Center for the Study of Aging and Human Development, Duke University Medical Center, Durham, NC 27710, USA.
J Gerontol A Biol Sci Med Sci. 2010 Dec;65(12):1325-31. doi: 10.1093/gerona/glq139. Epub 2010 Jul 30.
Older women experience disability more commonly than their male peers. This disparity may be due, in part, to sex-based differences in the prevalence or the disabling effects of common medical conditions. The objectives of this analysis were to (a) quantify the extent to which excess disability in women is explained by higher prevalence of selected medical conditions and (b) evaluate whether the same conditions have differing effects on disability in men and women.
We analyzed cross-sectional data from 5,888 community-dwelling older men and women. Disability was defined as difficulty with greater than or equal to one activity of daily living. Thirteen medical conditions were assessed by self-report, testing, or record review.
Controlling for age, race, education, and marital status, women were more likely to experience disability (odds ratio = 1.70, 95% confidence interval = 1.36-2.11). Higher prevalence of arthritis and obesity in women explained 30.2% and 12.9%, respectively, of the sex-based difference in disability rates, whereas male prevalent diseases like vascular conditions and emphysema narrowed the disability gap. Women with arthritis, hearing problems, coronary artery disease, congestive heart failure, stroke, and claudication were more likely to exhibit disability compared with men with the same conditions (p < .001).
Efforts to lessen sex-based inequality in disability should focus on reducing the prevalence of arthritis and obesity. Future generations may see greater functional disparity if rates of vascular disease and emphysema rise among women. Several conditions were more often associated with disability in women, suggesting additional sex-based differences in the disablement process.
老年女性比同龄男性更容易出现残疾。这种差异可能部分归因于常见医学疾病的患病率或致残影响方面的性别差异。本分析的目的是：(a) 量化因某些特定疾病患病率较高而导致女性残疾人数过多的程度；(b) 评估相同的疾病对男性和女性残疾的影响是否不同。
我们分析了来自 5888 名居住在社区的老年男女的横断面数据。残疾定义为日常生活活动中存在≥1 项困难。通过自我报告、测试或病历回顾评估了 13 种医疗条件。
在控制年龄、种族、教育程度和婚姻状况后，女性更有可能出现残疾（优势比=1.70，95%置信区间=1.36-2.11）。女性中关节炎和肥胖症的高患病率分别解释了残疾率性别差异的 30.2%和 12.9%，而男性常见疾病如血管疾病和肺气肿缩小了残疾差距。患有关节炎、听力问题、冠状动脉疾病、充血性心力衰竭、中风和跛行的女性比患有相同疾病的男性更有可能出现残疾（p<.001）。
减少残疾方面性别不平等的努力应侧重于降低关节炎和肥胖症的患病率。如果女性中血管疾病和肺气肿的发病率上升，未来几代人可能会看到更大的功能差异。一些疾病与女性残疾的相关性更高，这表明残疾过程中存在其他性别差异。
