The health challenges women face as they get older

SINGAPORE: Singaporean women may outlive Singaporean men by six years, going by the latest World Health Statistics report by the World Health Organisation.

But the extra years are not necessarily easy ones for them, according to the experts at the Health, Wealth & Relationships – Spotlight on Older Women symposium organised by Duke-NUS Medical School on Friday (Nov 24).

Elderly woman

FRAILTY IN WOMEN

Frailty, for instance, affects women more than men, said Associate Professor Reshma Merchant, head and senior consultant with the geriatric medicine division at the Yong Loo Lin School of Medicine at National University of Singapore.

In a study on 1,051 adults with an average age of 71 in the northwestern part of Singapore, 37 per cent of them were found to be pre-frail, while 6.2 per cent of them were frail. Of the frail cohort, 46 per cent of them were women compared to 19 per cent of men.

The condition goes beyond the physical such as falls and disability, said Assoc Prof Merchant, adding that frailty also encompasses social frailty and cognitive frailty.

"Frailty signifies the increased vulnerability to minimal stressors leading to functional impairment," she said.

Assoc Prof Merchant said that the presence of any of these five components – fatigue, inability to climb stairs, inability to walk the distance of a block, the presence of five or more illnesses, and unintentional loss of 5 per cent of the body’s weight – could point to frailty.

However, the phenomenon is reversible, especially for those in the pre-frail stage, said Assoc Prof Merchant. In the Healthy Ageing Promotion Programme For You (Happy) programme launched in August, she noted that dual-task exercises like marching on the spot while playing memory games could improve the memory scores of the seniors in three months.

MORE KNEE PAIN

Knee osteoarthritis is the most common type of arthritis, said Katy Leung, an assistant professor at the Duke-NUS Medical School. And the global prevalence of the joint disease will continue to increase, owing in part, to increases in the worldwide prevalence of obesity and longevity.

While osteoarthritis is a painful joint condition that comes with age, especially after the age of 40, women appear to bear the greater brunt, said Assoc Prof Leung, who is also senior consultant at the Rheumatology and Immunology department of Singapore General Hospital.

In the National Health Surveillance Survey in 2013 that examined 3,364 Singaporeans, Assoc Prof Leung noted that female patients with knee osteoarthritis make up 11 per cent, while men only take up 4.7 per cent of the participants.

"The risk of disability attributable to knee osteoarthritis alone is greater than any other medical condition in people aged 65 years and over," said Assoc Prof Leung, who added that there is currently no drug that can slow down knee osteoarthritis’ progress.

"Knee replacement surgery is offered to those with end-stage disease," she said.

LESS FINANCIAL SECURITY

Overall, marital status is a major factor in economic conditions, said Professor Rhema Vaithianathan, a senior research fellow with Singapore Management University’s Centre for Research on the Economics of Ageing.

She based her observation on the ongoing five-year Singapore Life Panel survey that has been collecting an average of 8,000 responses from Singaporeans aged 50 to 70 each month since 2013.

"Married women reported that they felt more secure about their retirement than single women. However, for married women, their husband’s health presents an important source of economic risk," she said.

It could explain why married respondents, whose husbands had a health scare like a heart attack or cancer, went back to work for up to seven months to supplement the family’s income.

The same behaviour isn’t observed in men when women had to bow out of work due to a health scare, said Prof Vaithianathan.

When Prof Vaithianathan and her team asked respondents how they felt about their "financial preparation for retirement", women in all age groups felt "financially less well-prepared for their retirement than men".

Among the 50 to 59 age group, single women felt less well-prepared than married women.

When it comes to whether they think they’d end up in nursing homes, one in three single women in the 50 to 59 age group thought they would. However, only one in four married women shared the same thought.

THE FEMALE SOCIAL NETWORK

When it comes to socialising, older women seem to faring better than their male counterparts.

At least 60 per cent of the world’s aged population are women, said Angelique Chan, an associate professor in the signature programme by Health Services & Systems Research at Duke-NUS Graduate Medical School, and the Department of Sociology at National University of Singapore.

However, the ways in which they live their later years significantly differ from their male counterparts. Older women are much more likely to be widowed, more likely to live alone, and have higher incidence of mobility problems and depression compared to older men, she said.

In terms of social networks outside the family, older women have stronger networks outside the household compared to men.

In fact, upon retirement, Dr Chan said that older women’s social networks expand whereas men’s social networks shrink.