Older women and health: an overview

Older women's health issues are unique. There are more older women than ever before. They are living increasingly longer than men, yet they report more acute and chronic illness and disability than men. They are disproportionally represented in nursing homes, since many women are alone: twenty-five percent aged 70 or over have no living children and over 60 percent of older women are widowed, divorced, or single. Older women have fewer personal financial resources for health care than men. Health care reimbursement does not meet their needs for financial coverage of chronic outpatient and nursing home care. They face age and sex discrimination on the part of many health care providers and are subject to a growing tendency to be seen as "burdens" and "problems" in the American health care system.     

Fluid-electrolyte balance during labor and exercise: concepts and misconceptions

Body water and electrolyte balance are essential to optimal physiological function and health. During exercise, work, or high temperatures, a significant level of dehydration can develop, and the ratio of extracellular to intracellular fluid can change, despite an ample supply of water. Physical and cognitive performance are impaired at 1-2% dehydration, and the body can collapse when water loss approaches 7%. Because fluid needs and intakes vary, formulating one general guideline for fluid replacement is difficult. Knowing the amount of water lost in sweat may enable predicting fluid needs via mathematical models for industrial, athletic, and military scenarios. Sodium imbalance might result from excessive Na+ loss or from gross overhydration. In most work or exercise lasting < 3-4 hr, the major concern is that fluid be available to prevent heat-related illnesses, which can be prevented if fluid and electrolyte losses are balanced with intake, using the recommendations presented.     

Older women in developing countries

Women's issues are markedly underrepresented in international policy and research discussions. This paper addresses these deficits by delineating the particular conditions of aging women in developing countries. While these women experience many of the age-related problems as their counterparts in developed countries, cultural and economic influences place them at a greater disadvantage.     

Older women entrants to medicine

In a study of women who first obtained a registrable qualification from a British Medical School in the years 1949–51 (early cohort) and 1965 (late cohort) it was found that 83% qualified when aged 21–25, 12% when aged 26–30, 3% when aged 31–35 and 2% when over 36. There was a higher level of practice over the 12 years after qualification by the older entrants, and these also obtained career posts earlier than the younger entrants.     

Riboflavin requirements and exercise adaptation in older women.

The effects of exercise training on riboflavin requirements and of riboflavin intake on endurance were examined in 14 women, 50-67 y of age, who participated in a 10-wk, two-period crossover exercise study at two riboflavin intakes, 0.15 micrograms/kJ (0.6 micrograms/kcal) and 0.22 micrograms/kJ (0.9 micrograms/kcal). Subjects exercised 20-25 min/d, 6 d/wk, for 4-wk periods on a cycle ergometer at 75-85% of their maximal heart rate. Riboflavin status was assessed by measuring the erythrocyte glutathione reductase activity coefficient (EGRAC) and urinary riboflavin excretion. Physical performance was evaluated by using a walking treadmill test to determine maximal oxygen capacity (VO2max) and anaerobic threshold by gas exchange (ATGE). Exercise significantly affected riboflavin status as EGRAC increased (P less than 0.001) and riboflavin excretion decreased (P less than 0.01) in both groups. VO2max increased significantly with exercise (P less than 0.01). However, changes in VO2max (L/min) and ATGE with exercise training were not different in the two groups. Riboflavin requirements of older women increased with exercise training, but increased riboflavin intake did not enhance improvements in endurance.     

Older women and dietary advice: occurrence, comprehension and compliance

BACKGROUND: When a person becomes ill, traditional food habits may come into conflict with the disease-related recommended diet. AIM: The aim was to study perceptions of receiving dietary advice, the occurrence and comprehension of such advice and compliance among older women diagnosed with Parkinson's disease, stroke or rheumatoid arthritis. METHODS: The study took an ethnographic approach. Fifty-four community-dwelling women, 64-88 years of age, were interviewed using an open-ended interview technique during visits to their homes. FINDINGS: Two themes were found: 'dietary advice - occurrence and comprehension' describes whether the women had received dietary advice and, if so, how they understood the information. In the theme 'compliance with dietary advice', two principal reasons for complying or not complying with advice were found: First, women expressed a 'food interest', such that they were either 'interested in disease-related diet' or held a general view of the significance of foods and complied with the advice for their own 'health interest'. Secondly, the women were 'uninterested in food changes'. This could be because of 'poor appetite', 'food and disease ambivalence', 'habitual and preferred foods'. CONCLUSION: Dietary advice should be based on women's food preferences and habitual foods. It is important to inform about known relations between food and disease, but also to support eating favourite foods, thereby facilitating women's well-being.     

Older women in nonindustrial cultures: consequences of power and privilege

In old age, women in many non-Western cultures gain influence, prestige, and freedom. Tensions, however, often develop with disadvantaged younger women who are subject to old women's authority and resent the privileges of their elders. After outlining the benefits of aging for women in nonindustrial cultures, this article examines the particular relations between old and young women that are subject to strain. It is argued that older women have a strong interest in maintaining young women's subordinate position. In a concluding section, the question of how social change affects the position of old women is considered.     

