Background. Despite their longer life spans, women show higher morbidity rates compared to men at all ages. The gender gap in mortality has decreased over the past twenty years, but few studies have examined sex differences in morbidity over time. This study examines sex differences in health and changes in sex differences between 1992 and 2002.

Methods. SWEOLD is a nationally representative interview survey of persons aged 77+. Outcomes include self-reported and objective health indicators.

Results. Women had significantly higher prevalence rates for most health problems. Analyses of change over time showed that women had greater increases in, e.g., hypertension and poor lung function, and men had greater increases in poor self-rated health (SRH) and myocardial infarction (MI). The sex difference decreased significantly for SRH due to men’s increased reporting of poor health and increased for MI due to increased prevalence among men.

Conclusions. Several health indicators seem to be developing differently for men and women. The gender gap has narrowed for poor SRH and widened for MI.

Background and aims: Research has shown increased prevalence rates over time in several health indicators in the older population. These increases have not been accompanied by corresponding increases in ADL and IADL disability. Given that disability and other health indicators follow different trends, the associations between them may change. Since both health and disability appear to follow different trends for men and women, we can also expect gender differences in the associations. We examined gender differences in how objective tests of function as well as self-reported health and function indicators were associated with ADL/IADL in 1992 and 2002.

Methods: Data were from the Swedish Panel Study of Living Conditions among the Oldest Old (SWEOLD), a nationally representative interview survey of persons aged 77+.

Results: Compared to men, women had significantly higher prevalence rates for most health indicators both survey years, but there were no significant gender differences in ADL/IADL limitations. Prevalence rates increased significantly between 1992 and 2002 for all health indicators, but not for ADL/IADL. Most of the associations between ADL/IADL and other health indicators were stronger for men than for women. The overall pattern was that associations have become weaker for women over time; for men, the picture was mixed.

Conclusions: The changing associations between ADL/IADL and other health indicators may reflect a complex interplay between changes in a range of social and environmental factors, some of which may be modifiable. ADL/IADL appear to reflect different dimensions of health and different kinds of needs for men and women.

Objectives. To analyze gender differences in care utilization and correlates to utilization among very old people for visits to physicians and dentists.

Methods. Based on non-institutionalized respondents in SWEOLD, a nationally represen­tative interview survey of persons aged 77+ (n=529).

Results: There were no gender differences in physician visits but men were more likely to have visited the dentist than women. Marriage was positively associated with visits to the physician and the dentist for men. Higher education was positively associated with physician visits for men and with dentist visits for women. Men with impaired mobility were less likely to report physician visits than men without mobility problems.

Discussion: Unmarried men may be at a disadvantage for both dental and physician care. Given women’s poorer physical and dental health status, they may be disadvantaged both regarding visits to physician and dentist.

Background. Life expectancy (LE) has increased. Health expectancy studies divide LE into life spent in different health conditions.

Objective. To describe the number of years spent with musculoskeletal pain in relation to total LE at age 65 in 1991/1992 and 2000/2002 and to examine the change in the proportion of LE spent free from musculoskeletal pain (pain-free life expectancy, PFLE) among men and women. Do the years added to life consist of years with or without musculoskeletal pain?

Methods. PFLE was calculated using Sullivan’s method by combining prevalence rates of musculoskeletal pain from two nationally representative population-based studies in Sweden (LNU and SWEOLD) from 1991/1992 and 2000/2002 and life tables from Statistics Sweden.

Results. In 1991/1992, both men and women aged 65 could expect to live 12 years free from musculoskeletal pain. However, the proportion of PFLE among men (75%) and women (60%) differed significantly (p = 0.000). Ten years later, both men and women could expect significantly more years with pain. PFLE among women had decreased to 51% (p = 0.059; 10.6 pain-free years, 10.0 years with pain); among men it had decreased to 68% (p = 0.152; 11.7 pain-free years, 5.5 years with pain). 

Conclusions. The estimated proportion of pain-free LE at age 65 decreased between 1991/1992 and 2000/2002. For men, the number of pain-free years remained unchanged, but years with pain increased. For women, there was both a decrease in pain-free years and an increase in years with pain.  Results suggest an expansion of morbidity in the older population.