The Significance of Gender in Treating Aging Adults

This month’s issue of Geriatrics & Aging focusses on Gender and Health. Because there are more women than men among the aging population, geriatricians have often considered themselves by virtue of practical experience to be up-to-date on gender-based issues. As well, geriatrics was the first specialty or subspecialty certified by the Royal College to achieve gender parity between men and women.

Not only do women predominate in the older age groups, they may also survive longer with serious diseases and disability, frequently presenting challenging diagnostic and management issues. The investigators in the New England centenarian project have long observed that while a 100-year-old woman may be sick and/or disabled, a 100-year-old man who develops serious disability usually dies rapidly. Of course, men also have distinct age-related problems (prostatic disease being the obvious example). The particular example of the under-recognition of osteoporosis in older men reminds me of when I was an intern and told my staff physician, “I have never seen that disease.” He gently corrected me, saying, “Barry, you might have seen it, but just not recognized it!”

The first article in this issue’s Gender and Health series, “Benign Breast Disease in Older Women” by Drs. Nehmat Houssami and Michael Dixon, is also our featured CME article. The article “Living with Ovarian Cancer: Perspectives of Older Women” by Dr. Margaret Fitch approaches this difficult topic from the patient’s point of view. As a contrast to the old view that Women’s Health was primarily a concern for obstetricians/gynecologists, we have the article “Postmenopausal Health” by Drs. Lynne T. Shuster, Sharonne N. Hayes, Mary L. Marnach, and Virginia M. Miller, which takes a broader view of women’s health concerns. Currently, almost half of a woman’s life spans the postreproductive years, and there are many more health concerns for older women than younger ones.

We also have our usual collection of articles on other topics. Cholesterol levels are a topic of concern and Dr. Patrick Couture and Nancy Gilbert provide an update on “Significance and Treatment of Hypertriglyceridemia.” Our Arthritis column by Marie D. Westby and Dr. Linda Li addresses the role of physiotherapy in maintaining the physical well-being of older adults living with arthritis. This issue’s Drugs & Aging column, “Alcohol and Prescription Drug Interactions Among Aging Adults” by Drs. Kristine E. Pringle, Frank M. Ahern, and Debra A. Heller, presents a key yet all-too-often neglected issue: the prevalence of older adults combining medication with alcohol usage, the consequences of which may be severe. Bathing and hygiene are critical issues for frail older people, particularly those with cognitive impairment who may be resistant to care. This topic is addressed by Meera George and Dr. Aanand D. Naik in their article “The Clinician’s Role in the Treatment of Bathing Disability in Older Adults.”

All of us are concerned with patient safety, but few of us have devoted our careers to this topic the way Dr. Ed Etchells has. Dr. Etchells, Tasnim Vira, and Dr. Vincent Tam contribute the article on “Medication Errors.” Every year the spectre of an influenza outbreak frightens all of us who care for older people. This year is particularly concerning because of the recent (as of late September) report that this year’s vaccine delivery will be delayed. This important issue is addressed in the article “Influenza Prevention and Treatment” by Dr. Roger Thomas. Finally, the journal’s Editorial Director, Kristin Casady, reports on results of a recent study aimed at improving medication compliance with telephone counselling.

Enjoy this issue,
Barry Goldlist