Older women in the post-Reagan era

This article explores the social, economic, and institutional factors that affect older women throughout the life cycle, and recent policy and ideological changes that will continue to affect older women in the decades ahead. The situation of the older woman is shown to result from lifelong patterns of socioeconomic and gender stratification in the larger society. The consequences for women flow from the complex and often subtle relationships in the social institutions of the family, the labor market, and the state and its social policy. The female roles of worker, unpaid caregiver, and beneficiary of public policies continue to be systemically unequal to those of men. The patriarchal structure of (and control over) the labor market and policy-making promotes the informalization of long-term care, ageism and sexism toward older women attempting to reenter the labor market, and the devaluing of female work that is not economically remunerated. The failure of social problems to address the underlying structural inequities of women perpetuates their disadvantaged economic and health situation throughout old age. Changes in social policies are required to address the problem of access to basic resources, including Social Security, housing, health, and long-term care, but most importantly, to abridge and compensate for the gendered division of labor and the lifelong discrimination that women experience.     

Older women and suntanning: the negotiation of health and appearance risks

This paper examines older women's experiences and perceptions of sunbathing, sun avoidance, and suntanned appearances. Using data from in-depth interviews with 36 women aged 71 to 94, we elucidate the motivations behind the women's sunbathing practices. Specifically, we explore how the women responded to the health and appearance risks associated with exposure to and avoidance of ultraviolet radiation as well as extant feminine beauty norms. The majority of women put their experiences of sunbathing in an emergent historical context. Although most of the women suggested that suntanned appearances were indicative of health and beauty, sunbathers tended to downplay their health risks by distancing themselves from those they considered to be most at risk, namely tanning bed users and individuals who acquired overly dark suntans. Sunbathers also emphasised the benefits of sun exposure for adequate vitamin D absorption. In contrast, the women who did not suntan tended to have experienced negative health and appearance consequences from their past sunbathing practices. Thus, these women emphasised the importance of future health over immediate appearance dividends. We discuss our findings in relation to the extant research on suntanning and the literature pertaining to health, risk, and beauty work.     

Pragmatic versus explanatory trials.

This article considers the distinction between "explanatory" and "pragmatic" aims in clinical trials--the distinction between testing a biological hypothesis and providing evidence to permit a choice between alternative treatment policies. The choice of treatments to compare, the selection of patients for the trial, the study size, and how the treatment comparison should be made are among the matters discussed. In general, where explanatory and pragmatic aims conflict, the pragmatic aim will often take priority.     

Older pregnant women and adolescents: nutrition data after enrollment in WIC

Although there has been an increase in pregnancy in women over 35 years of age, the literature contains no information on dietary intakes of older pregnant women. Several studies have reported the nutritional status of pregnant adolescents who are considered to be at nutritional risk. This study investigated the energy, nutrient, and food intake patterns of 63 low-income pregnant women over 35 compared with 526 pregnant adolescents. Nutrient intake was assessed using a standardized 24-hour dietary recall protocol. Energy values for both groups were below recommended levels, and neither group gained the recommended amount of weight. Obesity may have been the reason for the lack of weight gain by the older pregnant women, since more than 50% of the older pregnant women were calculated to be obese prior to pregnancy. The younger women reported consuming less milk but more snack foods with lower nutrient densities, which significantly increased their energy values over those of the older group. In comparison with diets reported in other studies, the diets of the older pregnant women were more nutrient dense for most nutrients. Although all participants were enrolled in WIC, an equal number of women from both groups stated that they did not have the supplemental foods in their households at the time of interview.     

Older women and mammography screening behavior: do possible selves contribute?

This study sought to explore the contribution of the self-concept to older women's adherence to regular mammography screening behavior. The PRECEDE and health belief model concepts were incorporated with a measure of the women's future selves to determine whether the self-concept adds to our ability to predict screening. A self-administered questionnaire was completed by 210 community-dwelling women ages 50 to 75 years, recruited from urban and rural women's groups. Logistic regression analyses revealed that predictors of adherence were clinical breast examination, physician recommendation, age, barriers, benefits, feared health-related possible self, and self-efficacy in the feared domain. The addition of the self measures significantly improved the overall fit of the model. Implications for theory development, practice, and future research are discussed.     

Older immigrant Tamil women and their doctors: attitudes toward breast cancer screening

Cultural beliefs have been hypothesized to be powerful barriers to breast cancer screening in minority women and physician recommendation is consistently reported to be the strongest incentive. This study investigated (1) beliefs regarding breast cancer and (2) the perception of barriers to mammography and clinical breast examination in a sample of immigrant Tamil women, as well as in a sample of primary care physicians. Three focus groups, each consisting of 10 immigrant Tamil women from Sri Lanka aged 50 years or over were conducted and 52 primary care physicians who serve this population completed mailed surveys. The most common barriers to screening reported by the women were (1) lack of understanding of the role of early detection in medical care, (2) religious beliefs and, (3) fear of social stigmatization. Physicians reported the most common barriers to their screening recommendations for this group of women to be (1) women's episodic care, (2) unrelated presenting problems and, (3) women refusing to be screened. Interventions to increase screening in this and other minority groups requires an elaborated understanding of utilization barriers for both women and their doctors.