Alzheimer's Disease and Older Women

The graying of America suggests that dementia will become "the epidemic of the 21st century." First described in 1907, Alzheimer's Disease (AD) accounts for an estimated two-thirds of all dementia. AD currently has no cure, thus causing a major drain on health care and family resources. Compared to men, women are uniquely affected by AD due to their gender-associated increased risk, longer life span, and roles as caregivers within families and institutions. Living successfully with dementia requires medical and behavioral interventions to manage disruptive symptoms, knowledge to optimize environmental conditions, and caregiver support and savvy to avoid burnout. Strategies for maximizing functioning in older women living with AD are provided.     

Heart Disease and Older Women

Heart disease has traditionally been thought of as a man's disease. However, one in three older women develop heart disease, making it the leading cause of death in older women. Current treatment for heart disease is based largely on studies using males as subjects. Doctors are just now beginning to learn about differences in men and women who have heart disease. The focus of this discussion is heart disease as it relates specifically to women. Risk factors considered are smoking, high blood pressure, elevated blood lipids, diabetes mellitus, obesity, stress, family history and physical inactivity. Diagnosis, treatment options and strategies for living productively with heart disease are presented.     

Barriers to Managing Coronary Artery Disease Among Older Women

Numerous barriers to managing coronary artery disease (CAD) among older women are reported in the literature; however, few studies adjust for demographic and health status differences. A survey assessing barriers and other factors was distributed to a stratified random sampling of older women with CAD. Factor analysis and multiple logistic regression procedures were used to estimate the impact of these issues on receiving a CAD-related office visit. The most problematic barriers included denial and low health literacy. Efforts to promote patient awareness of heart health and better communication between patients and clinicians may alleviate these barriers.     

Older Women Caring for Older Women: The Rewards and Challenges of the Home Care Aide Job

As our population ages, the need for personal assistance services increases. Paid personal care is predominantly provided by women, often older women, and has been considered low-status, low-wage work. This article reports on a mixed-method, longitudinal study of 261 home care aides; study participants were 46 years old, on average. Predictors of termination included younger age and lack of health insurance. Study participants reported more rewarding than challenging aspects to the job, though low and inconsistent compensation often forced them to leave the work they loved. Implications of the study with regard to older women caring for older women are explored.     

Abused Older Women:

Due to the recent "discovery" of elder abuse and the failure of the battered women's movement to reach out to older persons, the physically abused older woman is not necessarily seen as a battered woman. Elder abuse has been viewed as more akin to child abuse, thus leading to a paternalistic approach to the problem. This article contrasts the prevalence, causal models, and effects of physical abuse amon young and older women. Interventions in the case of spouse and elder abuse are also compared. The author concludes by suggesting ways in which helpers might borrow from the battered women's movement in order to better serve older battered women.     

Older Women with Cardiovascular Disease: Perceptions of Initial Experiences and Long-Term Influences on Daily Life

ABSTRACT

In 2004, we conducted qualitative interviews with 29 White women diagnosed with cardiovascular disease (CVD) living in Southwest Virginia, aged 69 to 92 years (M age = 79.2 years; SD = 6.8); time since diagnosis ranged from 1 to 50 years (M = 14.3; SD = 11.2). We explored the women's initial illness episode and the influence of CVD on their current daily functioning, family activities and relationships, and social engagement. The women were slow to seek help for CVD symptoms. Postrecovery, 62% of women perceived their heart disease as influencing change in their daily lives. The influence of CVD varied depending on how congruent behavior changes were with their sense of self.     

Understanding and Reducing Stress and Psychological Distress in Older Women with Heart Disease

ABSTRACT

Stress and psychological distress were assessed in 457 older women who were subsequently randomized to a six-week heart disease management program (“Women take PRIDE”) or to a “usual care” control group. Baseline distress was significantly associated with age, symptoms, physical functioning, social support, optimism, and self-esteem (p < .05). Only 20% of women reported their physician had recommended reducing stress. At four months follow-up, intervention women compared to controls were significantly more likely to report reductions in stress levels (p = 0.02) and also showed improvement in emotional behavior (p = 0.09).     

