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Geriatrics (Women’s Health Series)

Andree Burnett, MD, Ashraf S. Abdo, MD, Stephen A. Geraci, MD
Volume: 106 Issue: 11 November, 2013

Abstract:

As women age, they face challenging health issues. Their average life expectancy is longer than their male counterparts, yet they often have multiple chronic, ongoing health problems that complicate their care, accentuate their infirmity, and reduce their quality of life. Often, they fail to receive the same quality or amount of healthcare service, sometimes because of a lack of data specific to their demographics, at other times for myriad unclear reasons. What data are available suggest that they will usually glean the same benefits as their male and younger female counterparts, often with little increased risk of adverse effects from available medical diagnostic and therapeutic options. Cardiovascular disease, malignancies, musculoskeletal disorders (particularly osteoporosis), and cognitive and psychiatric illness are the most frequent, and often most devastating, health issues in this growing segment of the population. An understanding of the differences in disease frequencies, presentations, and response to treatments is necessary to provide older adult women with optimal health care.

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References:

1. Sibbald B. Unique health needs of elderly women being ignored, symposium told. CMAJ. 1999; 161: 1309–1310.
 
2. US Census Bureau. 2008 national population projections. http://www.census.gov/population/projections/data/national/2008.html. Accessed June 27, 2011.
 
3. Barry PP. Appropriate health care for older women. Public Health Rep. 1987; 102: 71–73.
 
4. Grines CL, Schreiber T. Sex differences in the drug-eluting stent era: do they still exist? JACC Cardiovasc Interv. 2012; 5: 311–312.
 
5. Foody JM, Wang Y, Kiefe CI, et al. Long-term prognostic importance of total cholesterol in elderly survivors of an acute myocardial infarction: the Cooperative Cardiovascular Pilot Project. J Am Geriatr Soc. 2003; 51: 930–936.
 
6. Stefanini GG, Kalesan B, Pilgrim T. Impact of sex on clinical and angiographic outcomes among patients undergoing revascularization with drug-eluting stents. JACC Cardiovasc Interv. 2012; 5: 301–310.
 
7. Redberg RF. Coronary artery disease in women: understanding the diagnostic and management pitfalls. Medscape Womens Health. 1998; 3: 1
 
8. Shaw LJ, Bugiardini R, Merz CN. Women and ischemic heart disease: evolving knowledge. J Am Coll Cardiol. 2009; 54: 1561–1575.
 
9. Douglas PS, Ginsburg GS. The evaluation of chest pain in women. N Engl J Med. 1996; 334: 1311–1315.
 
10. Canto JG, Rogers WJ, Goldberg RJ, et al. Association of age and sex with myocardial infarction symptom presentation and in-hospital mortality. JAMA. 2012; 307: 813–822.
 
11. Ng JH, Kaftarian SJ, Tilson WM, et al. Self-reported delays in receipt of health care among women with diabetes and cardiovascular conditions. Womens Health Issues. 2010; 20: 316–322.
 
12. Brannstrom J, Hamberg K, Molander L, et al. Gender disparities in the pharmacological treatment of cardiovascular disease and diabetes mellitus in the very old: an epidemiological, cross-sectional survey. Drugs Aging. 2011; 28: 993–1005.
 
13. Tillmanns H, Waas W, Voss R, et al. Gender differences in the outcome of cardiac interventions. Herz. 2005; 30: 375–389.
 
14. Linton MF, Fazio S. National Cholesterol Education Program (NCEP)—the Third Adult Treatment Panel (ATP III). A practical approach to risk assessment to prevent coronary artery disease and its complications. Am J Cardiol. 2003; 92: 19i–26i.
 
15. Rodondi N, Locatelli I, Aujesky D, et al. Framingham risk score and alternatives for prediction of coronary heart disease in older adults. PLoS One. 2012; 7: e34287
 
16. Ridker PM, Rifai N, Cook NR, et al. Non-HDL cholesterol, apolipoproteins A-I and B100, standard lipid measures, lipid ratios, and CRP as risk factors for cardiovascular disease in women. JAMA. 2005; 294: 326–333.
 
