Gender and Health Risks After Fifty

Gender and Health Risks After Fifty

For all of us who are 50+, it is important to recognize that our health must be a bigger priority in our lives. It is also important that we develop positive relationships with our medical providers as we age. Further, we need to recognize that ageism and sexism can affect our health care and that postmenopausal women will likely experience aging and health issues differently than men.

While you may not think of yourself as older when you are still in your fifties, now is the time to start thinking ahead. If you are a woman, you definitely need to start thinking about changes that are already occurring with your health—even if they are not yet apparent.

Disclaimer

As a disclaimer, I must tell you that I have no medical background whatsoever. I do a lot of reading and believe that writing about issues is one way to build awareness of health issues that we might need to understand. The only recommendation I can make is to talk with your medical provider if you have any questions or concerns about health issues.

Medical Bias

Dr. Louise Aronson, a geriatrician, and author of Elderhood provided insights into implicit age bias in the medical community. As Aronson noted, medical schools typically don’t give students a lot of training in the care of older patients. (I personally thought this book was an eye-opener.)

Aronson and others have suggested that some doctors may believe than tending to older patients can be less interesting and more frustrating due to multiple health issues. Or, as one report that described a cross-sectional study indicated, some doctors assumed it was normal to be depressed and to have more aches and pains simply because of age.

My neighbor experienced a sudden health problem that her doctor dismissed as old age. She continued to feel ill for months. She went to another doctor who looked at her medicine and realized that she was experiencing a drug interaction. As soon as her medicines were changed, she was back to being her active, healthy self.

Aronson explained that older people, who are often excluded from drug trials, may experience medications differently than younger people. Another report suggests that women have been historically excluded from medical drug trials. Again, there is a difference between how women and men may react to certain drugs. While attempts have been made to correct study biases, they may still be “skewed towards men…”

Age, gender, race, or any other stereotypes can create implicit biases that medical providers may not even recognize. These biases can potentially affect health care. Sometimes we see such biases communicated through ‘elderspeak’ or the use of ‘child talk’ when interacting with older patients or older female patients such as, “Okay dear, can we get up on the table now?” In addition, when we are treated differently because we are older or perhaps older and female, we are more likely to internalize these negative stereotypes to our own detriment.

 Signs of the Times

An interesting study conducted by the University of Vienna found that facial changes among men and women were similar as they aged when they were between 40 and 50 years old. However, once women reached about 50, evidence of facial aging accelerated for women but not for men. As menopause typically occurs around 50, the assumption was that changes to the skin such as additional drying, wrinkling, and sagging were related to changes in hormonal levels.

Frailty and Broken Bones

A study involving 120,000 people over 60 in 28 countries found that with aging comes an increased risk of frailty. This same study found that women were more vulnerable than men.

According to the CDC, over 300,000 older people (65 and older) are hospitalized with hip fractures each year. Women, who are more likely to have osteoporosis after menopause are more likely to have weakened bones that break more easily. Women account for three-quarters of all hip fractures.

Hip fractures can be quite serious and can result in death. According to one report, up to 50 percent of older adults who have broken their hips may end up with a lower quality of life or need ongoing assistance.

As we get older, working on our balance to avoid unnecessary falls may be of help. My daughter-in-law has a doctorate in physical therapy and advised me to work on my balance. It has helped me. Again, do talk to your own medical provider about your needs. Your doctor may recommend increased calcium or vitamin D supplements or may recommend bone scans to determine if some other medication would be beneficial.

Hot Flashes and Health

A 2019 CNN article, summarizing the findings from the North American Menopause Society, reported that night sweats were potentially linked to both cognitive functioning and cardiovascular events later in life. The findings also suggested a relationship between childhood trauma and the severity of hot flashes during menopause. Women who had a history of childhood physical or sexual abuse tended to have more hot flashes during sleep, according to the lead author of a study presented at the conference.

Cognitive Functioning and Dementia

Some cognitive decline and dementia are often associated with older age (though it is not automatically paired with aging). It is believed there are several different possible contributors to dementia. Some of those possible contributors might include PTSD and stress in general that increases cortisol levels and related damage to the hippocampus area of the brain.

NPR reported that members of the LGBTQ community were 29% more likely to experience memory loss and early signs of dementia than their cisgender or straight counterparts. Researchers think that contributors to cognitive difficulties might include higher rates of depression, PTSD, higher stress, and lack of access to regular healthcare.

Women are at a higher risk of dementia than men. “One explanation has to do with sex differences in the stress response.” Also, according to Vanderbilt University Medical Center as reported in Forbes, abnormal Tau protein may spread more widely in regions of female than male brains. This protein causes tangles leading to brain death and Alzheimer’s disease—one type of dementia. This may help explain why two-thirds of Americans who end up with Alzheimer’s disease are women. However, women are often underdiagnosed because they typically do better than men on verbal tests and don’t necessarily reveal early cognitive decline.

Interestingly though, findings suggest healthy lifestyle factors and mental stimulation may decrease the likelihood of developing the disease.

Heart Attack and Stroke

According to Harvard Health Publishing of Harvard Medical School, cardiovascular disease is the main cause of death for both men and women. The report notes that most of what we know about heart disease and treatment comes from studies based on middle-aged men. Women tend to develop coronary artery disease at an older age. Women may have blockages in tiny vessels within the heart muscle rather than in the arteries and may not be diagnosed for heart problems. Women can also have “silent” heart attacks with no obvious symptoms. If a woman is over 50, her risk for heart attack significantly increases. And even though heart attacks are more common in men than women, a woman is more likely to die as a result of a heart attack than a man.

Research reported in the National Library of Medicine suggests a lesser-known risk for cardiovascular disease could be related to adverse childhood experiences (ACE). Ace experiences could include abuse, neglect, household dysfunction, or other trauma-related experiences. The higher the ACE score, the more likely a child will experience great health risks later, including cardiovascular problems and the development of atherosclerosis.

Strokes

Harvard Health Publishing reports that 55,000 more women have strokes each year than men. In part, the greater number of strokes is likely due to an increased age span. In addition, other factors that affect women include hormone-related risks, reproductive health, and pregnancy. In addition, women are more susceptible to emotional stress, which is considered a risk factor.

Women who are not able to discuss anger or negative emotions with those close to them may also be at higher risk for a stroke according to a study reported in HealthDay News. Women who experienced “self-silencing” had an increased risk of greater plaque in their carotid arteries. While the study could not prove a causal relationship, women who felt less comfortable expressing their needs or feelings with significant others showed a 14% higher likelihood of plaque in their carotid artery.

Good News

The Centers for Disease Control and Prevention reported that risk reduction of most illnesses is a choice. Numerous studies show that both men and women who maintain a healthy lifestyle (including appropriate diet and exercise as well as a positive mindset) have a lower risk of developing a number of chronic diseases, including dementia. It is important for all of us to do everything we can to take care of ourselves. A little prevention can be worth more than all the drugs or medical care money can buy. Don’t wait until after retiring to get started. Now is the time!

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