In Your 40s? What Your Primary Care Doctor Is Looking For | Keck Medicine of USC

In Your 40s? What Your Primary Care Doctor Is Looking For

You’re in your 40s. You have settled into your career. If you have children, you’re watching them grow and you’re in a busy routine that works for you.

As we enter mid-adulthood, we become more prone to risk of disease. Degenerative disease is no longer something in the far-off future, but something we have to consciously avoid by making changes in our diet and lifestyle.

But how do you maintain your health while also balancing so many different obligations? All it takes is setting aside a few hours to see your doctor for a checkup.

But what happens in this process? What are they looking for? We reached out to one of our most trusted resources on the topic.

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Rose Taroyan, MD, MPH

Rose Taroyan, MD, MPH

Keck Medicine of USC’s very own Rose Taroyan, MD, MPH, assistant professor of clinical family medicine, describes what she and her staff look for when you go to visit the doctor’s office in your 40s.

1. Heart disease prevention

When you’re in your 40s, the first thing your primary care physician is going to want to check is your risk for heart disease. The goal here is to prevent cardiovascular disease and reduce the risk of a myocardial infarction, also known as a heart attack.

If anything looks out of the ordinary, your physician will be able to provide tips and instructions on how to manage any health concerns.

If you’re a man, between the ages of 45-79, your primary care physician may recommend medications, like aspirin, to help prevent cardiovascular disease.

2. Diabetes screening

After your heart is checked, the next thing your primary care physician will do is screen you for diabetes. This goes on regularly from the ages of 40 to 70. There are many risk factors for diabetes, such as being overweight, obese or experiencing hypertension or hyperlipidemia.

Based on your results, your doctor will be able to provide treatment options.

3. Dyslipidemia screening

Your primary care physician will also do a screening for dyslipidemia, a condition characterized by abnormal concentrations of lipids or lipoproteins in the blood. Screenings for dyslipidemia are also based on age and gender.

4. BMI evaluation

Additionally, your primary care physician will check your body mass index (BMI) — a measure of body fat determined by the ratio between your weight and height. This number indicates how healthy your weight is.

During this process, your primary care physician is going to do an obesity screening. If this value seems out of the ordinary, counseling will be provided.

This is a good time to talk to your primary care physician about your:

  • Physical activity
  • Nutrition
  • Daily habits

This discussion will determine whether there should be some counseling on:

  • Exercise tips and activities
  • Eating habits (consuming 5 or more servings of fruits or vegetables daily)
  • Preventing heart disease
  • If you’re a woman and planning for pregnancy, adding supplements like folic acid to your diet may be discussed.

5. Depression screening

While seeing your primary care physician, they will be checking for signs of depression. If you feel down or think you may be experiencing depression, be honest with your doctor.

During this screening, they will go through a quick and simple test that consists of 10 questions:

  1. Little interest or pleasure in doing things?
  2. Feeling down, depressed or hopeless?
  3. Trouble falling or staying asleep, or sleeping too much?
  4. Feeling tired or having little energy?
  5. Poor appetite or overeating?
  6. Feeling bad about yourself or thinking that you are a failure, or have let yourself or your family down?
  7. Trouble concentrating on tasks and activities, such as reading the newspaper or watching television?
  8. Moving or speaking so slowly that other people have noticed. Or the opposite — being so fidgety or restless that you have been moving around a lot more than usual?
  9. Have you experienced thoughts of suicide or of hurting yourself in some way?
  10. If you checked off any problems, how difficult have these problems made it for you to do your work, take care of things at home or get along with other people?

Your answers are evaluated based on a numerical scale that will help your physician determine if you’re experiencing depression. Recommendations for a treatment plan may also be part of the assessment.

6. Anxiety screening

In your 40s, you may have a wide range of personal and professional responsibilities which could, in turn, elevate your level of anxiety. In addition to the screening for depression, your physician will also evaluate your level of anxiety.

The quiz looks like this:

Over the last two weeks, how often have you been bothered by the following problems?

Not at all    Several days Over half the days Nearly everyday

Feeling nervous, anxious or on edge

Not being able to stop or control worrying

Worrying too much about different issues

Trouble relaxing

Being so restless that it’s hard to sit still

Becoming easily annoyed or irritable

Feeling afraid as if something awful might happen

7. Alcohol misuse (CAGE) – screening and behavioral counseling interventions

Your primary care physician is going to want to check for is alcohol misuse through a screening and behavioral counseling interventions.

This starts off by identifying your CAGE score. To figure this out, your primary care physician will ask you 4 simple questions:

  1. Have you ever felt you should Cut down on your drinking?
  2. Have people Annoyed you by criticizing your drinking?
  3. Have you ever felt bad or Guilty about your drinking?
  4. Have you ever had a drink first thing in the morning to steady your nerves or to get rid of a hangover (Eye-opener)?

A total score of two or greater is considered significant.

8. Tobacco use counseling and pharmacotherapy intervention

During the checkup, your doctor will be asking about your use of tobacco, providing counseling (if necessary) and discussing pharmacotherapy invention (if needed). Pharmacotherapy invention is basically medication to help end tobacco use: for instance, nicotine gum, the patch or prescription pills.

9. Nutritional counseling and physical

In your 40s, diet is key to maintaining a long life. Your primary care physician will ask you about what you are eating, what vitamins you are taking and how much physical activity you are involved in each week. A plan will then be laid out to prevent damage to the heart’s major blood vessels.

10. Domestic violence screening

Some people end up in homes with domestic violence and they don’t know where to turn. If something is happening in your life and you have been looking for someone to share it with, discussions with your primary care physician are safe.

Request an appointment

Understanding what your primary care physician is looking for will help you be prepared for your visit. Remember, both you and your physician have the same goal — to keep you healthy.

If you’re in the Los Angeles area and are looking for exceptional care from some of the top physicians in the world, be sure to schedule an appointment by calling (800) USC-CARE (800-872-2273) or by visiting

by Leonard Kim