17. Sheppard JR, Singh S, Fletcher K, et al. Impact of age and sex on primary preventive treatment for cardiovascular disease in the West Midlands, UK: cross-sectional study. BMJ. 2012; 345: e4535
 
18. Franklin SS  Elderly hypertensives: how are they different? J Clin Hypertens (Greenwich). 2012; 14: 779–786.
 
19. Denti L. The hormone replacement therapy (HRT) of menopause: focus on cardiovascular implications. Acta Biomed. 2010; 81: 73–76.
 
20. Rosano GM, Vitale C, Fini M. Hormone replacement therapy and cardioprotection: what is good and what is bad for the cardiovascular system? Ann N Y Acad Sci. 2006; 1092: 341–348.
 
21. Tabata M, Grab JD, Khalpey Z, et al. Prevalence and variability of internal mammary artery graft use in contemporary multivessel coronary artery bypass graft surgery: analysis of the Society of Thoracic Surgeons National Cardiac Database. Circulation. 2009; 120: 935–940.
 
22. Reynolds HR, Srichai MB, Iqbal SN, et al. Mechanisms of myocardial infarction in women without angiographically obstructive coronary artery disease. Circulation. 2011; 124: 1414–1425.
 
23. van der Meer MG, Cramer MJ, van der Graaf Y, et al. Gender difference in long-term prognosis among patients with cardiovascular disease. Eur J Prev Cardiol. 2012;Sep 5 [Epub ahead of print]
 
24. Mitka M. AHA statement calls attention to risk of peripheral artery disease in women. JAMA. 2012; 307: 1474–1475.
 
25. Hirsch AT, Allison MA, Gomes AS, et al. A call to action: women and peripheral artery disease: a scientific statement from the American Heart Association. Circulation. 2012; 125: 1449–1472.
 
26. Yancik R. Population aging and cancer: a cross-national concern. Cancer J. 2005; 11: 437–441.
 
27. Centers for Disease Control and Prevention. Top 10 cancers among women. http://www.cdc.gov/cancer/dcpc/data/women.htm. Accessed September 24, 2013.
 
28. Petrakis IE, Paraskakis S. Breast cancer in the elderly. Arch Gerontol Geriatr. 2010; 50: 179–184.
 
29. Kosiak B, Sangl J, Correa-de-Araujo R. Quality of health care for older women: what do we know? Womens Health Issues. 2006; 16: 89–99.
 
30. Qaseem A, Snow V, Sherif K, et al. Screening mammography for women 40 to 49 years of age: a clinical practice guideline from the American College of Physicians. Ann Intern Med. 2007; 146: 511–515.
 
31. Tahir M, Robinson T, Stotter A. How not to neglect the care of elderly breast cancer patients? Breast. 2011; 20: 293–296.
 
32. Welch HG, Albertsen PC, Nease RF, et al. Estimating treatment benefits for the elderly: the effect of competing risks. Ann Intern Med. 1996; 124: 577–584.
 
33. Van Leeuwen BL, Rosenkranz KM, Feng LL, et al. The effects of under-treatment of breast cancer in women 80 years of age and older. Crit Rev Oncol Hematol. 2011; 79: 315–320.
 
34. Howlader N, Noone AM, Krapcho M, et al. SEER cancer statistics review, 1975–2010.http://seer.cancer.gov/csr/1975_2010. Accessed January 5, 2013.
 
35. Luo J, Chlebowski R, Wactawski-Wende J, et al. Diabetes and lung cancer among postmenopausal women. Diabetes Care. 2012; 35: 1485–1491.
 
36. Blanco JA, Toste IS, Alvarez RF, et al. Age, comorbidity, treatment decision and prognosis in lung cancer. Age Ageing. 2008; 37: 715–718.
 
