American Journal of Epidemiology Vol. 150, No. 8: 834-842
Copyright © 1999 by The Johns Hopkins University School of Hygiene and Public Health
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Do Elderly Women Have More Physical Disability than Men Do?
1Epidemiology Department, Buck Center for Research in Aging Novato, CA
2Present address: Division of Research, Kaiser Permanente, Oakland, CA
Reprint requests to Dr. Doug Oman, Buck Center for Research in Aging, P. O. Box 638, Novato, CA 94948-0638.
This study investigated whether the commonly observed higher prevalence of physical disability among women is due to higher incidence rates or to other factors such as selective mortality or poor recovery. Methods included observed measures of prevalent lower body physical disability and potential risk factors at baseline (1989–1991) and 4-year follow-up of 2,025 community-dwelling adults aged 55 years and older in Marin County, California. Incidence, recovery, and mortality rates were determined at the follow-up examination. Results indicated that women had higher age-specific and age-adjusted prevalence rates at both examinations (odds ratios = 1.66 and 1.60, p < 0.001) but that incidence rates were not significantly different (odds ratio = 1.12, 95% confidence interval: 0.77, 1.64). In the classic formulation, prevalence = incidence x duration, the higher prevalence rates in women could not be due to a higher incidence rate, but could be explained by longer duration due to lower recovery and mortality rates in women. Incident physical disability was predicted by prevalent chronic illnesses, poor vision, obesity, physical inactivity, poor memory, fewer social activities, and higher depression scores, but not by sex. Prevention efforts should concentrate on reducing known risk factors in both men and women and on promoting higher recovery rates among women. Am J Epidemiol 1999;150:834-42.
aged; disabled persons; Markov chains; prospective studies; recovery of function; sex differentiation
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