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Aging, Systemic Disease and Oral Health: Implications for Women Worldwide (Part I)

Course Number: 302

Changing Patient Demographics

Technological advances, improved screening tools, and better disease management are among several factors that have led to the expression “sixty is the new forty.” Retirement today often means a transition to a new career as people are enjoying greater longevity. An average American female and male today in the U.S. is expected to live to be 79.3 and 73.5 years of age, respectively.1,7 In the most countries, women live four to eight years longer than men. This is due to biological sex differences and gender behaviors such as smoking and drinking excessive amounts of alcohol.1 According to the U.S. Census Bureau, 20.7% of the population will be 65 years or older by 2050.2 These changing demographic trends are similar across most of the globe.

From 2000 to 2019, global life expectancy increased from 67 years to 73 years, due to the fall in child and maternal mortality and the decline in incidence and mortality from many infectious diseases.3 Also, expansions in access to health services, including improvements in prevention and treatment for non-communicable diseases, played a role. However, the COVID-19 pandemic halted progress against many global health indicators, which slowed or stagnated.3

Image: Average life expectancy in the US for men and women.

Figure 1. Life Expectancy at Birth, WHO regions and global, 1950-20481

According to the Administration for Community Living, in 2019, there were 30 million women and 24.1 million men aged 65 and older in the US, which means that there were 125 women for every 100 men. The sex/gender gap widens even more in the 85+ age group, where there were 178 women for every 100 men.4 Despite the universal appeal of extending our life expectancy, living longer may also bring health complications that can negatively impact overall well-being in those later years. Women are more susceptible to certain chronic diseases as they age,4 and recent studies suggest periodontal health may play a role in the progression of many systemic conditions.5 This includes Alzheimer’s disease, inflammatory bowel diseases, and oral cancer, emphasizing the importance of the oral cavity in systemic health.5 This increased risk also presents at a time when oral hygiene may be challenging, since dexterity and ability can be impaired due to memory loss, poor vision, arthritis and other factors.

Oral health care professionals have the opportunity to improve the health of patients by understanding their individual needs based on factors such as health status, age, and sex/gender. Since older female patients will represent a growing portion of our patient population, it is important that we are familiar with their specific health concerns. This article will concentrate on three common conditions women may experience as they age: cardiovascular disease, diabetes, and osteoporosis. It will discuss risk factors and common approaches to treatment and prevention. It will also explore links to oral health and outline treatment plans, including home care products to promote optimal oral health.