Women live longer, but not as well as men, in their golden years, Duke study finds
DURHAM, N.C. — Although women continue to have a longer life expectancy than men, they are now living worse and suffering more disabilities in their golden years, a new study finds.
Researchers compared data from studies of people 65 and older and enrolled in Medicare that were done in 1982, 2004 and 2011. The studies surveyed participants about whether a disability kept them carrying out various daily activities, and then followed the participants in the years following the survey to determine their mortality rate.
The researchers found that between 1982 and 2011, the number of additional years that women at age 65 could expect to live increased by two years, from 18.5 years to 20.5 years, while the life expectancy of men at age 65 increased by five years from 14 to 19 years.
More striking was the improvement in how men spent their golden years. Whereas women at age 65 were estimated to spend 30% of their remaining years with a disability in both 1982 and 2011, the proportion of the time left that men at 65 would have a disability decreased from 22% in 1982 to 19% in 2011.
The researchers considered an individual as having a disability if they reported that a disability or health problem prevented them from doing at least one of their normal activities, such as eating, shopping for groceries and getting out of bed.
“Despite the fact that women live more years than men, they can expect fewer active years,” said Vicki A. Freedman, a research professor at the Institute for Social Research at the University of Michigan, and lead author of the study, which was published on Thursday in the American Journal of Public Health.
It came as a surprise to see that men and women traded places between 1982 and 2011, and that men started to surpass women in terms of disability-free years, Freedman said.
For both genders, trends in disabilities were moving in the right direction between 1982 and 2004. The number of women and men age 65 who experienced a physical limitation dropped from 25.8% to 20.2% and from 22.3% to 15.5%, respectively. But then from 2004 to 2011, the number leveled off for men and actually climbed back up to 24.2% for women.
“The reasons are likely to be complex,” Freedman said.
“Men and women certainly experience different health conditions later in life and maybe we are getting better at treating health conditions that men have,” she said. It is possible that there has been more progress in treating heart disease, which disproportionately afflicts men, than conditions such as arthritis that tend to affect women, she added.
Another reason could have been differences in the health behavior of the older adults who made up the survey cohort in 2011 compared with previous years.
For one, cigarette smoking had increased among women but decreased among men in previous decades. In addition, “older women on average have fewer economic resources than men,” and thus could have been less able to maintain their health, Freedman said.
Looking on the bright side, Freedman pointed out that there at least was not an increase in recent years in the number of people with severe disability, defined as those who were unable to carry out at least three different activities. In 2004 and 2011, about 10% of women and 7% of men fell into this category, down from 13.2% of women and 10.7% of men in 1982.
Part of the reason that older women are more likely to have disabilities is that “women are just living longer regardless of the disability,” said Jen’nan Read, an associate professor of sociology and global health at Duke University who was not involved in the study. “Whereas for men, there’s a selection effect going on in that those making it to the oldest ages are the healthiest,” she added.
No one really seems to understand why women appear more able to keep on ticking through physical adversity, although a number of gender differences could be at play, Read said.
“As the population is aging, and women are more likely to live longer, it has huge implications for [women’s] quality of life. They live longer and have poor quality of life years and also tend to be less likely to have the social and economic resources to deal with these problems,” Read said.
As the baby boomer generation ages, it is expected that 20% of the population will be 65 and older in 2030, compared with 15% in 2015.
“We need systems in place, such as assisted living facilities, nursing homes and home help programs, but we are nowhere near the level we would need as this population of baby boomers explodes in the next 10, 20, 30 years,” Read said.