TY - JOUR
T1 - Chronic medical conditions and the sex-based disparity in disability
T2 - The cardiovascular health study
AU - Whitson, Heather E.
AU - Landerman, Lawrence R.
AU - Newman, Anne B.
AU - Fried, Linda P.
AU - Pieper, Carl F.
AU - Cohen, Harvey Jay
N1 - Funding Information:
This work was supported by the National Institutes of Health (AG-023629, CHS was supported by contract numbers N01-HC-85079 through N01-HC-85086, N01-HC-35129, N01 HC-15103, N01 HC-55222, N01-HC-75150, and N01-HC-45133; grant number U01 HL080295 from the National Heart, Lung, and Blood Institute, with additional contribution from the National Institute of Neurological Disorders and Stroke; and R01 AG-15928, R01 AG-20098, and AG-027058 from the National Institute on Aging; and R01 HL-075366 from the National Heart, Lung, and Blood Institute, University of Pittsburgh Pepper Center P30-AG-024827), the John A. Hartford Foundation, Duke Pepper Center P30-AG-028716, and K23-AG-032867. A full list of principal CHS investigators and institutions can be found at http://www.chs-nhlbi.org/pi.htm.
PY - 2010/12
Y1 - 2010/12
N2 - Background. Older women experience disability more commonly than their male peers. This disparity may be due, in part, to sex-based differences in the prevalence or the disabling effects of common medical conditions. The objectives of this analysis were to (a) quantify the extent to which excess disability in women is explained by higher prevalence of selected medical conditions and (b) evaluate whether the same conditions have differing effects on disability in men and women. Methods. We analyzed cross-sectional data from 5,888 community-dwelling older men and women. Disability was defined as difficulty with greater than or equal to one activity of daily living. Thirteen medical conditions were assessed by self-report, testing, or record review. Results. Controlling for age, race, education, and marital status, women were more likely to experience disability (odds ratio = 1.70, 95% confidence interval = 1.36-2.11). Higher prevalence of arthritis and obesity in women explained 30.2% and 12.9%, respectively, of the sex-based difference in disability rates, whereas male prevalent diseases like vascular conditions and emphysema narrowed the disability gap. Women with arthritis, hearing problems, coronary artery disease, congestive heart failure, stroke, and claudication were more likely to exhibit disability compared with men with the same conditions (p <. 001). Conclusions. Efforts to lessen sex-based inequality in disability should focus on reducing the prevalence of arthritis and obesity. Future generations may see greater functional disparity if rates of vascular disease and emphysema rise among women. Several conditions were more often associated with disability in women, suggesting additional sex-based differences in the disablement process.
AB - Background. Older women experience disability more commonly than their male peers. This disparity may be due, in part, to sex-based differences in the prevalence or the disabling effects of common medical conditions. The objectives of this analysis were to (a) quantify the extent to which excess disability in women is explained by higher prevalence of selected medical conditions and (b) evaluate whether the same conditions have differing effects on disability in men and women. Methods. We analyzed cross-sectional data from 5,888 community-dwelling older men and women. Disability was defined as difficulty with greater than or equal to one activity of daily living. Thirteen medical conditions were assessed by self-report, testing, or record review. Results. Controlling for age, race, education, and marital status, women were more likely to experience disability (odds ratio = 1.70, 95% confidence interval = 1.36-2.11). Higher prevalence of arthritis and obesity in women explained 30.2% and 12.9%, respectively, of the sex-based difference in disability rates, whereas male prevalent diseases like vascular conditions and emphysema narrowed the disability gap. Women with arthritis, hearing problems, coronary artery disease, congestive heart failure, stroke, and claudication were more likely to exhibit disability compared with men with the same conditions (p <. 001). Conclusions. Efforts to lessen sex-based inequality in disability should focus on reducing the prevalence of arthritis and obesity. Future generations may see greater functional disparity if rates of vascular disease and emphysema rise among women. Several conditions were more often associated with disability in women, suggesting additional sex-based differences in the disablement process.
KW - Comorbidity
KW - Disability
KW - Disparity
KW - Function
KW - Gender
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U2 - 10.1093/gerona/glq139
DO - 10.1093/gerona/glq139
M3 - Article
C2 - 20675619
AN - SCOPUS:78649556145
SN - 1079-5006
VL - 65 A
SP - 1325
EP - 1331
JO - Journals of Gerontology - Series A Biological Sciences and Medical Sciences
JF - Journals of Gerontology - Series A Biological Sciences and Medical Sciences
IS - 12
ER -