Sex-related differences in the length of disability prior to death in older persons.
OBJECTIVE
It is acknowledged that, in spite of their generally worse health, women live longer than men. However, whether women also enjoy longer disability-free lives is still unclear. Using data from a representative, Italian cohort followed for 6 years, this study aimed at estimating differences between men and women in the age of disability onset and in total survival.


METHODS
In 1989, 651 persons aged > or = 65 years were interviewed and their medical status was assessed by a geriatrician. In 1995, the time of onset of disability was reconstructed by re-interviewing 392 survivors and collecting proxy information for 201 subjects who had died. No information was available for 58 subjects who refused to be re-interviewed or were lost to follow-up. Data on changes in functional status were also collected by proxy interview for 34 additional persons who had died during the follow-up period, although they had not been originally interviewed at baseline.


RESULTS
Of the 235 deaths, 113 were men and 122 were women. On average, the age at death was 3.5 years higher among women than among men. However, the age at onset of disability was similar in the two sexes. In survival analysis in which age was the time variable, women were as likely as men to develop disability, but significantly less likely to die over the follow-up period.


CONCLUSIONS
Compared with men, women experience longer disability before death. This may be due to sex-related differences in the lifetime prevalence of lethal vs. disabling diseases.
Ferrucci
Luigi
L
Longitudinal Studies Section, Clinical Research Branch, National Institute on Aging, Baltimore, USA.
Turchi
Angela
A
Fumagalli
Stefano
S
Di Bari
Mauro
M
Silvestrini
Gabriella
G
Zacchei
Simona
S
Nesti
Alessandra
A
Magherini
Lorenza
L
Tarantini
Francesca
F
Pini
Riccardo
R
Antonini
Enrico
E
Masotti
Giulio
G
Marchionni
Niccolò
N
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D006233:Persons with Disabilities / Q000145:classification* / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D007558:Italy; D008297:Male; D015995:Prevalence; D012727:Sex Characteristics