37. Beckett P, Callister M, Tata LJ, et al. Clinical management of older people with non-small cell lung cancer in England. Thorax. 2012; 67: 836–839.
 
38. Janssen-Heijnen ML, Maas HA, van de Schans SA, et al. Chemotherapy in elderly small-cell lung cancer patients: yes we can, but should we do it? Ann Oncol. 2011; : 22: 821–826.
 
39. Gingras D, Béliveau R. Colorectal cancer prevention through dietary and lifestyle modifications. Cancer Microenviron. 2011; 4: 133–139.
 
40. Lieberman DA. Clinical practice. Screening for colorectal cancer. N Engl J Med. 2009; 361: 1179–1187.
 
41. Jin XW, Lipold L, McKenzie M, et al. Cervical cancer screening: what’s new and what’s coming? Cleve Clin J Med. 2013; 80: 153–160.
 
42. Tabloski PA. Global aging: implications for women and women’s health. J Obstet Gynecol Neonatal Nurs. 2004; 33: 627–638.
 
43. Cerda D, Peris P, Monegal A, et al. Identification of clinical features and laboratory abnormalities associated with the development of vertebral fractures in women with postmenopausal osteoporosis. Med Clin (Barc). 2012; 139: 626–630.
 
44. Sandhu SK, Hampson G. The pathogenesis, diagnosis, investigation and management of osteoporosis. J Clin Pathol. 2011; 64: 1042–1050.
 
45. Bell JS, Blacker N, Edwards S, et al. Osteoporosis—pharmacological prevention and management in older people. Aust Fam Physician. 2012; 41: 110–118.
 
46. MacLean C, Newberry S, Maglione M, et al. Systematic review: comparative effectiveness of treatments to prevent fractures in men and women with low bone density or osteoporosis. Ann Intern Med. 2008; 148: 197–213.
 
47. Irvine K, Laws KR, Gale TM, et al. Greater cognitive deterioration in women than men with Alzheimer’s disease: a meta analysis. J Clin Exp Neuropsychol. 2012; 34: 989–998.
 
48. Maki PM, Zonderman AB, Resnick SM. Enhanced verbal memory in nondemented elderly women receiving hormone-replacement therapy. Am J Psychiatry. 2001; 158: 227–233.
 
49. Robinson D, Friedman L, Marcus R, et al. Estrogen replacement therapy and memory in older women. J Am Geriatr Soc. 1994; 42: 919–922.
 
50. Henderson VW, Watt L, Buckwalter JG. Cognitive skills associated with estrogen replacement in women with Alzheimer’s disease. Psychoneuroendocrinology. 1996; 21: 421–430.
 
51. Barnes LL, Wilson RS, Schneider JA, et al. Gender, cognitive decline, and risk of AD in older persons. Neurology. 2003; 60: 1777–1781.
 
52. Kern S, Skoog I, Ostling S, et al. Does low-dose acetylsalicylic acid prevent cognitive decline in women with high cardiovascular risk? A 5-year follow-up of a non-demented population-based cohort of Swedish elderly women. BMJ Open. 2012; 2: pii: e001288
 
53. Kang JH, Cook N, Manson J, et al. Low dose aspirin and cognitive function in the women’s health study cognitive cohort. BMJ. 2007; 334: 987
 
54. Knight BG, Sayegh P. Mental health and aging in the 21st century. J Aging Soc Policy. 2011; 23: 228–243.
 
55. Malatesta VJ. Introduction: the need to address older women’s mental health issues. J Women Aging. 2007; 19: 1–12.
 
56. Fiske A, Wetherell JL, Gatz M. Depression in older adults. Annu Rev Clin Psychol. 2009; 5: 363–389.
 
57. Goveas JS, Espeland MA, Woods NF, et al. Depressive symptoms and incidence of mild cognitive impairment and probable dementia in elderly women: the Women’s Health Initiative Memory Study. J Am Geriatr Soc. 2011; 59: 57–66.

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