Sex-Based Differences in Noncommunicable Diseases in Older Adults: Raising the Profile of Older Females.

This commentary highlights examples of noncommunicable diseases that demonstrate their impact on older females and males. Despite the reporting of data on sex and age, the intersection of sex and age differences is often not sufficiently considered in medical practice in terms of diagnosis, treatment, or disease management [ 63 ]. Exploring the differences in the way noncommunicable diseases impact older females will help increase awareness and provide insights that can be used to guide and tailor care, screen for these conditions appropriately, and address unmet needs; all of which will help improve health outcomes for older females. Although many of the conditions listed in Figure  1 affect older females, there is a lack of data examining prevalence ratios or sex differences in these conditions specifically for females in the older adult age group. As a result, much of the data presented come from studies encompassing adults of all ages more generally. The adequate inclusion of older females in research studies and research disaggregated by sex and age, will help bridge gaps in knowledge, and better inform clinicians to make evidence‐based decisions that address the specific health needs of their older female patients [ 10 , 11 ]. Disaggregating data by both sex and age are integral to understanding how diseases manifest, progress, and respond to treatment differently in both sexes, which allows for better prevention and management, and ultimately improved health outcomes [ 63 ]. The ongoing lack of sex‐ and age‐disaggregated data risks the overlooking of important sex differences and leaves the needs of older females largely unrecognized [ 11 ]. Furthermore, while this commentary has focused on differences between the biological sexes, it is important to recognize that sociocultural factors are also important contributors to health‐related disparities. For instance, language barriers, and socioeconomic status have been associated with negative cardiovascular disease outcomes in females [ 14 ]. The intersectionality of sex and sociocultural variables needs to be considered when delivering care and designing studies to ensure that the diverse needs of older adults are being met.

Concept and design: All authors. Drafting of the manuscript: Aathmika Nandan. Critical revision of the manuscript for important intellectual content: All authors. Creation of figure: Joyce Li.

This work was supported by the University of Toronto Summer Older Adult Research (SOAR) Experience Program.

No specific funding was received for this work. Aathmika Nandan was supported by the University of Toronto Summer Older Adult Research (SOAR) Experience Program. Dr. Paula Rochon holds the Barry J Goldlist Chair in Geriatric Medicine at Sinai Health System.

Noncommunicable diseases that impact females exclusively primarily involve health conditions and cancers that affect the female reproductive organs.

Older females are impacted by noncommunicable diseases, living longer than males yet paradoxically experiencing higher rates of disability and poor health. The information presented in this commentary highlights examples of noncommunicable diseases that impact females disproportionately, differently, and uniquely. This commentary emphasizes the importance of physician awareness of these differences and highlights the need for greater inclusion of older females in research along with the reporting of sex‐ and age‐disaggregated data. These concerted efforts can lead to more effective care delivery and reduce inequities in healthcare.

Dr. Paula Rochon is the deputy editor for the journal. The authors declare no other financial or personal conflicts of interest.

Some noncommunicable diseases such as migraines, Alzheimer's disease, gastroparesis, osteoarthritis, and breast cancer not only have a higher prevalence in females but also manifest or progress differently than in males. Lack of awareness of these sex‐specific differences can contribute to the underdiagnosis or misdiagnosis of conditions that are particularly prevalent in females. For example, despite advancing Alzheimer's disease, females tend to score better on verbal memory tests which are often used in diagnosis and may conceal the extent of progression, delay diagnosis, and potentially cause harm in a population that is already disproportionately impacted [ 45 ].