Osteoporosis and Older Women:

Osteoporosis, a metabolic bone disorder, affects four times as many women as men. Each year 1.3 million fractures, primarily of the vertebra, hip, and wrist can be attributed to osteoporosis. Risk factors for the development of this disease include age, sex, body build, family history, race, loss of estrogen, calcium deficiency, sedentary lifestyle, smoking, and the excessive use of alcohol. Three common approaches used in the treatment and prevention of osteoporosis are hormone replacement therapies, nutrition interventions. and exercise programs. These strategies are aimed at maintaining or stabilizing bone mass and preventing further loss. Living with osteoporosis presents older women with a variety of physical, psychological, and social challenges. To maintain a productive and healthy lifestyle, older women must recognize their physical limitations and make adjustments in their daily lives to cope successfully with these changes.     

Anxiety Disorders and Older Women

SUMMARY

Anxiety is a problem for millions of Americans. It poses special challenges for women as they grow into advanced age. This paper provides a general overview of anxiety disorders, including panic disorder, agoraphobia, specific phobia, social phobia, obsessive compulsive disorder, and generalized anxiety disorder. Etiology, assessment and treatment strategies are then addressed. Special focus is directed at biological and psychosocial issues as they relate to older women in the development, experience, treatment and prevention of anxiety disorders.     

Functional Health of Older Women:

Many elderly women need long-term care assistance to help them remain independent. A stresscoping framework was used to test predictors of functional health in a sample of 110 community- residing, older women. The causal relationships among hardiness, self-esteem, social support, stress, coping, and service utilization were examined. Results from the regression analyses indicated that 36% of the variance in physical and independent health was explained by hardiness, stress, coping, and service utilization and 52% of the variance in psychosocial health was explained by hardiness, selfesteem, stress, and coping. The discussion is orgaruzed according to the stress-coping paradigm and explicates the various relationships found.     

Older Women and Cosmetic Tattooing Experiences

Aging for the older women in the 21st century is more than medical issues. In this study, 62 women (ages 51–81+) obtained a total of 97 permanent makeup procedures. Procurement cues included self-improvement and friend's appearance, consistent with internal, external, and appearance perspectives of body image. Poor eyesight was also of concern (14/23%). Actual benefits included saving makeup time and money (external), while achieving personal goals (internal). This study seems to confirm that for these older women, body image remains important, especially qualities of the face. They did not shed their internal, external, nor appearance concerns associated with body image, as they aged.     

Chronic Pain and Older Women:

Drawing upon the available research literature, this article highlights the research and practice issues that must be addressed if we are to be responsive to the chronic health problems, and subsequent pain, that often codront individuals as they age. This list should by no means be 'seen as exhaustive, but rather as a starting point from which to further our understanding of chronic pain in the lives of older women.     

Group Work with Older Women:

No abstract available for this article.     

Posttraumatic Stress Disorder and Older Women

SUMMARY

This article examines the literature related to the identification and treatment of posttraumatic stress disorder in older women. From this review, several key findings emerge. Consistent in the research literature is the fact that American women are more at risk for PTSD than are men as a result of the high frequency of sexual and domestic physical abuse that women experience. Studies on older women and PTSD indicate that older women are under-diagnosed and are more typically perceived as suffering from depression, anxiety or poor physical health. It was found consistently that older women who present with age-related stressors may not be asked about earlier trauma history or it may not be understood within the context of trauma-related variables. In several research studies, trauma history was often not identified either as a result of current assessment practice or because women from certain age cohorts did not disclose trauma-related data to health professionals. Key researchers emphasize the necessity of clinicians, staff and medical personnel to attend to the historical variables present in trauma histories of older women. Researchers underscore the importance of understanding the impact of early and repeated trauma, especially interpersonal trauma, on the physical health and social functioning of older women–even though a significant amount of time may have elapsed since exposure. These findings indicate that further study of PTSD in older women is warranted. The paper concludes with a discussion of assessment and treatment options.     

Recent Perspectives on Active Life Expectancy for Older Women

SUMMARY

This article provides a critical review of recent active life expectancy literature, describing trends of special interest to women. We review findings from leading perspectives used to study life expectancy and active life expectancy, including gender, racial and socioeconomic differences, disease-specific effects, and biodemography. We examine three competing theories of population health that frame active life expectancy research—compression of morbidity, expansion of morbidity, and dynamic equilibrium—concluding there is support for both the compression of morbidity and dynamic equilibrium theories. Policy implications for women include a greater understanding of the role of education and racial and ethnic diversity in active life trends, and an increased public policy emphasis on prevention and treatment of chronic disease, together with adoption of more healthy lifestyles.     

