Diseases and Conditions that Affect Older Women

Women ages 65 or older make up 58% of the elderly population and 7.3% of the total U.S. population.(1), (2)

The top ten leading causes of death for women ages 65 or older are heart disease, cancer, stroke, chronic obstructive pulmonary diseases (COPD), and pneumonia and influenza, diabetes, Alzheimer's disease, unintentional injuries, kidney disease, and atherosclerosis.(3)

	Cancer is the second leading cause of death for women ages 65 or older.(3)
	More than 50% of breast cancer cases occur in women 65 years of age and older and as many as 50% of that population will die from the disease.(4)
	Women age 65 and older are less likely to get mammograms than younger women even though breast cancer risk increases with age.(5)
	Ovarian cancer, the fifth leading cause of cancer death among U.S. women, kills about 14,000 women each year.(6) Women age 65 or older are more likely to be diagnosed with the advanced disease and make up almost half of all ovarian cancer cases.(7)
	More than 10% of women 65 years of age or older smoke. Smoking is directly responsible for 87% of all lung cancer cases each year and the leading cause of cancer deaths in American women.(8), (9)
	Ninety percent of people diagnosed with colorectal cancer are over 50 years old and approximately 90% of all colorectal cancer cases and deaths are thought to be preventable through the use of screening tests.(6)
	It is estimated that approximately 13,700 women in the U.S. will develop invasive cervical cancer, and 4,900 women will die from this disease. Women ages 65 and older account for nearly 25% of all cervical cancer cases and 41% of all cervical cancer deaths in the U.S.(10), (11)

	Approximately 38% of women older than 60 suffer from urinary incontinence.(12)
	Urinary incontinence is common among elderly women, who are often embarrassed or convinced that involuntary loss of urine is normal with aging, so that they are often reluctant to seek medical assistance or discuss their problems.(13)
	Aging does not cause urinary incontinence, but age-related factors such as smaller capacity of the bladder, increased residual urine, and involuntary bladder contractions may contribute to the condition.(13)
	Incontinence predisposes patients to other health problems, contributes to depression and social isolation, is a significant source of dependency among the elderly, and is widely cited as a factor in nursing home admissions.(12)

	4.5 million women aged 60 years or older have diabetes, the sixth leading cause of death for elderly women, and one-quarter of them, 1.2 million, do not know that they have the disease.(14)
	Elderly women with diabetes are particularly at risk for cardiovascular disease, visual problems, and hypothermia and may also be at greater risk for metabolic disorders, cognitive dysfunction, and depression.(15-18)
	Women ages 65 and older reporting a history of diabetes were more likely than those without the disease to report a major disability, urinary incontinence, and impairments in hearing or vision.(19)

	Cataracts, a clouding of the lens of the eye, are a leading cause of visual impairment in the elderly and are more common in women than men. Cataract surgery, used to alleviate this problem, is often performed on women more frequently than men.(20)
	Like cataracts, age-related macular degeneration (AMD) is more common in women than men, but for AMD, the loss of vision is irreversible and no treatment has yet been found to save the sight of a person affected with AMD.(20)
	Glaucoma is a potentially serious eye disorder which, if left untreated, can cause irreversible blindness. The rate of elderly women with glaucoma rises yearly and half of those affected are unaware of their condition.(20)

	Falls account for 87% of all fractures for people 65 years and older and are the leading cause of injury deaths and the second leading cause of spinal cord and brain injury in this age group.(21-23)
	Women sustain 75%-80% of all hip fractures.(24) About one-fifth of hip fracture patients require long-term nursing home care, and 10% remain functionally dependent for daily living care.(25)
	Caucasian women have the highest risk of fractures from falls because the greater prevalence and severity of osteoporosis increases bone fragility and probability of hip fracture.(26)

