Credit: Jimmy Tan
Summary:
- As people age, they often overlook screenings for conditions like osteoporosis, vision and hearing loss, frailty, and cognitive decline, mistaking them as normal signs of ageing rather than treatable health issues.
- Experts stress that maintaining physical and functional health –through targeted screenings for bone density, sensory functions, oral health, and mobility – is as vital as managing chronic diseases like diabetes or hypertension.
- Regular and specific screenings such as eye exams, hearing tests, bone density scans, urological check-ups, and cancer screenings enable early detection, prevention, and better long-term quality of life for older adults.
When his wife wanted to get a bone density scan at SATA CommHealth upon turning 50 some years ago, Jimmy Tan, then 56, decided to provide moral support by getting scanned too.
To his shock, although his wife got an all-clear, Jimmy – who is an avid swimmer and gym-goer – was diagnosed with osteopenia in his left hip and osteoporosis in the first four vertebrae (L1, L2, L3, and L4) in the lumbar (lower back) region of his spine.
Osteoporosis (a disorder that weakens bones and increases fracture risk) and osteopenia (low bone mass) are but two common ageing-related health conditions affecting both men and women aged 50 onwards.
Other conditions that may affect us as we age include declining vision and hearing, increased urinary frequency, and cognitive decline.
While basic health screenings mainly focus on common chronic diseases such as hypertension, high cholesterol, and diabetes (admittedly among the most common health issues affecting seniors in Singapore), these often don’t cater for other ageing-related health conditions such as bone mass loss, sensory decline, and frailty.
Many older adults often overlook specific health screenings for those because they assume that slowing down or feeling weaker is simply “part of ageing” rather than a health issue, says Associate Professor Reshma Merchant, Head & Senior Consultant, Division of Geriatric Medicine, Department of Medicine, National University Hospital (NUH).
"Others prioritise managing existing chronic conditions and may not realise that muscle and mobility loss increase their risk of falls, hospitalisation, and poorer recovery from illness."
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Importance of specific health screenings
As we age, maintaining function becomes just as important as controlling disease, asserts Prof Reshma.
"Specific screenings for issues such as frailty, sarcopenia, cognitive decline, sensory loss, oral health, and nutrition help detect early, subtle changes in strength, mobility, and vitality that predict future dependency."
Credit: National University Hospital
Therefore, beyond annual checks on chronic diseases such as hypertension, diabetes, and heart disease, do consider the following specific health screenings as well. Remember, detecting decline early ensures we can live life fuller for longer.
- Vision screening
As we grow older, our vision goes beyond “can’t see near or far” situations.
For starters, most of us will get cataracts, which is the clouding of the eye’s lens that leads to blurry or dim vision. According to NUH, cataracts affect over 60% of people aged 60-64 and nearly 95% of people aged 75 years and older in Singapore.
I actually developed cataracts in my 50s – earlier than most. Since I wear glasses, I assumed regular visits to the optician would be enough. Thankfully on one visit, my optician noticed signs of cataracts in my left eye and advised me to see an eye specialist.
That started my journey of having regular eye health checks with a private ophthalmologist. The cataracts in my left eye were surgically removed at age 53, while those in my right were removed at 59. I’ll also visit my eye doctor if I have issues like ageing-related floaters (small flying specks in vision) or severe conjunctivitis (“red eyes”).
Even if you do not wear glasses, regular eye exams are important as other serious ageing-related eye conditions like glaucoma (which damages the optic nerve), astigmatism (caused by an irregular cornea), and macular degeneration (deterioration of the retina) can lead to severe vision loss or even blindness if not detected early.
You can get checks at the Singapore National Eye Centre (SNEC), eye centres at public hospitals such as Singapore General Hospital or at private hospitals such as Parkway East Hospital (or get referrals from CHAS GPs or polyclinics). If not, the NUH Community Eye Clinics @ Pioneer and Choa Chu Kang (by appointment only), or private eyecare specialists or clinics works too.
Estimated charges*: SNEC from $25-$60 (basic consultation) for Singapore citizens; $150-$200 (private consultation). First-time consultation at public hospitals $29-$75 (subsidised) and $165-$210 (private); first-time consultation at private eye clinics $150-$250.
- Hearing test
If you find it hard to follow conversations or need people to speak louder to get your attention, it may be time to check your hearing. Recent studies have also shown that untreated hearing loss can increase the risk of dementia, as it often leads to social withdrawal and isolation.
A hearing test usually begins with a visual ear examination to check on problems including ear wax blockage (which can cause dizziness and vertigo) and tinnitus (ringing in the ears). This is followed by a pure-tone audiometry test to assess how well you can hear different pitches and frequencies.
Retiree Chen Xiu Xiu experienced sudden hearing loss in her right ear in her 50s, even though her late mother only had hearing issues in her 80s. Her affected ear was diagnosed with 100% hearing loss by a specialist at Mount Elizabeth Hospital. Thanks to medication and regular ear cleaning, the 65-year-old has now regained 97% of her hearing, with doctors attributing the 3% loss to ageing.
If you are 60 and above, a more affordable option is by having your ears checked through Project Silver Screen, a national functional screening programme held year-round at Active Ageing Centres, Community Clubs, and at Residents’ Networks.