Assessment of Older Women with Chronic Pain

Females suffer from a larger number of chronic pain syndromes, live longer with chronic pain and disability, and more often live alone than males. Thus, they should be prime candidates for pain treatment. Yet a number of factors inhibit geriatric patients from receiving rehabilitation for their pain. Chronic pain has been determined to be a complex perceptual event that is influenced by psychosocial, behavioral, and biomedical factors. A comprehensive strategy for assessing chronic pain patients is described. Special attention is given to the association between pain and depression and the important medication of perceived interference with life, social support, and functional activities as these variables appear to be particularly relevant to a geriatric pain population.     

Aging of Indian Women in India: The Experience of Older Women in Formal Care Homes

The feminization of aging is a process that has begun in India but is not occurring uniformly throughout India. Older women are more likely to be widowed, poor, and suffer vulnerability to adverse outcomes like poor health. With the changing social landscape of India, middle-income older women are increasingly opting for ‘pay and stay homes’, an emerging type of old age home in India. Majority of the 97 women residents of ‘pay and stay’ homes reported being widowed (68%), and 25% were childless. Childlessness and widowhood were important considerations in the decision to relocate to an old age home. Older women reported higher degrees of psychological closeness and contact with daughters than sons, and the overall social network size was small. High prevalence of diabetes rates among older women carries implications for potential functional disability. Strong advocacy measures for empowering older women in India should be a priority policy directive.     

Alternative Therapies and Empowerment of Older Women

SUMMARY

There has been a striking increase in Americans' awareness and use of alternative therapies over the last decade. Women, in particular, have been drawn to explore these unconventional health practices, which include herbal medicine, acupuncture, homeopathy, manual therapies, energy healing, and mind-body therapies. From a feminist perspective, the rise in alternative therapies' use in the United States represents a shift in cultural concepts of health from an outmoded patriarchical model which disempowers older women, to a more feminine, holistic model which can reempower older women. Throughout history, older women have developed, applied, and taught the principles and practices of what are now considered alternative healing modalities, in their roles as mothers, expert herbalists, midwives, wise women, and shaman. By becoming familiar with these therapies, older women can increase their control over their health, enhance prevention and self-care, and enjoy a health-care pathway that leads to wholeness in body, mind, and spirit.     

养老金收入与收入不平等对老年人健康的影响

文章利用中国收入分配课题组2002和2007年城镇住户调查数据,分析了养老金对中国老年人健康的影响作用。结果显示,2002～2007年,随着养老金收入水平的提高,老年人自评健康状况越来越好,相比其他家庭人均收入,养老金对保障老年人健康的作用越来越突出;养老金通过家庭内部老年人口之间的再分配,发挥的作用更明显。由于收入差距的扩大和城市贫困问题的凸显,不平等对老年人的健康影响开始显现;对于单独居住老人,养老金的健康保障作用越来越重要。     

Discrimination Against Older Women in Health Care

Growing awareness of apparent gaps in health care received by women and men raises concern over possible discrimination. This literature review examines this issue for elderly women, whose health care is obtained in a system that also may be permeated with age discrimination. Physicians tend to spend more time with women and older patients, suggesting that discrimination may not be an issue in the physician-patient relationship or may work in favor of older women. However, this may simply reflect elderly women's poorer health. Gender and age disparities in medical treatments received provide a more compelling argument that the health care system is a source of discrimination against older women, who are less likely than others to receive available treatments for cardiac, renal, and other conditions. The history of medical treatment of menopause suggests that stereotypes of older women have been advantageous for segments of the health care system. Finally, in addition to discrimination that has its source within the health care system itself, societal-wide inequities, particularly economic, are extremely detrimental to older women's health care. As we respond to the health care crisis, we must be alert to the potential to rectify those structures and tendencies that can lead to discrimination against women and the aged. Health care reform presents a unique opportunity to ensure health care equity.