventive Services Task Force.
        JAMA. 2016; 316: 2008-2024https://doi.org/10.1001/jama.2015.15629
        • Zhang H.
        • Plutzky J.
        • Shubina M.
        • Turchin A.
        Drivers of the sex disparity in statin therapy in patients with coronary artery disease: a cohort study.
        PLoS One. 2016; 11e0155228https://doi.org/10.1371/journal.pone.0155228
        • Davidson K.W.
        • Barry M.J.
        • et al.
        • US Preventive Services Task Force
        Screening for prediabetes and type 2 diabetes: US Preventive Services Task Force Recommendation Statement.
        JAMA. 2021; 326: 736-743https://doi.org/10.1001/jama.2021.12531
        • American Diabetes Association
        2. Classification and diagnosis of diabetes: Standards of Medical Care in Diabetes—2018.
        Diabetes Care. 2018; 41: S13-S27https://doi.org/10.2337/dc18-S002
        • American Association of Clinical Endocrinology
        Screening and Monitoring of Prediabetes.
        • American Diabetes Association
        12. Older adults: Standards of Medical Care in Diabetes—2019.
        Diabetes Care. 2019; 42: S139-S147https://doi.org/10.2337/dc19-S012
        • Grossman D.C.
        • Curry S.J.
        • et al.
        • US Preventive Services Task Force
        Screening for prostate cancer: US Preventive Services Task Force Recommendation Statement.
        JAMA. 2018; 319 (Published correction appears in JAMA. 2018;319(23):2443): 1901-1913https://doi.org/10.1001/jama.2018.3710
        • National Institutes of Health, National Cancer Institute
        Prostate Cancer: Prostate-Specific Antigen (PSA) Test.
        • Davidson K.W.
        • Barry M.J.
        • et al.
        • US Preventive Services Task Force
        Colorectal cancer screening: US Preventive Services Task Force Recommendation Statement.
        JAMA. 2021; 325 (Published correction appears in JAMA. 2021;326(8):773): 1965-1977https://doi.org/10.1001/jama.2021.6238
        • U.S. Preventive Services Task Force
        Screening for lung cancer: US Preventive Services Task Force Recommendation Statement.
        JAMA. 2021; 325: 962-970https://doi.org/10.1001/jama.2021.1117
        • American Cancer Society
        About Melanoma Skin Cancer: Key Statistics for Melanoma Skin Cancer.
        • Briceno L.M.
        • Chang A.S.
        • Eminger L.
        • Loo D.S.
        • Shroff-Mehta V.
        • Urman C.
        Melanoma strikes men harder.
        • Alvear M.
        Spotting Skin Cancer.
        • Bolick N.L.
        • Geller A.C.
        Epidemiology of melanoma.
        Hematol Oncol Clin North Am. 2021; 35: 57-72https://doi.org/10.1016/j.hoc.2020.08.011
        • Curry S.J.
        • Krist A.H.
        • et al.
        • U.S. Preventive Services Task Force
        Screening for osteoporosis to prevent fractures: US Preventive Services Task Force Recommendation Statement.
        JAMA. 2018; 319: 2521-2531https://doi.org/10.1001/jama.2018.7498
        • Samakkarnthai P.
        • Sfeir J.G.
        Osteoporosis in the Elderly.
        in: Cusano N.E. Osteoporosis: A Clinical Casebook. Springer Nature, 2021: 91-100
        • World Health Organization
        Live life: preventing suicide. World Health Organization.
        http://www.who.int/mental_health/suicide-prevention
        Date: 2018
        Date accessed: May 12, 2022
        • Canetto S.S.
        Suicide: why are older men so vulnerable?.
        Men Masc. 2017; 20: 49-70
        • US Preventive Services Task Force
        Screening for Depression, Anxiety, and Suicide Risk in Adults, Including Pregnant and Postpartum Persons.
        • Struszczyk S.
        • Galdas P.M.
        • Tiffin P.A.
        Men and suicide prevention: a scoping review.
        J Ment Health. 2019; 28: 80-88https://doi.org/10.1080/09638237.2017.1370638
        • LeFevre M.L.
        • U.S. Preventive Services Task Force
        Screening for suicide risk in adolescents, adults, and older adults in primary care: U.S. Preventive Services Task Force Recommendation Statement.
        Ann Intern Med. 2014; 160: 719-726https://doi.org/10.7326/M14-0589
        • Haesen S.
        • Merkt H.
        • Imber A.
        • Elger B.
        • Wangmo T.
        Substance use and other mental health disorders among older prisoners.
        Int J Law Psychiatry. 2019; 62: 20-31https://doi.org/10.1016/j.ijlp.2018.10.004
        • Na P.J.
        • Nichter B.
        • Hill M.L.
        • Kim B.
        • Norman S.B.
        • Pietrzak R.H.
