Over decades of practicing medicine, I have seen a reality that repeats itself more than many imagine: older people who undergo medical studies convinced that they are taking care of their health, but who end up facing unexpected consequences. Not because the medicine is dangerous, but because many tests are ordered automatically, without evaluating whether they really provide a real benefit at that age.

From the age of 70, the body changes. Organs become more fragile, the ability to recover decreases, and the margin of error is greatly reduced. At this stage of life, not everything that is medically possible is necessarily the most convenient.

These are five check-ups that, except for very well-justified situations, I would not routinely have after the age of 70.

1. Colonoscopy as a routine exam

Colonoscopy has for years been a mainstay in colon cancer prevention, especially in young or middle-aged people. However, in older adults without clear symptoms, its automatic indication may be more risky than beneficial.

With aging, the intestine loses elasticity and the wall of the colon becomes more fragile. Added to this is a particularly aggressive preparation, which includes powerful laxatives and large volumes of fluids, capable of causing severe dehydration, alterations in blood pressure and cardiac or renal decompensation.

In addition, the risk of intestinal perforation during the procedure increases considerably after the age of 70. In that case, the only way out is emergency surgery, which at this stage of life can bring serious complications.

There are safer alternatives, such as fecal occult blood tests, which allow reasonable monitoring and only warrant a colonoscopy if the result is abnormal.

2. Computed tomography scan with contrast dye

Contrast tomography is often perceived as a modern, reliable study. However, in older adults, contrast can pose a significant risk to the kidneys, whose function silently declines with age.

The contrast is eliminated through the kidneys, and in older people it can cause acute kidney damage. In some cases, a single unnecessary CT scan can trigger irreversible kidney failure that leads to lifelong reliance on dialysis.

There are also risks of serious allergic reactions, even in people who never had previous allergies.

Whenever possible, safer alternatives such as non-contrast CT scans, ultrasounds, or MRIs should be evaluated, and kidney function should be checked beforehand.

3. Cardiac stress test with no clear symptoms

The stress test seeks to evaluate the heart by subjecting it to intense physical stress. In young people or with clear symptoms it can be useful, but in older adults without specific discomfort, it can become an excessive test.

Forcing the heart to work at the limit can trigger arrhythmias, sudden drops in pressure, fainting or even heart attacks. In addition, this study has a high rate of false positives in older people, leading to a cascade of unnecessary invasive tests.

In many cases, a resting electrocardiogram and echocardiogram provide enough information without putting extreme stress on the heart.

4. Full-body PET-CT as a general check-up

PET-CT promises a complete examination of the body and often generates a false sense of security. However, in older adults without clear symptoms, their use as a general check-up usually causes more problems than benefits.

This study is extremely sensitive and detects minimal alterations that, in most cases, do not pose a real threat. The problem is that once a suspicious image appears, a chain of biopsies, invasive procedures and constant anxiety begins.

In addition, PET-CT radiation is elevated, and the aging body’s ability to repair cell damage is lower. Paradoxically, a study done to look for cancer can increase the risk of developing it.

5. Digestive endoscopy with sedation

Endoscopy itself is not the main problem, but sedation. In older adults, sedatives are metabolized more slowly and can lead to respiratory depression, prolonged confusion, falls, and serious complications.

There are cases in which, after sedation, the person does not wake up as expected and requires intensive care. In addition, the state of subsequent daze significantly increases the risk of falls, which at this stage of life can be devastating.

In many cases, endoscopy without sedation is perfectly tolerable, lasts a few minutes and avoids unnecessary risks.

Check-ups that are worthwhile at this stage

Taking care of your health after 70 does not mean losing control of yourself, but choosing better:

• Basic blood tests to monitor glucose, cholesterol, and kidney function.
• Regular blood pressure measurement.
• Bone densitometry to prevent fractures.
• Ophthalmological and hearing check-ups.
• Simple fecal occult blood tests.
• Balance assessment and fall prevention.

Tips and recommendations

• Before any study, always ask: what is being looked for, what is the risk, and will my treatment really change?
• Avoid “routine” checkups without a clear indication.
• Prioritize healthy daily habits over complex studies.
• Reduce unnecessary medications and periodically review your treatment.
• Maintain an adequate diet, good hydration and physical activity adapted to your age.
• Quality of life should always be part of the medical decision.

Taking care of one’s health is not about doing more studies, but about making decisions with criteria, information and respect for the body that has sustained a lifetime. Well-applied medicine is not the one that intervenes the most, but the one that best chooses when to do it.