Stephanie Faubion, director of the Mayo Clinic’s Center for Women’s Health, launched into a critique when I asked her about the current state of research on older women’s health: “It’s completely inadequate,” she told me.
For example, many drugs commonly prescribed for older adults: Contains statins for high cholesterolwas primarily studied in men, and the results were also extrapolated to women.
“It’s believed that pre- and post-menopausal women will respond in the same way, regardless of a woman’s biology,” Fabion says.
“This has to stop. The FDA needs to require clinical trial data to be reported disaggregated by sex and age so we can determine whether drugs work as well, better or not in women,” she added.
Take Lukemvy, a drug for Alzheimer’s disease that was approved by the Food and Drug Administration last year after its manufacturer reported that it slowed the rate of cognitive decline in people who took it by 27%. Supplementary Appendix Lukembi’s study, published in the New England Journal of Medicine, found substantial gender differences — a 12 percent drop in women and a 43 percent drop in men — raising questions about the drug’s effectiveness for women.
This is especially important because about two-thirds of older people with Alzheimer’s are women, who are more likely to develop the disease than older men. Multiple medical conditions,hindrance, Autoimmune disorders, depression Numerous research studies have shown that it can lead to problems like anxiety, uncontrolled high blood pressure, and osteoarthritis.
Yet women are resilient, living more than five years longer than men in the United States. By their 70s and 80s, women vastly outnumber men. If you’re concerned about the health of older adults, you should also be concerned about the health of older women.
When it comes to research priorities, here are some suggestions from doctors and medical researchers:
Why are fewer treatments recommended for women than for men with heart disease, which becomes so common after menopause and claims more women’s lives than any other disease?
“We’re definitely not treating women as aggressively,” says Martha Gulati, director and associate chair of preventive cardiology at the Barbra Streisand Women’s Heart Center at Cedars-Sinai Hospital in Los Angeles. “We’re delaying testing for chest pain. We’re not giving anticoagulants as often as we used to. We’re not doing procedures like aortic valve replacement as often. We’re not addressing hypertension as well.”
“We need to understand why these biases in care exist and how to eliminate them.”
Gulati also noted that older women are less likely than men to have obstructive coronary artery disease (blockage of the large blood vessels) and more likely to suffer damage to small blood vessels that goes undetected. Women also suffer more bleeding and complications when undergoing procedures such as cardiac catheterization.
Given these issues, what’s the best treatment for older women? “The data is very limited. This is where we need to focus,” Gulati said.
How can women reduce their risk of age-related cognitive decline and dementia?
“This is an area where we really need clear messaging to women and effective interventions that are actionable and accessible,” said Dr. Women’s Health InitiativeThe largest study of women’s health in the United States.
Many factors influence women’s brain health, but stress from sexism, caregiving responsibilities and financial burdens can increase inflammation. Women experience a decline in estrogen, a hormone important for brain health, during menopause. They also have higher rates of diseases that seriously affect the brain, such as multiple sclerosis and stroke.
“Alzheimer’s doesn’t start at 75 or 80,” says Gillian Einstein, the Wilfred and Joyce Poslunds Professor of Women’s Brain Health and Aging at the University of Toronto. “Let’s take a life course approach and understand how things that happen early in a woman’s life predispose her to Alzheimer’s.”
Why are older women more susceptible to anxiety and depression?
Research suggests Many factors are involved, including hormonal changes and accumulated stress. Writing in Nature Aging, Paula Rochon, professor of geriatrics at the University of Toronto, said:Age discrimination based on genderIt’s an unfortunate combination of ageism and sexism that makes older women “virtually invisible.”
Helen Lavretsky, professor of psychiatry at the University of California, Los Angeles and past president of the American Academy of Geriatric Psychiatry, suggests several themes that require further investigation: How does the menopausal transition affect mood and stress-related disorders? What non-pharmaceutical interventions (e.g., yoga, meditation, music therapy, tai chi, sleep therapy) can increase psychological resilience in older women and help them recover from stress and trauma? What combinations of interventions would be most effective?
How can we improve cancer screening recommendations and cancer treatment for older women?
Supriya Gupta Mohir, director of the Geriatric Oncology Research Group at the University of Rochester’s Wilmot Cancer Institute, has called for better health-specific breast cancer screening guidelines for older women: Currently, women over 75 are lumped together, even though some are very healthy and others are extremely frail.
Recently, the U.S. Preventive Services Task Force said,Current evidence is insufficient The study’s goal is to “assess the balance of benefits and harms of mammography screening for women over 75,” without clear guidance for doctors. “Right now, I think we’re underscreening healthy older women and overscreening frail older women,” Mohill said.
She also hopes to advance further research into effective and safe treatments for lung cancer in older women, many of whom have multiple diseases and functional disabilities.
“With this population, research is needed to determine who can tolerate the treatment based on their health status and whether there are gender differences in tolerability for older men and women,” Mohill said.
Bone Health, Functional Health and Frailty
How can older women maintain their mobility and ability to take care of themselves?
Osteoporosis, which causes bones to become weak and brittle, is more common in older women than in older men, increasing the risk of dangerous fractures and falls, and again may be related to the decline in estrogen that comes with menopause.
“This is an area that is so important to the quality and longevity of life in older women, yet it’s understudied and overlooked,” said Munson of Brigham and Women’s Hospital.
Jane Corley, a distinguished professor at the University of Pittsburgh School of Public Health who studies bone health, would like to see more data on osteoporosis in older black, Asian and Hispanic women, whose condition is undertreated, and she would like better drugs with fewer side effects.
Marcia Stefanick, a professor of medicine at the Stanford University School of Medicine, wants to know what strategies are most effective for encouraging physical activity in older women, and she would like to see more research explore how older women can best maintain their muscle mass, strength and ability to help themselves.
“Frailty “It’s one of the biggest problems for older women and it’s essential that we learn what we can do to prevent it,” she said.
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