Higher rates of arthritis and obesity help to explain why women are more likely than men to become disabled as they age, according to a new study.
“It's an important message for younger and middle-aged women: Extra pounds that accrue during child-bearing and perimenopause are associated with higher rates of disability in old age,” explains study author Heather E. Whitson, MD, assistant professor of medicine in the Division of Geriatrics at Duke University Medical Center in Durham, NC.
For this study, Dr. Whitson and her team analyzed rates of disability in 5,888 men and women older than age 65 living in four communities in California, Pennsylvania, North Carolina and Maryland.
“This study was not looking at whether people can walk a mile or play tennis in their 70s and 80s,” Dr. Whitson says. “We considered disability in basic activities of daily living – which refers to needing help with basic things like walking around a house, getting out of bed, bathing, dressing.”
Researchers found that women had an 83 percent greater risk of becoming disabled than men. About a third of that increased risk was due to higher rates of arthritis in women – 57 percent of the female participants had arthritis compared to 44 percent of the men.
The study did not address why women have more arthritis than men, but obesity is a major risk factor for arthritis. In the study, morbid obesity was about four times as common among women – 8 percent of women were obese compared to 2 percent of men.
In addition to arthritis, women with hearing problems, coronary artery disease, congestive heart failure and stroke were more likely to suffer disability then men with the same conditions.
“Arthritis has a 'double whammy' effect on the disparity in disability rates between men and women. Not only are women more likely to have arthritis, but we found that arthritis was more strongly associated with disability in women compared to men,” Dr. Whitson explains. “It looks like this is partly because women experience higher rates of other problems, such as depression and vision loss, which can enhance the disabling effects of a condition like arthritis.”
The study was published in the Journal of Gerontology: Medical Sciences.
While the news for women sounds grim, Patience White, MD, vice president for public health at the Arthritis Foundation, says disability doesn’t have to be an inevitable part of aging.
“You can do a lot to prevent arthritis if you pay attention through the years and get yourself physically active,” Dr. White explains.
She says when it comes to your joints, it’s not endurance that you need to focus on, but building strength, flexibility and balance. Dr. White says this will help delay the onset of osteoarthritis of the knees and hips in particular if it’s in your genes, or at the very least, slow the progression of it.
Physical activity, she says, is key. So in your 30s and 40s, if you don't have some regular exercise habits, it’s a good time to start.
“If you do it with friends and family you are more likely to do it in your 50s and 60s, as well,” Dr. White explains.
Start thinking about injury prevention, too. “If you injure yourself before your 30s, you will have osteoarthritis in that joint within ten years,” Dr. White says. “Don’t go out and do crazy things without being prepared.”
If you’re in your 50s, Dr. White suggests keeping focused on building your strength and start paying attention to balance. “Can you stand on one leg, close your eyes and not fall over?” Dr. White asks.
She says you want to make sure your core is strong in this decade too, by doing things like sit-ups and Pilates. And focus on joint friendly activities like walking and swimming, even rowing.
And in every decade – focus on your weight. Dr. White says your ideal weight goes down as you age, even though people’s actual weight tends to go up.
“Weight is crucial here. For every pound you gain it’s like 4 pounds across your knees and things just plain wear out,” Dr. White says. “If you have a little knee pain and you lose just a little weight, like 5 or 10 pounds, your pain lessens. It’s incredible."
Lawrence Cheskin, MD, director of the Johns Hopkins Weight Management Center in Baltimore says that the average person gains close to 1 pound a year between the ages of 40 and 60. He says being aware of that, and being mindful of what you eat, are the first and most important ways to keep from putting on those pounds.
He says watching portions is key in this supersized world.
“A big problem is people aren’t conscious of what is a normal size portion. It’s generally much smaller than you think. So your plate of pasta may be five portions of pasta, not one,” Dr. Cheskin says. “A portion of meat might be the size of the palm of your hand, not a 16 ounce T-bone."
Everyone knows to choose things that aren’t high in fat or sugar. Dr. Cheskin says it’s also a good idea to spread out your intake of calories throughout the day.
“One thing associated with obesity is eating only one meal a day. It’s the thinner people who are eating all day long – small but frequent meals and snacks,” Dr. Cheskin explains.
People tend to have a lower metabolism as they age, so Dr. Cheskin says you probably need to eat a little bit less as you age. One way of doing that is to avoid trigger foods that often come in the form of bags of potato chips or cartons of French fries or ice cream.
“Nutritionists are fond of saying all foods are fine, as long as you watch the quantity. But I think there are some foods that are trigger foods and it’s best to avoid them,” Dr. Cheski explains. “Maybe you are better off not starting.”
There’s nothing wrong with an early bird special, but Dr. Cheskin also says be aware of the ‘all you can eat’ specials. “Buffets are generally not a good idea because food is unlimited and it’s the same price and a lot of us have a ‘get your money’s worth’ feel out of it. You could eat an entire day’s calories in one meal,” Dr. Cheskin explains.
He says also be aware of the effect that dining with others can have on your waistline. It often brings subtle or unrecognized social pressure to eat more by doing things like adding an appetizer or a dessert or mindlessly sampling the bread basket’s offerings. “We encourage each other to eat too much,” Dr. Cheskin says.