These screenings, which include a very basic eye test and oral check, are free for Pioneer Generation, $2 for Merdeka and CHAS (Community Health Assist Scheme) Blue/Orange cardholders, and $5 for Green CHAS cardholders.
The healthcare staff will check your ears for earwax blockage and, if none, provide an audiometry test. If treatment is required, you will be referred to a specialist for follow-up care.
ENT units at public and private hospitals such as Singapore General Hospital, specialised ENT clinics, and dedicated hearing clinics such as Hearing Partners and The Hearing Centre are also viable options.
Estimated charges*: Consultations for public hospital specialists are $110–$220+, while private ENT doctors are $180–$400+. Some hearing clinics offer free hearing tests.
- Bone density scans
The risk of a senior having bone mass loss is high, particularly for women after menopause and for both men and women aged 65-70.
The best way to check for bone mass loss is via a Bone Mineral Density (BMD) scan, which is a non-invasive procedure using low-dose X-rays to measure bone mineral density (a.k.a DXA scan).
Besides osteoporosis and osteopenia, a BMD/DXA scan is able to highlight other musculoskeletal disorders such as inflammatory arthritis (which causes pain, swelling, and stiffness in joints) and osteoarthritis (degenerative disease of joint cartilage and underlying bone). It also assesses an individual’s risk to develop fractures.
Credit: Jimmy Tan
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"My spine and left hip are showing gradual improvements each year and I do annual check-ups at Sengkang General Hospital’s endocrinology department."
BMD/DXA scans can be done at SATA CommHealth, public and private hospitals, NHG Diagnostics polyclinics and Mobile BMD (selected days and various venues), as well as at dedicated health screening clinics such as ATA Medical.
Estimated charges*: From $60 at SATA to $130-$400 (depending on test requirements) at private and public hospitals. Or sign up for a research study that offers free BMD scans as part of their research.
- Urological screening
Due to ageing, our bladder and pelvic muscles start to weaken from age 50.
Regular check-ups with a urologist – especially if you have a family history of urological issues – help detect common ageing-related concerns such as frequent urination (especially at night), urinary incontinence, kidney disease, and prostate issues.
For men, prostate screenings are essential (recommended from age 40) as they address prevalent male health issues such as prostate enlargement (which causes frequent/difficult/night-time urination), reproductive system problems (eg. erectile dysfunction) and cancers affecting the kidney, bladder, or prostate.
For women, routine urological check-ups are recommended as hormonal changes (especially if undergoing menopause) and weakened pelvic floor muscles are often the reasons for an overactive bladder, pelvic pain, or kidney problems.
Get urological screenings done at specialists at public and private hospitals or private specialist clinics such as Raffles Medical Group.
Estimated charges*: Specialists at public hospitals start from $29 (subsidised, first visit) to $220 (private) not including test and medication; private hospitals from $150 onwards.
- Cancer screenings
According to the Singapore Cancer Society, the five most common cancers in Singapore (2017-2021) are: Breast (women), Prostate (men), Colorectal & Rectum (both men and women), Uterine (women) and Lung.
Before you “touch wood”, remember early detection is key. Regular cancer screenings can detect signs even before symptoms appear, improving the chances of successful treatment. This is especially important if you have a family history of cancer.
Early this year, a 66-year-old friend of mine went for a mammogram – her last one was done in 2021 – at Clementi Polyclinic as it is currently free for Healthier SG enrollees aged 50 and above.
Her results revealed Stage 1 breast cancer after cancer nodes were found in her right breast. Thanks to early detection, surgery was swiftly arranged at NUH and she is now undergoing chemotherapy and radiation treatment. The timely screening helps in stopping the cancer from spreading to other areas of her body.
Credit: Breast Cancer Foundation
Breast cancer screening is recommended every two years for women aged 50–69. Mammograms can be booked at approved BreastScreen Singapore centres (selected CHAS GPs, polyclinics, and hospitals), Community Mammobus under Breast Cancer Foundation, NHG Mammobus, and at the Singapore Cancer Society Clinic @ Bishan.
Prostate cancer (uncontrolled growth of cells in the prostate) is the most common cancer in Singapore men and risk increases with age. Men aged 40 and above are encouraged to go for regular screening, which may include a prostate-specific antigen (PSA) blood test and a digital rectal exam. These are available at CHAS GPs, polyclinics, hospitals, and specialty clinics like DTap. Fees are $40-$400++, depending on tests required.
Colorectal cancer screening, usually done via colonoscopy, is available at public and private hospitals (with or without referrals). Eligible individuals may get subsidised screening under Healthier SG, which includes cervical cancer screening.
Lung cancer (genetic damage to cells in the airways) screening is recommended if you’re a long-term smoker, a recent quitter, or even a pensive smoker. Screenings can be done at National Cancer Centre Singapore (NCCS), hospitals, and specialist clinics.
According to SingHealth, liver cancer (a.k.a HCC) is the 4th most common cancer among men in Singapore and affects about 20-30 in every 100,000 people a year. A thorough screening may include blood tests, ultrasound, CT/MRI scans, and biopsy. These can be done at NCCS, hospitals, and private liver specialists.
If you are unable to visit a healthcare facility, healthcare providers such as Minmed and Speedoc offer home-based health screening services including blood pressure, cholesterol, and tumour markers (ovarian, prostate, colon, etc). Packages range from $105 to $500++.
*Charges listed are correct/estimated at time of publishing and subject to change.
