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Women continue to outlive men, but with more years of disability, study finds

Thirty years ago, women had an advantage over men in the number of disability-free years they could expect to live after age 65. But that may no longer be true, according to a study published recently in the American Journal of Public Health.

Life expectancy has expanded for both men and women over the past three decades — by an average of five years for men and two years for women. But women appear to be losing ground to men in terms of how many years, on average, they are able to take care of themselves and maintain their regular daily activities without help.

“Older men have been living longer and experiencing disability at later ages than they used to, while older women have experienced smaller increases in life expectancy and even smaller postponements in disability,” said Vicki Freedman, the study’s lead author and a researcher on aging and health at the University of Michigan, in a released statement. “As a result, older women no longer can expect to live more active years than older men, despite their longer lives.”

She and her co-authors say that their findings suggest that long-term care strategies need to put a greater emphasis on quality-of-life issues.

And the sooner, the better. The long-term care needs of the baby boom generation are expected to peak in 2030. That same year, 1 in 5 Americans will be aged 65 years or older, according to projections from the U.S. Census Bureau.

Greater gains for men

For their study, Freedman and her colleagues analyzed disability data collected from two large federal health surveys of Medicare enrollees in the years 1982, 2004 and 2011.

During that 30-year period, the age an average 65-year-old woman could expect to live increased from 82.5 years to 85.5 years, the analysis found. For men, the longevity increase was significantly greater, rising from 78 years to 83 years.

Women, therefore, continue to outlive men, but the extra couple of years are not necessarily something to cheer about.

That’s because women have made little progress in staving off disability in their later years. The analysis revealed that women at age 65 could expect in both 1982 and 2011 to spend, on average, an estimated 30 percent of their remaining years with a disability. Compare that to 65-year-old men, who in 2011 could expect to spend 19 percent of their remaining years disabled, down from 22 percent in 1982.

The gender difference becomes even starker when people reach the age of 85.

“Men this age can now expect nearly four-and-a-half additional active years, up from two-and-a-half years three decades ago,” said Freedman. “Women this age can expect to live only about two-and-a-half years free from disability, just about the same amount as in 1982.”

The study did, however, uncover one encouraging finding for men and women alike: The average duration of severe disability after age 65 has not increased among either gender. In fact, it’s fallen. In 2011, about 10 percent of women and about 7 percent of men aged 65 and older had a severe disability, down from 13.2 percent of women and 10.7 percent of men in 1982. (A severe disability is one that makes it impossible to do at least three different daily activities, such as bathing, shopping or preparing meals.)

Complex reasons

Why are men and women trading places in terms of disability-free years in later life?

Several factors are probably involved, according to Freedman and her colleagues.

“Women are more likely than men to develop a number of debilitating conditions including arthritis, depressive symptoms, fall-related fractures, and Alzheimer’s disease and related dementias that have implications for active life,” they write. “Older women are also more likely to be sedentary and obese, and their smoking behaviors appear more detrimental than for men.”

Gender income inequality also plays a role. Older women “continue to have fewer economic resources than men with which to accommodate declines in functioning in ways that stave off disability,” they add.

Indeed, women in the U.S. are 80 percent more likely than men to end up in poverty after the age of 65, according to a report released earlier this month by the National Institute on Retirement Security.

FMI: You’ll find an abstract of the current study on the website for the American Journal of Public Health, but the full paper is behind a paywall.

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