Elderly men who rate their health as poor are more likely to die than are elderly women who rate their health similarly, according to a new study. The researchers suggest that women may perceive both serious and mild illnesses as evidence of poor health, while men are more likely to focus on life-threatening conditions.
"We found that both sexes also rate their health more poorly when experiencing emotional distress, but for men that distress is typically related to a life-threatening illness," said lead author Yael Benyamini, PhD, of Tel-Aviv University. "For women, in contrast, emotional distress may come from a range of factors that may or may not be directly related to their health."
The research team, centered at the Institute for Health, Health Policy, and Aging Research at Rutgers University, New Jersey, interviewed 830 elderly men and women (average age 73) about their health status and emotional and physical functioning. A greater proportion of the men (19 percent) than women (10 percent) died over the five-year follow-up period. The researchers reported their findings in the May/June issue of Psychosomatic Medicine.
Men's perceptions of their health turned out to be a better predictor of their risk of death than did women's. Men who rated their health as fair or poor were nearly five times more likely to die than men who rated their health as very good or excellent. Among women, in contrast, those who rated their health as fair or poor were just 2.2 times more likely to die than were women who rated their health as very good or excellent.
The researchers found that both men and women downgraded ratings of their health in the face of emotional distress. However, high levels of emotional distress had distinctly different consequences for the two sexes. Men with more emotional distress faced a greater risk of dying, whereas women with higher levels of distress faced a lower risk of death.
One clue to this paradox can be found in the sources of distress for men and women. For men, distress seems to reflect primarily life-threatening illnesses, such as heart disease and cancer, and other negative life events occurring in conjunction with poor health. For women, distress came from both health-related and non-health-related life events, such as relationship and family problems.
In assessing their health, both sexes factor in the emotional distress they are experiencing, but women are more likely than men to base their assessment on a more "global" view that takes into account factors that may be unrelated to the risk of death. Women, for example, were not only troubled by their own problems but were also more distressed if their spouse had a serious problem in the previous year.
"While the data suggest that women's ratings of their health are less accurate than men's in predicting the risk of death, they also suggest that emotional distress and involvement with others are an integral part of living for older women and do not necessarily predict death," said Benyamini.
"In addition, this research underscores the importance of combining medical and psycho-social perspectives when studying health issues." The Rutgers research team exemplified this type of multidisciplinary approach, including among its members two health psychologists, Benyamini and Dr. Howard Leventhal, and a physician/geriatrician, Dr. Elaine Leventhal.
This research was supported by a grant from the National Institute on Aging.
Psychosomatic Medicine is the official bimonthly peer-reviewed journal of the American Psychosomatic Society. For information about the journal, contact Joel E. Dimsdale, MD, at (619) 543-5468.
Posted by the Center for the Advancement of Health < http://www.cfah.org >. For information about the Center, call Petrina Chong, pchong@cfah.org , (202) 387-2829.
Journal
Psychosomatic Medicine