Year : 2020 | Volume
: 9 | Issue : 2 | Page : 75--76
Woman and ageing: Extent of the problem and the way ahead
Department of Neurology, Sri Venkateswara Institute of Medical Sciences, Tirupati, Andhra Pradesh, India
Director-Cum Vice-Chancellor, Senior Professor and Head, Department of Neurology, Sri Venkateswara Institute of Medical Sciences, Tirupati 517 507, Andhra Pradesh
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Vengamma B. Woman and ageing: Extent of the problem and the way ahead.J Clin Sci Res 2020;9:75-76
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Vengamma B. Woman and ageing: Extent of the problem and the way ahead. J Clin Sci Res [serial online] 2020 [cited 2021 Aug 3 ];9:75-76
Available from: https://www.jcsr.co.in/text.asp?2020/9/2/75/291375
Some unicellular organisms, cancer cells and some fishes do not age; it is not clear so as to why mammals, especially humans, age. Ageing is an imperfectly understood phenomenon characterised by a mixture of cellular and systemic physiological changes that are intrinsic to the species and environmental factors that interact with these processes. While the bodily changes of ageing have been documented, what actually causes ageing is not known. Ageing is considered to be both a biological and a social construct.
Various mechanisms postulated for ageing include telomere shortening, random damage, somatic mutations, error catastrophe, pleotropic antagonism, growth inhibitors and suicide genes. Other postulated mechanisms for ageing include infections, environmental factors such as radiation, autoimmunity, hormonal and nutritional factors, neoplasms and metabolic disorders.
The term life span refers to 'the number of years a person can live if all environmental risk factors are removed'; life expectancy refers to the number of years a person can live in a given environment. Ageing in years constitutes chronological ageing; ageing of biological systems is termed biological ageing. Psychological ageing refers to ageing of the mental faculties. Elderly have been variously defined as over and above 60 years, 65 years. Terms such as young-old (60–69 years), old-old (70–79 years) and older-old/very old (80 years and above) have been used. The biological process of ageing is senescence. Gerontology refers to a scientific study of elderly and ageing. Geriatrics is the study of clinical problems of elderly.
Elderly population is on the rise globally. As per the estimates of World Health Organization (WHO), the number of people aged above 60 years will be twice (22%) than that of 2000 (11%) by 2050. In India, the expected increase in population aged over 60 years is 10.7% by 2021.,
In contrast to sex, a biological term,gender refers to the roles, responsibilities and opportunities assigned to women and men by family and society. Women aged 50 years and older are referred to as olderwomen. However, ageingwomen refers to the same age group but denotes the ageing process that can occur at different rates among individuals or groups. In the context of female gender, ageing is also thought to be a continuumofindependence,dependenceandinterdependence, i.e., from independent through those requiring assistance to those dependent on others for support and care.
Ageing women are becoming a sizable proportion of world's population. The number is likely to increase from existing 336 million (2000) to over 1 billion by 2050. Ageing women outnumber ageing men, and this contrast becomes more with age. Currently, the worldwide ratio of women to men above 60 years of age is 123/100. This ratio is higher in developed countries, but majority of ageing women live in developing countries, where population ageing is occurring at a rapid pace. The increase in numbers is highest in the oldest-old (age 80-plus) group, with a worldwide ratio of women to men reaching 180/100. By age 100, this ratio leaps to 385/100. It is this oldest-old who most often require help with day-to-day activities amounting to chronic care.
Older women land up in significant inequities in health as compared to their male counterparts due to many factors. These factors include lower literacy rate, different working patterns, women pursue and financial insecurity. The additive effect of gender and age discriminations account for poverty in older women. Further, ageing women do not get the benefits of social progress that occurred in tackling violence and abuse.
This is one factor that should be a part of research and policies in this area. However, older women still do not receive their due because of exclusion in research. The tendency of clinical studies is still to focus adult age group and men, leading to paucity of findings on gender differences in the social determinants of health. Even the longitudinal studies on the social determinants of health and health conditions in ageing had little gender analysis.
Life expectancy is longer in women in both developed and developing countries. Non-communicable diseases, such as heart disease and stroke, osteoarthritis and osteoporosis, breast and cervical cancer, are the predominant causes of disability and death in women in the world except Africa. Around 80% of deaths due to chronic disease are seen in middle- and low-income countries, where majority of ageing women live. More older women are blind compared to their male counterparts, as they not only live longer but also have restricted access to treatment. Gender, interacting with factors such as age, social support, culture and violence, is a strong determinant of mental health. While mental illness observed in women is not different in incidence compared to men, they are more prone to anxiety and depression. The likelihood of developing Alzheimer's disease and other dementias is equal in men and women, but the prevalence is higher in women due to their higher longevity. Women have two times more chance of a depressive episode. The causes, especially in the later years of life, may be related to socioeconomic status, medical disorder or stressful life events such as bereavement and caring for chronically ill family members and friends. Furthermore, ageing women, who do carry a risk of developing for human immunodeficiency virus (HIV) infection and other sexually transmitted infections, are required to face a disproportionate burden of the disease sequelae. The HIV/AIDS epidemic in Sub-Saharan Africa is an example where it had devastating impact on health, economic, social and psychological aspects of older women.
Thus, there appears to be a gender difference in ageing and women particularly appear to be more vulnerable. Several approaches to address this problem such as the three pillars of a policy framework for active ageing (health care, participation and security) have been postulated. For these to be effective, there is a need for political will, administrative support, ownership and commitment, which are presently not well organised.,, Only then, the removal of misconceptions and negative attitudes about older women along with empowering older women to take an active role in economic growth and development process will be possible. This development definitely will have a high impact on the growth of the society as the ageing woman has abundant experience playing crucial roles in development of family and society.
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