        Severity of substance use as an indicator of suicide risk among US military veterans.
        Addictive Beh. 2021; 122107035
        • Han B.H.
        • Moore A.A.
        Prevention and screening of unhealthy substance use by older adults.
        Clin Geriatr Med. 2018; 34: 117-129https://doi.org/10.1016/j.cger.2017.08.005
        • Ewing J.A.
        Detecting alcoholism. The CAGE questionnaire.
        JAMA. 1984; 252: 1905-1907https://doi.org/10.1001/jama.252.14.1905
        • Stewart D.
        • Oslin D.W.
        Recognition and treatment of late-life addictions in medical settings.
        J Clin Geropsychol. 2001; 7: 145-158https://doi.org/10.1023/2FA/3A1009589706810
        • Blow F.C.
        • Gillespie B.W.
        • Barry K.L.
        • Mudd S.A.
        • Hill E.M.
        Brief screening for alcohol problems in elderly populations using the Short Michigan Alcoholism Screening Test-Geriatric Version (SMAST-G).
        Alcohol Clin Exp Res. 1998; 22: 131A
        • Beullens J.
        • Aertgeerts B.
        Screening for alcohol abuse and dependence in older people using DSM criteria: a review.
        Aging Ment Health. 2004; 8: 76-82https://doi.org/10.1080/13607860310001613365
        • Moore A.A.
        • Beck J.C.
        • Babor T.F.
        • Hays R.D.
        • Reuben D.B.
        Beyond alcoholism: identifying older, at-risk drinkers in primary care.
        J Stud Alcohol. 2002; 63: 316-324https://doi.org/10.15288/jsa.2002.63.316
        • Substance Abuse and Mental Health Services Administration (SAMHSA)
        Screening, Brief Intervention, and Referral to Treatment (SBIRT).
        https://www.samhsa.gov/sbirt
        Date accessed: August 19, 2022
        • Heisel M.J.
        • Flett G.L.
        Screening for suicide risk among older adults: assessing preliminary psychometric properties of the Brief Geriatric Suicide Ideation Scale (BGSIS) and the GSIS-Screen.
        Aging Ment Health. 2022; 26: 392-406
        • Lutzman M.
        • Sommerfeld E.
        • Ben-David S.
        Loneliness and social integration as mediators between physical pain and suicidal ideation among elderly men.
        Int Psychogeriatr. 2021; 33: 453-459https://doi.org/10.1017/S104161022000112X
        • Williamson V.
        • Stevelink S.A.M.
        • Greenberg K.
        • Greenberg N.
        Prevalence of mental health disorders in elderly US military veterans: a meta-analysis and systematic review.
        Am J Geriatr Psychiatry. 2018; 26: 534-545https://doi.org/10.1016/j.jagp.2017.11.001
        • Baker P.
        Men’s health: time for a new approach.
        Phys Ther Rev. 2018; 23: 144-150https://doi.org/10.1080/10833196.2018.1452562
        • Conejero I.
        • Olie E.
        • Courtet P.
        • Calati R.
        Suicide in older adults: current perspectives.
        Clin Interv Aging. 2018; 13: 691-699https://doi.org/10.2147/CIA.S130670
        • Misra A.
        • Lloyd J.T.
        • Strawbridge L.M.
        • Wensky S.G.
        Use of welcome to Medicare visits among older adults following the Affordable Care Act.
        Am J Prevent Med. 2018; 54: 37-43
        • Cuenca A.E.
        • Kapsner S.
        Medicare wellness visits: reassessing their value to your patients and your practice.
        Fam Pract Manag. 2019; 26: 25-30
        • Abraham R.A.
        • Brinker S.K.
        Chronic obstructive pulmonary disease and the physical examination.
        Med Clin North Am. 2022; 106: 423-435https://doi.org/10.1016/j.mcna.2022.02.001
        • Mangione C.M.
        • Barry M.J.
        • et al.
        • U.S Preventive Services Task Force
        Screening for chronic obstructive pulmonary disease: US Preventive Services Task Force Reaffirmation Recommendation Statement.
        JAMA. 2022; 327: 1806-1811https://doi.org/10.1001/jama.2022.5692
        • Deal J.A.
        • Lin F.R.
        USPSTF Recommendations for hearing loss screening in asymptomatic older adults—a case of missing evidence and missing treatment options.
        JAMA Netw Open. 2021; 4e210274https://doi.org/10.1001/jamanetworkopen.2021.0274

      Biography

      Ann Kriebel-Gasparro, DNP, FNP, GNP, is Contributing Faculty at Walden University, Minneapolis, MN, and can be contacted at [email protected]

      Biography

      Aparna Gupta, DNP, MBA, ANP-BC, is a Director of the National Hospice and Palliative Care Program

      Biography

      Lois Chappell, DNP, FNP-C is Senior Clinical Service Manager Optum Home & Community, Senior Community Care