@drmaryclaire: Since 1982, the share of a woman's life after 65 spent independent has not moved: 70 percent then, 70 percent now. Men went from 78 to 81. In a study published in the American Journal of Public Health in 2016, Vicki Freedman's team at the University of Michigan tracked disability-free life expectancy across 30 years and found that older women, who started ahead, no longer live more active years than men despite living longer lives. Freedman named the conditions that took those years: arthritis, depressive symptoms, fall-related fractures, and Alzheimer's disease. Her own conclusion was that "enhanced attention to these and other preventable causes of limitations among older women could extend active life." Preventable is her word, and it is the right one. Bone density can be screened and treated before the first fracture; falls can be trained against with strength and balance work; depression in older women can be diagnosed instead of written off as aging; and the 2024 Lancet Commission on dementia attributes roughly 45 percent of cases to 14 modifiable risk factors, hearing loss, hypertension, LDL cholesterol, physical inactivity, and depression among them. In my practice, none of that gets ordered when a woman is told her decline is normal for her age. The system that produced this gap was not built to look for these things in women. It can be. Full breakdown on Substack, link in bio. Source: Freedman VA, Wolf DA, Spillman BC. Disability-Free Life Expectancy Over 30 Years: A Growing Female Disadvantage in the US Population. Am J Public Health. 2016. https://pubmed.ncbi.nlm.nih.gov/26985619/ Livingston G, et al. Dementia prevention, intervention, and care: 2024 report of the Lancet standing Commission. Lancet. 2024.

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