Gender differences in health status and care among HIV-infected minority drug users

Gender differences were examined in health status and HIV care among HIV-infected minority drug users. More women than men reported having HIV-related symptoms and other health conditions, such as asthma and allergies. Hepatitis B or C was more often reported by men. As compared to men, women delayed HIV care and fewer attended HIV support groups. Delayed entry into HIV treatment was also significantly related to being Hispanic and being diagnosed with HIV in the pre-HAART era. No significant gender difference was found in current use of HIV medications. Use of HIV medications was significantly related to being married, no history of childhood sexual abuse, enrollment in an HIV clinic and attending HIV support groups. The findings demonstrate the importance of family and social support for HIV-positive drug users and also suggest a need for special attention to those who have childhood sexual abuse experience.     

Gender differences in predictors of mental health among older adults in South Korea

As aging is occurring at a rate never before seen in South Korea, the present study examines the predictors of mental health in a nationally representative sample of older adults (n = 4,155), drawn from Wave I of the Korean Longitudinal Study on Aging. Findings show that sociodemographic factors, chronic health conditions, level of cognition, and social activities contribute to life satisfaction and mental health among older adults in South Korea. Life satisfaction is mainly determined by sociodemographic factors for both women and men. Compared to women, men's levels of depression and life satisfaction appear to be more influenced by their health, cognitive functioning, and social activity participation. Implications for practice and policy are discussed.     

Urban-rural differences in physical performance and health status among older Japanese community-dwelling women

Background/PurposeAssessment of physical performance allows the identification of health and functional independence among older adults. Several factors, such as environmental conditions, influence the results; therefore our objective was to compare the physical performance and the health status between older Japanese women living in urban and rural communities.MethodsThe Japanese women were aged ≥65 years, and recruited in urban (n = 41, age = 73.8 ± 3.92 years) and rural (n = 54, age = 73.8 ± 4.15 years) locations through the local press. Physical performance was assessed by the Timed Up and Go (TUG), one leg stand (OLS), repeated chair stands (CS) and handgrip strength (HGS) tests. Health status was investigated using socio-demographic characteristics; anthropometric measures and body composition; physical activity, a pedometer, Life-Space Assessment (LSA); Geriatric Depression Scale; incidence of falls, fear of falling; and medical information. Variables were compared by χ² test, Independent-Samples t test and Mann Whitney U-test.ResultsRural individuals presented a better performance in the HGS test (p = 0.01) than urban individuals, who had a better performance in the CS test (p < 0.001). No statistical differences were found in the TUG or OLS tests. Rural women also had a higher body mass index (p = 0.04), waist circumference (p < 0.01), and body fat percentage (p = 0.014) than urban women, who showed higher scores in LSA (p < 0.001). Concerning medical information, more rural women complained of low back pain (p = 0.01) and gastrointestinal problems (p = 0.02).ConclusionOur findings showed that the physical performance and health status varied according to the place. Rural individuals had worse results in the CS test, but a better performance in the HGS test than urban individuals. We emphasize that health interventions should address the specific demand of each location.     

Involving older people in health research

BACKGROUND: It is a UK policy requirement to involve patients and the public in health research as active partners. OBJECTIVE: We reviewed published reports of studies which involved older people in commissioning, prioritizng, designing, conducting or disseminating research. Search strategy and selection criteria: systematic searches of databases (PubMed, SCI-EXPANDED, SSCI, A&HCI, ASSIA, Embase, CINAHL and Medline) for English language studies published between 1995 and 2005 which had involved older people as partners n the research process as opposed to research subjects. Articles were reviewed by two authors using a standardised matrix for data extraction. RESULTS: Thirty studies were included and classified according to the stage in the research process in which older people were involved. Barriers to involving older people were: cultural divisions, language barriers, research skills capacity, ill health, time and resources. Four of the studies had been formally evaluated to identify the impact of involvement. Evaluation focussed on the impact on participants rather than on impact on research processes and outcomes. Benefits to participants included: increased knowledge, awareness and confidence, meeting others in similar situations, empowering older people to become active in their community regarding decisions/policies which affect them. CONCLUSIONS: Factors hindering the involvement of older people in research were the same as reported factors hindering involvement of younger people, suggesting that age, per se, is not a barrier. To demonstrate the impact of user involvement on research quality, the definition of user involvement requires clarification, and systematic evaluation of research involving older people needs to be developed.     

