Annual Laboratory Tests for Geriatric Patients

Core Laboratory Tests

The American College of Physicians recommends that annual laboratory tests for geriatric patients should include a comprehensive metabolic panel, complete blood count, lipid profile, hemoglobin A1C, urinalysis with albumin-to-creatinine ratio, and thyroid-stimulating hormone 1
Complete Blood Count (CBC) with differential screens for anemia, infection, and blood disorders commonly found in older adults 1
Comprehensive Metabolic Panel (CMP) assesses kidney function, liver function, and electrolyte balance, which are particularly important in geriatric patients who often have multiple chronic conditions 1
Hemoglobin A1C screens for diabetes and prediabetes, which affect over 29% of people over age 65 2, 3
Urinalysis with albumin-to-creatinine ratio screens for kidney disease and urinary tract infections 1
Thyroid-Stimulating Hormone (TSH) is particularly important for older adults as thyroid disorders increase with age 1

Prostate-Specific Antigen (PSA) is recommended annually in men aged 50+ years (earlier in high-risk men) 1
Vitamin B12 levels should be checked annually in patients taking metformin, which is common in older adults with diabetes 1
Serum potassium levels should be monitored in patients taking ACE inhibitors, ARBs, or diuretics, medications frequently prescribed to older adults 1

Annual screening for geriatric syndromes is recommended in older adults with diabetes, including assessment for cognitive impairment, depression, urinary incontinence, and persistent pain 2, 4

For geriatric patients with diabetes, more frequent monitoring is recommended, including A1C test at least twice yearly if meeting treatment goals, and quarterly A1C if therapy has changed or not meeting goals 1, 3
Glycemic goals should be individualized based on functional status, with A1C <7.5% for older adults who are otherwise healthy, and A1C 8.0-8.5% for those with multiple chronic illnesses or functional dependence 1, 4