	Older women have the highest rates of heart attack due to their higher rates of high blood pressure, high cholesterol, diabetes, obesity, and physical inactivity.(27)
	The percentage of women with coronary heart disease who are disabled by their illness range from 47% in women age 65 to 74 years to 55% in women age 75 years and older.(28)
	Sixty five percent of women ages 65-74 and 79% of women ages 75 and older have some form of cardiovascular disease.(29)
	Since women are generally older when they have strokes, they are more likely to die as a result.(30)
	The chance of having a stroke more than doubles for each decade of a woman's life after age 55.(31)
	Taken together, heart disease and stroke kill nearly twice as many American women as do all types of cancer combined.(32)

	Depression is not a normal part of aging, but over 58% of older adults think it is.(33)
	Late-life depression affects some six million adults, most of them women, but only 10% of these persons ever get treated. Twice as many women as men are diagnosed with clinical depression, which can be triggered by other chronic illnesses common in later life such as diabetes, stroke, heart disease, cancer, chronic lung disease, Alzheimer's disease, Parkinson's disease, and arthritis.(34), (35)
	Women accounted for 16% of suicides among persons aged 65 and older in 1999.(36)

	Not only do more women than men have Alzheimer's disease, but women also provide a disproportionate amount of the informal community care for people with the disease.(37), (38)
	The risk of Alzheimer's disease increases dramatically with advancing age and many more women than men survive to the ages where Alzheimer's disease is most common.(39)

	Overall, approximately eight million American women have osteoporosis.(40)
	Women are four times more likely than men to develop osteoporosis because of the loss of estrogen, which blocks or slows down bone loss, at menopause.(40)
	Over half of all women over the age of 65 have osteoporosis and it is usually not diagnosed until a fracture or break occurs.(40)
	Many elderly women who survive hip fractures due to osteoporosis suffer a significant compromise in quality of life. About one-fifth of hip fracture patients require long-term nursing home care, and 10% remain functionally dependent for daily living care.(25)
	Approximately one-third of women will suffer a vertebral fracture in their middle to late 60s, and one-third will suffer a hip fracture in their late 70s or early 80s.(41)
	The best ways to prevent the loss of bone mass associated with osteoporosis is to eat foods rich in calcium and vitamin D, do weight-bearing exercises, stay active and mobile, don't smoke, limit alcoholic beverages, and talk about options for drug therapy to treat bone loss.(40)

1. Hetzel L, Smith A. The 65 Years and Over Population: 2000. Washington, DC: U.S. Department of Commerce, Economics and Statistics Administration, U.S. Census Bureau; October 2001.

2. Older Americans 2000: Key Indicators of Well-Being. Washington, D.C.: Federal Interagency Forum on Aging-Related Statistics; August 2000.

4. Balducci L, Phillips DM. Breast cancer in older women. Am Fam Physician. 1998;58(5):1163-1172.

5. Breast Cancer Facts and Figures: 1997-1998. Atlanta: American Cancer Society; 1997 1997-1998.

6. Cancer Facts & Figures 2002. Atlanta: American Cancer Society; 2002. 02-250M-No. 5008.02.

7. Yancik R. Ovarian cancer. Age contrasts in incidence, histology, disease stage at diagnosis, and mortality. Cancer. 1993;71(2 Suppl):517-523.

8. Cigarette smoking among adults--United States, 1999. MMWR. Oct 12 2001;50(40):869-873.

10. Cervical Cancer. Paper presented at: NIH Consensus Statement; April 1-3, 1996, 1996; Bethesda.

11. Cancer Facts and Figures: 1997. Atlanta: National Cancer Institute; 1997.

12. Burgio KL, Locher JL, Goode PS, et al. Behavioral vs drug treatment for urge urinary incontinence in older women: a randomized controlled trial. Jama. 1998;280(23):1995-2000.

13. Cobbs EL, Ralapati AN. Health of older women. Med Clin North Am. 1998;82(1):127-144.

14. Interim report: Proposed Recommendations for Action / A National Public Health Initiative on Diabetes and Women's Health: CDC Diabetes Public Health Resource; 2001.