Gender differences in the association between socioeconomic status (SES) and depressive symptoms in older adults

With rapid population aging, increasing attention is given to the mental health of older people. This study examined the association between SES and depressive symptoms in older adults. The study population consisted of a representative community sample of 4165 persons aged 65 and older from Wave 1 of the Korean Longitudinal Study of Aging. The Center for Epidemiologic Studies Depression scale was used to measure the extent of depressive symptoms. Socioeconomic indicators included education, household income, and net worth. Analyses were conducted by gender, using multiple linear regression analysis, to identify independent effects of socioeconomic variables on depressive symptoms, controlling for demographics and health-related variables. There was an inverse association between higher levels of socioeconomic factors and depressive symptoms in the study population. A clear difference in the association between depressive symptoms and socioeconomic factors by gender was observed. In the multivariate analysis, wealth was significantly associated with depressive symptoms in men, whereas education and income was so in women. Gender disparities in depressive symptoms across social gradients suggest the need for gender-sensitive investments in health and social services for the disadvantaged segments of the older population.     

Gender differences in the health related quality of life of older adults with heart failure

OBJECTIVE: The objective of this study was to explore whether gender differences exist in health-related quality of life for older adult men and women with heart failure. DESIGN: A secondary data analysis was conducted on an existing dataset of heart failure patients. The original study used an exploratory, correlational longitudinal design. SUBJECTS: 138 subjects (69 men and 69 women) with heart failure completed both data points of the study. RESULTS: Men and women were similar on the number and types of heart failure-related symptoms they experienced. Twenty-seven percent of the subjects could be classified as depressed. The men had better physical functioning than the women did with gender making a greater contribution to physical functioning than age or marital status. Twenty-three percent of the subjects were rehospitalized 4 to 6 weeks after the initial hospital discharge. CONCLUSIONS: This study showed that the health related quality of life for older men and women with heart failure is significantly impacted by heart failure. Older men and women have similar heart failure symptoms, depression, and rehospitalization following a hospital admission for heart failure. Both older men and older women with heart failure have impairments in their physical functioning with older women more physically impaired than older men.     

Gender differences in physical health and psychosocial well being among four age-groups of elderly people in Israel

The purpose of this study was to investigate the extent to which the well-established gender differences in physical and psychosocial well being in adulthood persist throughout different age groups of elderly persons, in order to support one of two opposing hypotheses: the convergence and divergence hypotheses. Data were collected by structured interviews from a random sample of 987 Israeli elderly (70+) in 1994. They were divided into four age groups for analysis: 70-74, 75-79, 80-84, and 85 and over. Findings indicate that in nearly every gender comparison by age, women score lower than men on indicators of physical and psychosocial well being, and in both genders increasing limitations on activities of daily living (ADL) were noticed. However, on all measures of physical health, except for ADL, the male advantage declines in the older age groups. This pattern is even stronger for the psychosocial indicators of well being, where no significant gender differences are found between the oldest groups. The trend of convergence among men and women thus occurs mainly in the age group of 85+. The results of multivariate analyses indicate that the sense of control of one's life is an important explanatory variable of satisfaction with life for men but not for women. The significant decline in the sense of control of men, aged 85 and over, is one of the main reasons for the more significant decline found in men's psychosocial well being in comparison to women. Our findings indicate that decline in health status, and other losses experienced with aging, affect more significantly men's sense of control over life, and therefore have a more deleterious effect on the psychosocial well being of men than on that of women. This conclusion, however, has to be supported by longitudinal studies.     

Gender differences in rehabilitation outcomes among older Chinese patients

Although gender differences have been demonstrated in cardiac and stroke rehabilitation, it remains unclear whether there are gender differences in geriatric rehabilitation. The purpose of this study is to investigate the relationship between gender and rehabilitation outcomes. We studied 1795 patients in two convalescence hospitals in Hong Kong. We defined absolute functional and motor gains as Barthel Index (BI) efficacy and Elderly Mobility Scale (EMS) efficacy while BI and EMS efficiency were efficacy divided by the length of stay. Satisfactory motor and functional outcomes were defined as discharge EMS ≥ 15 and BI ≥ 75. Compared with men, women had higher BI but lower EMS on admission and discharge. EMS and BI efficacy and efficiency were similar in both sexes. Female gender was a significant negative predictor for satisfactory motor outcome (p = 0.0002) but a positive predictor for functional outcome (p = 0.0007). Other predictors for satisfactory motor outcome were: age (p < 0.001); urinary incontinence (p = 0.0049); living at home (p = 0.0056); admission EMS (p < 0.001); admission BI (p = 0.044). Other predictors for satisfactory functional outcome were: age (p = 0.009); infection other than chest (p = 0.047); urinary incontinence (p < 0.001); Mini Mental State Examination (MMSE) (p = 0.0004); admission EMS (p = 0.005); BI (p < 0.001). Women achieved a better functional outcome but a poorer motor outcome on discharge. Female gender was a positive predictor for functional outcome but a negative factor for motor outcome.     

