Gender Matters Differences and change in disability and health among our oldest women and men

Sammanfattning: This thesis investigates gender differences in health and how they have changed between 1992 and 2002 among very old people. It explores gender differences in the association between disability and health, and gender differences in care utilization among our oldest old people. The studies are based on nationally representative data of the population in Sweden aged 77 and older (SWEOLD). Results from Study I showed that women generally had more health problems than men. Analyses of change between 1992 and 2002 showed increased prevalence rates for both sexes, especially women. However, women’s reporting of poor global self-rated health did not increase. There were no gender differences and there was no change over time in activities of daily living (ADL). Several health indicators seem to be developing differently for women and men. Study II showed that associations between ADL disability and other health indicators changed between 1992 and 2002, with several health problems and functional limitations becoming less disabling over time. This trend was especially true for women, while for men, the findings were mixed. Study III found no gender differences in physician visits and dental visits, despite women’s worse health and dental status. Marriage was associated with more physician visits for men and dentist visits for women. Results imply that women and unmarried older adults may have unmet health-care needs. Study IV examined whether the increase in life expectancy at age 65 observed between 1992 and 2002 consisted of years with or without musculoskeletal pain. Results showed that total years without pain decreased for both women and men, but more so for women. Women also had more years with pain added to life. The results of this thesis suggest an increase of health problems, but not disability, in the oldest Swedish population. However, gender variations in the findings highlight the importance of analyzing health trends separately for women and men.