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Women more prone to disability in late life than men

Women who live to an old age are more likely than men to develop disability during their last two years of life, shows a US study.

The study
The prospective cohort study included 8,232 participants (3,877 men and 4,355 women) with a mean age at death of 79 years, who were part of the Health and Retirement Study lasting from 1995 to 2010. Each participant was interviewed at least once during their last two years of life. Disability was defined as the need to ask for help with at least one daily activity including dressing, bathing, eating, transferring in or out of bed, walking across the room and using the toilet.

The findings
The prevalence of disability increased during the last two years of life, from 28% two years before death to 56% in the last month of life. The older the participants were, the higher their risk of disability towards the end of their life and the need for care.

The disability rate increased from 14% in the 50–69 years age group, to 21% in the 70–79 years group, 32% in the 80–89 years age group and 50% in the over-90s, giving a statistically significant trend for disability across increasing age groups.

Women were more affected than men, with 32% of women reporting more disability in the last two years of life compared with 21% of men, after adjusting for age of death and sociodemographic factors.

In addition, poorer people suffered greater functional impairment and disability in late life, with 32% of people in the lowest quartile for net household worth reporting disability in the last two years of life, compared with 23% of those with the greatest wealth.

What this means for GPs
The authors concluded: ‘Those who live to an older age are likely to be disabled, and thus in need of caregiving assistance, many months or years prior to death. Women have a substantially longer period of end-of-life disability than men.’

JAMA Intern Med 2013; available online 8 July

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