Gender and age differences in pain, coping and health status among children with chronic arthritis

OBJECTIVE: To investigate pain, coping and health status in children with chronic arthritis. Additional aims were to explore gender variations in pain, coping and health status, and the same factors in children under 16 years versus children 16 years or older. METHODS: For 125 children (43 boys) with a median age of 14.1 years (range 10.3-17.8) disability and discomfort were assessed (Childhood Health Assessment Questionnaire, CHAQ). Pain, coping, fatigue, sleeping and satisfaction with life were evaluated (Visual Analogue Scales). The Pain Intensity Scale was used to assess the variation in pain intensity during one week. RESULTS: The CHAQ disability index (DI) was 0.63. In the total sample, girls had larger numbers of affected joints in upper extremities (p = 0.028) and more days with morning pain (p = 0.025) than boys. Boys reported greater perceived ability to reduce pain than girls (p = 0.020). Compliance with treatment was more frequent in girls than in boys (p = 0.029). In children 16 years of age and older, boys reported greater perceived ability to control pain (p = 0.032) and to reduce pain than girls (p = 0.001) and fewer days with worst pain in the mornings (p = 0.013), as well as less pain variations over the period of a day (p = 0.014) and over a period of a week (p = 0.035). CONCLUSIONS: As a group, the children were clearly affected by their arthritis. Pain was related to the severity of disease. Some significant gender and age differences were highlighted, which should be considered in clinical pain management.     

Gender differences in tuberculosis: a prevalence survey done in Bangladesh.

SETTING: Bangladesh national tuberculosis control programme districts supported by the Damien Foundation (population 18 million). OBJECTIVE: To determine whether the observed gender difference is epidemiologically true or whether it is due to accessibility barriers for women. DESIGN: Two-stage random sampling population survey. People were interviewed by teams composed of one male and one female volunteer about the presence of symptoms suggestive of tuberculosis. One early morning sputum specimen of all thus identified tuberculosis suspects was examined by Ziehl-Neelsen technique. RESULTS: A total of 266189 people were surveyed, among whom 223 936 (84.1%) could be interviewed. This led to the identification of 7001 tuberculosis suspects (2406 females and 4595 males) and 64 confirmed TB cases (16 females and 48 males). The female/male ratio (0.33:1) of cases found during the survey was not higher than that observed through routine diagnosis (0.42:1). The routine case-notification rate of sputum-positive cases during 2000 was about twice the rate observed during the survey (44.3 vs. 24.0 per 100 000 population). CONCLUSIONS: The gender difference observed in routine tuberculosis diagnosis is real, and is not due to lesser accessibility of women to the health services. The routine notification rate compares favourably with the detection of previously unknown cases found during the survey.     

Gender differences in the impact of metabolic syndrome components on mortality in older people: A systematic review and meta-analysis

Background and aimsThe influence of metabolic syndrome (MetS) on mortality may be influenced by age- and gender-related changes affecting the impact of individual MetS components. We investigated gender differences in the association between MetS components and mortality in community-dwelling older adults.Methods and resultsProspective studies were identified through a systematic literature review up to June 2019. Random-effect meta-analyses were run to estimate the pooled relative risk (RR) and 95% confidence intervals (95% CI) of all-cause and cardiovascular (CV) mortality associated with the presence of MetS components (abdominal obesity, high triglycerides, low HDL cholesterol, high fasting glycemia, and high blood pressure) in older men and women. Meta-analyses considering all-cause (103,859 individuals, 48,830 men, 55,029 women; 10 studies) and CV mortality (94,965 individuals, 44,699 men, 50,266 women; 8 studies) did not reveal any significant association for abdominal obesity and high triglycerides in either gender. Low HDL was associated with increased all-cause (RR = 1.16, 95% CI: 1.02–1.32) and CV mortality (RR = 1.34, 95% CI: 1.03–1.74) among women, while weaker results were found for men. High fasting glycemia was associated with higher all-cause mortality in older women (RR = 1.35, 95% CI: 1.22–1.50) more than in older men (RR = 1.21, 95% CI: 1.13–1.30), and CV mortality only in the former (RR = 1.36, 95% CI: 1.04–1.78). Elevated blood pressure was associated with increased all-cause mortality (RR = 1.16, 95% CI: 1.03–1.32) and showed marginal significant results for CV death only among women.ConclusionsThe impact of MetS components on mortality in older people present some gender differences, with low HDL cholesterol, hyperglycemia, and elevated blood pressure being more strongly associated to all-cause and CV mortality in women.