Women are more disabled in basic activities of daily living than men only in very advanced ages: a study on disability, morbidity, and mortality from the Kungsholmen Project.
OBJECTIVE
We explored the effect of morbidity, mortality, and occurrence of new disability on gender differences in activities of daily living (ADL) functioning in different age groups in the elderly population.


METHODS
All 77+-year-old members of a community-based cohort were clinically examined by physicians, assessed by psychologists, and interviewed by nurses at baseline and after a 3-year interval. Diseases were diagnosed according to ICD-9 and the DSM-III-R criteria for dementia. The Katz index of ADL was used to measure basic functional status.


RESULTS
After adjustment for socio-demographic characteristics, the oldest women (90+ years) had higher disability prevalence and a tendency for higher long-term disability incidence. Women aged 85+ years also had higher morbidity prevalence. Mortality among disabled subjects was similar for both genders, whereas higher mortality was found in younger nondisabled men (77-84 years).


CONCLUSIONS
We conclude that gender differences in disability, morbidity, and mortality vary with age in the elderly population. Gender differences in morbidity and basic functional dependence were evident only in the oldest old. Based on current and previous findings, we speculate that more women may be at higher risk of developing severe disability than men in the advanced ages due to longer survival with slight disability earlier in adult life.
von Strauss
Eva
E
Aging Research Center, Division of Geriatric Epidemiology and Medicine, Neurotec, Karolinska Institutet, Stockholm, Sweden. eva.von.strauss@neurotec.ki.se
Agüero-Torres
Hedda
H
Kåreholt
Ingemar
I
Winblad
Bengt
B
Fratiglioni
Laura
L
D000203:Activities of Daily Living; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology; D015331:Cohort Studies; D006233:Persons with Disabilities / Q000706:statistics & numerical data*; D005260:Female; D015577:Geriatric Assessment; D006304:Health Status; D006801:Humans; D008297:Male; D009017:Morbidity; D012737:Sex Factors; D016019:Survival Analysis; D013548:Sweden / Q000453:epidemiology