Cardiac Diseases, Heart Failure, AMI, COPD, Dementia
The Symmetry of Getting Older
No doubt there are these diseases that men get more than women as they get older and vice versa. But what are the diseases that both genders experience equally as they reach their golden years?
Different age groups have different anatomical, physiological, behavioral and aging risks. Whereas in many ways, male and female begin life with nearly identical bodies in terms of risk (minus the genetics), as life progresses we see certain ICDs begin to express more on one side of the population pyramid than the other. As life continues into the older years, we find that some ICDs become very assymetrical whereas others retain their symmetry, or if asymmetric for most of the decades prior, suddenly become very symmetric due to old age.
There are three patterns noted with aging and disease that appear related to the association of incidence-prevalence for 1-year age-gender pyramids.
- First, there are those diseases that demonstrate obvious and expected differences due to gender alone, such as uterine fibroma and cervical cancer versus benign prostatic hypertrophy and certain penile infections.
- Second, there are those diseases which women get that far outnumber the numbers of males cases. Some of these are presented elsewhere like anorexia (women 40X > men), osteoporosis, and rheumatoid arthritis.
- Finally, there is a batch of diseases that tend towards equalization of incidence-prevalence [IP] during the older years. Younger people demonstrate a tendency for the condition to favor one gender over the other slightly, only to later stabilize their gender-specific IP rates due to the biological and behavioral equalization of people in the two genders. In the case of diabetes for example, there is an equalization noted for the IP of diabetic retinopathy. For heart disease, it was found that endocardial diseases and conditions are gender equal whereas pericardial and myocardial diseases and conditions are not, favoring male IP.
If we classify getting older into several categories based on level at which the disease initiates, we find the following to be true:
A. These three age categories are as follows:
- Progressively getting older by gender, beginning in the 30s or even 20s.
- Progressively getting older by gender, but only after the age of 65
- