12 Dec 2021

Why women and men age differently

From Sunday Morning, 10:07 am on 12 December 2021

Of the top 12 causes of death, there's only one in which women die at a higher rate than men. And 85 to 90 percent of centenarians are women. But why?

Dr Steve Austad, an expert on ageing at the University of Alabama at Birmingham, says that because we've never really taken these findings all that seriously before, often blaming the lopsided stats on things like heart disease and the faster male decline, we don't really understand why this is the case.

The paradox, says Dr Austad, is that women survive better but, particularly later in life, men are in better health.

Mature couple walking in the park in the afternoon

Photo: 123RF

He also believes there could be a time in the future when we end up with different medicine for men and women.

Longevity in women is found across all the data, he told Jim Mora.

“It's found across every country, and every historical epoch that we have reasonable data about. And it's even true in terms of survival through childhood where girls survive better than boys, even though both survive very, very well these days.”

And women die at lower rates of virtually every disease that kills us, he says.

“Of the top 12 causes of death, there's only one in which women die at a higher rate all the others, men die.

“So, men die of not just heart disease, but strokes, cancer, infectious diseases, Covid-19, influenza, kidney disease, lung disease, I mean, it's just a very, very robust feature of human biology.”

Although men who do make it to old age tend to have fewer morbidities than women, he says

“That's an interesting paradox. So, women survive better. But particularly late in life, men are in better health. And one explanation of that is that the men that were not in better health have died by that time. And so, there's a survivor effect.

“But we don't know if that's the case or not, or if one of the things is that we're just more vulnerable to dying easily.”

It could be that men die more suddenly and don’t have prolonged poor health in old age, he says.

“What I like to say is a goal of medical research should be to make men live as long as women, and to make women in their later years as healthy as men.”

People over the age of 80 have a level of fitness that would have been unthinkable in the past, he says.

“I mean, the fact that we now have a world record for the marathon by 100-year-old is just remarkable to me.

“Centenarians used to be a big deal. I mean it really still is, there's fewer than one in 1000 people live to the age of 100.

“Even today, and even in Japan, the longest-lived country in the world. But still, the numbers are increasing incredibly fast there.”

Research also shows that some common pharmaceuticals might work better in men than women or vice versa, he says.

“We may end up with male medicine and female medicine, which would be really quite a change.”

The morbidity/mortality paradox kicks in for women at around age 50, Dr Austad says.

“One of the things that women seem to be more prone to than men is joint problems, they get more arthritis, for instance, and that causes a lot of later-life disability, difficulty doing chores that you normally wouldn't have any problem with.

“It may be that a lot of this really has to do with a difference in our joint biology. Now women's joint biology, particularly in the hips, is quite a bit different than men because of childbirth. You know, their bones have to be able to be stretched apart more during childbirth.”

The science on hormones and aging is not settled, he says.

“One of the ideas is that we may lose these hormones as we get older, because it's beneficial to lose them. What was really good early in life may turn out to be not so good later in life, and that by topping these things up, we may actually be doing ourselves some injustice. But we won't really know that until the clinical trials are done.”

Although it does seem that later menopause is associated with longer life, he says.

“There's something about reproductive aging, that seems to almost signal what's going on with the rest of the body.

“All women will undergo menopause around the age 50. But some are a few years before and some are a number of years after, and there does seem to be a relationship there. So that the women that age reproductively, the most slowly also seem to be aging more slowly, across their entire body.”

To live well into your 80s is to a large extent about how you live prior to that; to be a centenarian is more about luck however, he says.

“If you want to be a healthy 80-year-old, then you want to do all the correct things. Don't smoke, eat right, get plenty of physical activity.

“If you want to be a healthy 100-year-old, have the right parents. That's the best thing you can do.”