Women outlive men but suffer long years of disability

Reuters Health - Women may have a longer life expectancy than men, but they are spending more of their golden years living with disabilities, a U.S. study finds.

Researchers analyzed studies of people 65 and older enrolled in Medicare, the U.S. health program for the elderly. The studies asked how often disabilities kept people from fully participating in daily activities and then followed them over time to see how long they lived. They looked at data from 1982, 2004 and 2011.

Over that period, the age an average 65-year-old woman could expect to live to increased by two years, from 82.5 years to 85.5 years, the analysis found. Men don’t live as long, but they gained more years – five – expanding their life expectancy at age 65 to a further 19 years from 14 years.

But women shouldn’t necessarily celebrate getting those extra birthdays.

After age 65, women consistently spent an estimated 30 percent of their remaining years with a disability. Men, on the other hand, started out spending 22 percent of their remaining years after 65 disabled and saw that decrease to 19 percent by the end of the study.

It’s hard to say exactly why women may experience more years of disability, but some of this might be due to unequal progress in treating their health conditions or different shifts in gender lifestyle habits like smoking and exercise over time, said lead study author Vicki Freedman, of the Institute for Social Research at the University of Michigan in Ann Arbor.

“Older women also have fewer economic resources than men on average so they may not be as able to accommodate their declines in functioning when they do occur,” Freedman said by email.

“Whatever the reason, this is an important trend to continue to monitor as the large Baby Boom cohorts continue to reach old age,” Freedman added.

Disabilities might make it harder to complete daily activities like dressing, bathing, cooking, shopping or driving.

Severe disability – when people had trouble with at least three different activities – declined for both women and men over the study period, researchers report in the American Journal of Public Health.

In 1982, 13.2 percent of women and 10.7 percent of men experienced severe disability after age 65. By 2011, this dropped to about 10 percent of women and 7 percent of men.

One limitation of the study is its reliance on data from just three individual years, which made it impossible to explore how disability onset or recovery might influence life expectancy, the authors note. They also limited the analysis of disability to mobility and completion of daily activities, which excludes other impairments that can influence health and quality of life.

It’s possible, though, that the same heartiness that makes women live longer than men also contributes to their greater propensity toward disability in their later years, said Dr. James Kirkland, director of the Robert and Arlene Kogod Center on Aging at the Mayo Clinic.

“Women are biologically more hearty than men so instead of dying from a heart attack or something like that they recover, but they recover disabled,” said Kirkland, who wasn’t involved in the study.

Many women may also assume caretaker roles that leave less time for recreational, social, and self-fulfilling activities that might help keep disability at bay, noted Dr. Lili Lustig, a family medicine specialist with the Cleveland Clinic in Warrensville Heights, Ohio.

At the same time, some women may also lack the financial resources to stop working as they get older or to pay for services they need, particularly if they are poor, Lustig, who wasn’t involved in the study, added by email. They may also struggle to pay for basic needs like food, medicine and housing.

“Women are not prepared for the golden years,” Lustig said. “The idea of the idyllic retirement portrayed on TV does not exist.”

SOURCE: American Journal of Public Health, online March 17, 2016.