NHS health checks

The NHS offers free health checks every five years for adults aged 40 to 74 years, to help spot early signs of: 

• Stroke 
• Kidney disease 
• Type 2 diabetes 
• Dementia. 

The check involves lifestyle questions; taking a family history; and measurements of blood pressure, cholesterol and possibly blood glucose. With the recent pressure on services due to COVID-19, not all customers may have been able to access these checks, so they might be looking for advice. 

Osteoporosis 

In later life, customers can be affected by a loss of bone that can make bones weaker and more fragile. This is a typical part of ageing, but some people lose bone much faster than normal, which can lead to osteoporosis. It develops slowly over several years and increases the risk of broken bones.¹ 1 in 2 women and 1 in 5 men over 50 will break a bone because of osteoporosis.² It is more common in women, as they have smaller bones and lower oestrogen during menopause.

To look after their bones, customers can be advised to eat healthily, with plenty of calcium-rich foods, and consider taking a daily vitamin D supplement (especially in autumn and winter). Regular exercise is advised to help keep bones healthy and reduce the risk of fracture, as well as lifestyle changes such as reducing alcohol consumption and stopping smoking. 

Incontinence 

Incontinence can affect men and women of all ages. Triggers include pregnancy, menopause and ageing. Customers may feel embarrassed to buy products for incontinence and often initially try to manage leaks with menstrual pads or liners, but as the condition progresses, these may not effectively control the volume of liquid or any associated odour. You can help reassure customers about the condition and how common it is. 

You could also offer to order incontinence products online for customers to be delivered directly to their home, removing the need for them to carry bulky products around while shopping and allowing discretion if customers are embarrassed about purchasing. 

Eye care 

Everyone aged 60 years and over can get a free eye test every couple of years (customers over 40 with a close relative with glaucoma are also eligible). Eye tests at a local Boots Opticians can be booked online by going to Boots.com/opticians/eyetest or by calling 0345 125 3752. 

Conditions such as glaucoma, cataracts and macular degeneration become more common with increasing age, and an optician can identify these conditions at an early stage. To help keep the eyes healthy, customers can be advised to attend regular appointments; wear sunglasses to protect the eyes from the sun; and eat a healthy and varied diet. Smoking can accelerate age-related eye problems, so you could advise customers to stop smoking as part of your lifestyle advice. 

Age-related macular degeneration (AMD) usually affects people over 50, but it can happen earlier. There are two forms of AMD – dry and wet:³ 

• Dry AMD is when there is a gradual deterioration of the macula (a part of the retina at the back of the eye with a high concentration of the cells that detect light) as the retinal cells die and are not renewed 
• Wet AMD develops when abnormal blood vessels grow into the macula. These leak blood or fluid which leads to scarring of the macula and rapid loss of central vision.

Hearing loss

Most people will experience some level of hearing loss with age. There can be age-associated damage to the inner ear, affecting hearing in both ears. Customers may find it harder to hear ‘s’, ‘f’ and ‘th’ sounds in words, and it can be hard to hear what people are saying when there is background noise.⁴ 

Adults aged 19 years and over can book a free 15-minute hearing check at Boots Hearingcare by visiting www.bootshearingcare.com. It is recommended to get a hearing check every two years when aged over 50 years. 

Flu vaccine 

The flu vaccine can be given free on the NHS to those aged 50 years and over, as well as those with certain health conditions. Customers can book online and select a convenient appointment in a local Boots store (subject to availability). 

Type 2 diabetes

The risk of type 2 diabetes can increase with age, particularly in those who are overweight; have hypertension; have a close family member with diabetes; or are of Asian, African-Caribbean or black African descent. It can be hard to spot the symptoms and is sometimes diagnosed when people are being tested for something else. 

Symptoms include:⁵ 

• Tiredness 
• Frequent urination 
• Unintentional weight loss 
• Repeated thrush infection 
• Cuts/wounds taking longer to heal 
• Blurred vision.

Hypertension 

Blood pressure is a measure of how hard the heart is working to pump blood around the arteries and push it to the rest of the body. The medical term for high blood pressure is hypertension. Blood pressure measurements can vary throughout the day, and may increase with activity, but when it is consistently high, it should be treated. Untreated hypertension may result in conditions such as heart and circulatory diseases (e.g. stroke), kidney failure or problems with sight. Medication to reduce blood pressure may need to be prescribed (e.g. ACE inhibitors or calcium channel blockers). Hypertension can have a genetic link and may worsen with age. It is also more common in people of black African or black Caribbean descent. 

Customers who are worried about hypertension can be advised to: 

• Maintain a healthy weight 
• Exercise regularly  
• Not eat too much salt  
• Stop smoking  
• Limit alcohol intake.  

Blood pressure can be tested using a digital blood pressure monitor. A cuff on the arm (or wrist) inflates to restrict the blood flow. The pressure is then slowly released and recordings are made when the blood is no longer restricted and starts to flow. 

A blood pressure reading is made up of two figures, e.g. 134/85mmHg (mmHg is millimetres of mercury). Systolic pressure (the pressure in arteries during heart contraction) is the top reading and diastolic pressure (the pressure when the heart is between beats) is the bottom one. Generally, normal blood pressure is considered to be between 90/60mmHg and 120/80mmHg. 

When customers have high blood pressure readings taken at the surgery, GPs may recommend ambulatory blood pressure monitoring. This is when someone has 24-hour testing, around once every 30 minutes, using a portable device. This helps to calculate the average blood pressure, as sometimes isolated readings can be misleading, and readings taken while people are carrying out their usual activities may be more accurate. This is useful for people who may have a high blood pressure reading due to the stress of being in the GP surgery – known as white coat syndrome. 

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