What to Ask For at Your Annual Physical After 65

This checklist covers the physical, mental-health, and cognitive screenings every adult over 65 should be receiving, but often aren’t. (Tap here to download a copy)

All of these are what a well-trained geriatrician would cover — and what most primary care doctors overlook.

1. Core Bloodwork (Request These Directly)

Many clinicians stop ordering full labs after 65 unless there’s an “active issue.”

Ask for:

• Comprehensive Metabolic Panel (CMP)
  Liver, kidneys, electrolytes — foundational.
  
  
• Complete Blood Count (CBC)
  To screen for anemia, infection, and nutrient issues.
  
  
• Lipid Panel
  Cholesterol, triglycerides — still matters after 65.
  
  
• Thyroid Panel (TSH, Free T4, ideally T3)
  Thyroid dysfunction is common and often missed.
  
  
• Vitamin D level
  Critical for bones, immunity, energy, cognition.
  
  
• Vitamin B12 level
  Low B12 mimics dementia — and is EASY to treat.
  
  
• A1C
  Screens for diabetes or prediabetes.
  
  
• Inflammatory markers (CRP or ESR)
  Helpful if you’re experiencing fatigue, pain, or malaise.

And a BIG one:

• Kidney function screening (GFR)
  Declines can be silent — and medication doses depend on this.
  

2. Cognitive + Mental Health Screening (INSIST on This)

A good geriatrician screens everyone, even if they seem “fine.”

Ask for:

• MoCA (Montreal Cognitive Assessment) or Mini-Cog
  Quick, evidence-based cognitive screenings.
  
  
• Depression & anxiety screening
  (PHQ-9 or GAD-7 — your provider will know these.)
  
  
• Medication review for cognitive side effects
  Especially anticholinergics, sleep aids, and some bladder meds.
  
  
• Alcohol & substance use review
  (Many older adults get overlooked here.)

Phrase that works:

“I’d like a full cognitive screening — not because I’m worried, but because I want a baseline.”

3. Mobility, Strength, & Fall Prevention (Often Ignored Until It’s Too Late)

This should be standard geriatric care.

Ask for:

• Balance assessment
  (Timed Up and Go test — “TUG.”)
  
  
• Gait evaluation
  How you walk can signal neurological or muscular issues.
  
  
• Fall risk screening
  Even if you haven’t fallen.
  
  
• Bone density scan (DEXA)
  Repeat every 2–3 years or sooner depending on risk.
  
  
• Grip strength test
  A powerful indicator of aging trajectory and sarcopenia.

Ask this:

“Can we review my fall risk, gait, balance, and muscle strength today?”

4. Heart & Lung Health

Cardiac disease presents differently as we age — so screening matters.

Ask for:

• EKG (baseline if you haven’t had one in 2–3 years)
  
  
• Auscultation for murmurs (aortic stenosis, etc.)
  
  
• Pulse oximetry & respiratory review
  
  
• Aortic aneurysm screening (one-time ultrasound if you’ve ever smoked)
  

If you’ve had shortness of breath, fatigue, or swelling:
  Ask for BNP test or an echocardiogram to check for heart failure.

5. Cancer Screening (Ageism shows up HERE a lot)

Clinicians often stop recommending cancer screening after 65–75 based on outdated assumptions.

Ask for:

• Mammogram (through at least 74–75, longer if healthy)
  
  
• Colorectal cancer screening
  Colonoscopy or other noninvasive tests.
  
  
• Skin cancer check
  Dermatology referral if needed.
  
  
• Lung cancer screening (low-dose CT if you have smoking history)
  
  
• Prostate screening (for men)
  Discuss PSA options.

Phrase to use:

“Let’s make screening decisions based on my health and goals, not just my age.”

6. Medication, Supplements, & Polypharmacy Check

This is CRITICAL after 65.

Ask your doctor to review:

• Every prescription
  
  
• Every OTC medication
  
  
• Every supplement
  
  

You want to know:

• “Do I still need this?”
  
  
• “Could any of these be interacting?”
  
  
• “Are any on the Beers List of risky meds for older adults?”

A good clinician will deprescribe when possible.

7. Sensory & Functional Assessment

These are often skipped — but they dramatically affect quality of life.

Ask for:

• Hearing screening
  (Untreated loss is linked to cognitive decline.)
  
  
• Vision screening
  Cataracts, glaucoma, macular degeneration.
  
  
• Foot exam
  Especially if diabetic or experiencing neuropathy.
  
  
• Oral health referral
  Dental issues worsen cardiovascular health.
  
  

8. Emotional, Social, and Daily Living Review

A geriatrician ALWAYS asks about:

• Sleep quality
  
  
• Loneliness & social connection
  
  
• Exercise & movement
  
  
• Sexual health
  
  
• Caregiver stress
  
  
• Appetite & nutrition
  
  
• Household safety
  

These dramatically impact longevity and independence.

Ask this:

“Can we review my lifestyle factors — sleep, movement, mood, nutrition, and social wellbeing?”

9. Advance Planning + Goals of Care (Not about dying — about LIVING WELL)

This isn’t about end-of-life. It’s about aligning care with your values.

Ask:

• “Can we review my medical power of attorney and advance directive?”
  
  
• “What preventive strategies can help me maintain independence?”
  
  
• “Are there specialists who could support my long-term health goals?”
  
  

10. The Advocacy Phrases That Change Everything

These are your power tools:

• “What would you test or check if I were 45?”
  
  
• “What else could this be?”
  
  
• “I’m not comfortable assuming this is ‘just aging.’”
  
  
• “I’d like these screenings for a full geriatric baseline.”
  
  
• “Please document that I requested this test.”
  (This one often results in the test being ordered.)