title: Preventive health care among older women in an academic primary care practice.
abstract: OBJECTIVE
  We sought to examine the use of preventive health services among older women and to assess how age and illness burden influence care patterns.
  
  
  METHODS
  The charts of 299 women aged > or =80 and 229 women aged 65-79 years who did not have dementia or terminal illness at 1 academic primary care practice in Boston were reviewed between July and December 2005 to determine receipt of screening tests (e.g., mammography), counseling on healthy lifestyle (e.g., exercise), and/or geriatric health issues (e.g., incontinence), and immunizations. Illness burden was quantified using the Charlson Comorbidity Index (CCI).
  
  
  RESULTS
  Women aged > or =80 were more likely than women aged 65-79 to have a CCI of > or =3 (24.0% vs. 16.7%) and were less likely to receive all screening tests. However, receipt of mammography (47.8%) and colon cancer screening (51.2%) was still common among women aged > or =80 and was not targeted to older women in good health. Women aged > or =80 were less likely to be screened for depression (adjusted relative risk [aRR] 0.6; 95% confidence interval [CI], 0.5-0.8), osteoporosis (aRR, 0.6; 95% CI, 0.5-0.9), or counseled about exercise (aRR 0.8; 95% CI, 0.6-0.9) than younger women, but were more likely to receive counseling about falls (aRR 1.9; 95% CI, 1.4-2.6) and/or incontinence (aRR 1.8; 95% CI, 1.2-2.6). However notes documenting discussions about mood (28.6%), exercise (40.0%), falls (28.8%), or incontinence (20.8%) were low among all women.
  
  
  CONCLUSIONS
  In a comprehensive review of preventive health measures for elderly women, many in poor health were screened for cancer. Meanwhile, many older women were not screened for depression or counseled about exercise, falls, or incontinence. There is a need to improve delivery of preventive health care to older women.
authors.affiliation: Department of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA. mschonbe@bidmc.harvard.edu
authors.forename: Mara A
authors.initials: MA
authors.lastname: Schonberg
authors.forename: Meghan
authors.initials: M
authors.lastname: York
authors.forename: Nisha
authors.initials: N
authors.lastname: Basu
authors.forename: Daniele
authors.initials: D
authors.lastname: Olveczky
authors.forename: Edward R
authors.initials: ER
authors.lastname: Marcantonio
mesh_terms: D000046:Academic Medical Centers / Q000706:statistics & numerical data; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001900:Boston / Q000453:epidemiology; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006304:Health Status; D006801:Humans; D008875:Middle Aged; D011314:Preventive Health Services / Q000706:statistics & numerical data*; D011320:Primary Health Care / Q000706:statistics & numerical data; D011322:Primary Prevention / Q000706:statistics & numerical data*; D012720:Severity of Illness Index; D016387:Women's Health