CHICAGO, Illinois—Women may live longer than men, but they don’t necessarily live better. New research shows that females are at greater risk for disability, and that obesity and arthritis are the two most important reasons. The findings were presented at the Annual Scientific Meeting of the American Geriatrics Society in Chicago.¹

“While women tend to live longer than men, this study shows that they are at greater risk of living with disability and much of the excess disability is attributable to higher rates of obesity and arthritis," said lead study author Heather Whitson, MD, an assistant professor of medicine at Duke University Medical Center in Durham, North Carolina.

Dr. Whitson and colleagues studied 5,888 people older than 65 in data from the Cardiovascular Health Study. This study asked participants about their ability to perform activities of daily living including grooming, eating, getting dressed, walking, and climbing stairs. The analysis showed that females were up to 2.5 times more likely than males to have disabilities, and that obesity and arthritis accounted for up to 48% of this disability gender gap.

Translating research into practice: intervene in the formative years

“The problems we characterized were in an older cohort, but we think the solution begins much earlier in life,” Dr. Whitson said. “We demonstrated that women’s greater tendency to develop obesity and arthritis translates into a loss of independence in older age,” she said. “If we can prevent obesity and either prevent arthritis or manage the pain it causes, we should be able to reduce this gender discrepancy.”

Women tend to gain weight during their child-bearing and premenopausal years, so helping women maintain a healthy weight during this time is key, she said. “Our study provides another talking point for physicians who are trying to help women battle their weight,” Dr. Whitson told MSKreport.com.

"Women have a natural tendency to gain more weight than men over their lifespan, but may be more motivated to maintain a healthy weight if they realize that those extra pounds make it more likely that they will be disabled in later years—potentially becoming a burden to their children or requiring a nursing home," she added.

“Women may have quantity, but they don’t have quality of life,” said Philadelphia-based women’s health expert Marie Savard, MD, author of several books including Ask Dr. Marie: Straight Talk and Reassuring Answers to Your Most Private Questions. “The message is that women have potential to live longer and more fulfilling lives and a lot of these illnesses can be prevented if physicians are vigilant at younger ages.”

Lifestyle changes make all the difference, she told MSK Report. “We need to tell our patients now that weight and movement is everything when it comes to osteoarthritis risk,” she said. “For every pound they lose, their knees will last that much longer.”

Gap could widen

In the study, women were also more likely than men to experience fractures, vision problems, and bronchitis. Men were more likely to have emphysema, coronary heart disease, congestive heart failure, stroke, diabetes, and hearing problems.

But women are gaining ground with men when it comes to cardiovascular disease, stroke and emphysema, the study authors note. If these conditions become more comparable between the sexes, there could be an even wider gap in disability rates, the study authors note.

The rates of disability among all adults is also on the rise, which may further fuel the disability gender gap according to a new report in the May 1, 2009 issue of Morbidity and Mortality Weekly Report.²

What’s more, the number of US adults reporting a disability increased by 3.4 million between 1999 and 2005. In fact, fully 1 of 5 US adults reports a disability, mainly of arthritis, back or spine problems, and heart disease.

"It is likely we will see more dramatic increases in the number of adults with a disability as the baby boomer population begins to enter higher risk, older age groups over the next 20 years," said Chad Helmick, MD, a medical epidemiologist at the federal Centers for Disease Control and Prevention (CDC) in Atlanta.

This study also found that women have a higher prevalence of disability compared with men at all ages, 24.4% versus 19.9%, respectively. The study also found that disability prevalence doubled for each successive age group.

References

1. Whitson HE. Comorbidities and the gender difference in disability analysis of the cardiovascular health study. Presented at:  Annual Scientific Meeting of the American Geriatrics Society; April 29-May 2, 2009;Chicago, Ill.
2. Brault MW, Hootman J, Helmick CG, Theis KA. Prevalence and most common causes of disability among adults – United States, 2008. MMWR. 1009;58:421-426.