15. Minaker K. What diabetologists should know about elderly patients. Diabetes Care. 1990 1990;13(Suppl 2):34-46.

16. Neil HA, Dawson JA, Baker JE. Risk of hypothermia in elderly patients with diabetes. Br Med J (Clin Res Ed). 1986;293(6544):416-418.

17. Tun PA, Nathan DM, Perlmuter LC. Cognitive and affective disorders in elderly diabetics. Clin Geriatr Med. 1990;6(4):731-746.

18. U'Ren RC, Riddle MC, Lezak MD, Bennington-Davis M. The mental efficiency of the elderly person with type II diabetes mellitus. J Am Geriatr Soc. 1990;38(5):505-510.

19. Cowie CC, Eberhardt MS. Sociodemographic Characteristics of Persons with Diabetes. In: Group NDD, ed. Diabetes in America, 2nd edition. Vol 95-1468. Bethesda: National Diabetes Data Group of the National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health; 1995:85-116.

20. Desai M, Pratt L, Lentzner H, Robinson K. Trends in Vision and Hearing Among Older Americans. Hyattsville: CDC: National Center for Health Statistics; March 2001 2001.

21. Hoyert DL, Kochanek KD, Murphy SL. Deaths: Final Data for 1997. MMWR. 1999 1999;47(19).

22. Fife D, Barancik JI. Northeastern Ohio Trauma Study III: incidence of fractures. Ann Emerg Med. 1985;14(3):244-248.

23. Kraus JF, Black MA, Hessol N, et al. The incidence of acute brain injury and serious impairment in a defined population. Am J Epidemiol. 1984;119(2):186-201.

24. Melton LJ, 3rd, Riggs BL. Epidemiology of age-related fractures. In: Avioli LV, ed. The Osteoporotic Syndrome. New York: Grune & Stratton; 1983:45-72.

25. Chrischilles EA, Butler CD, Davis CS, Wallace RB. A model of lifetime osteoporosis impact. Arch Intern Med. 1991;151(10):2026-2032.

26. Stevens J, Olsen S. Reducing falls and resulting hip fractures among older women. MMWR. March 31, 2000 2000;49(RR02):1-12.

27. Risk factors and coronary heart disease. The American Heart Association. Available at: http://216.185.112.5/presenter.jhtml?identifier=539. Accessed October 22, 2002, 2002.

28. Soldo BJ, Manton KG. Health status and service needs of the oldest old: current patterns and future trends. Milbank Mem Fund Q Health Soc. 1985;63(2):286-319.

29. Heart and Stroke Statistical Update. Dallas: American Heart Association; 2002.

30. Depression and Stroke Fact Sheet. National Institute of Mental Health, NIH, Department of Health and Human Services. Available at: http://www.nimh.nih.gov/publicat/depstroke.pdf. Accessed October 22, 2002, 2002.

32. A Study of Women's Awareness of and Attitudes Towards Heart Disease and Stroke: Yankelovich Partners Inc. The American Heart Association; 1997.

33. American Attitudes about Clinical Depression and its Treatment. Alexandria: National Mental Health Association; March 27, 1996 1996.

34. The Brown University long-term care quality advisor. July 14, 1997 1997;9(13):5.

37. Evans D, Scherr P, Cook N, al. e. Estimated Prevalence of Alzheimer's Disease in the United States. Milbank Quarterly. 1990;68(2):267-289.

38. Group CSoHaAW. Canadian study of health and aging: Study methods and prevalence of dementia. Canadian Medical Association Journal. 1994 1994;150:899-913.

39. McCann J, Herbert L, Bennett D, Skul V, Evans D. Why Alzheimer's disease is a women's health issue. Journal of the American Medical Women's Association. 1997 1997;52(3):132-137.

41. Bockman RS. Osteoporosis and its management in older women. J Am Med Womens Assoc. 1997;52(3):121-126.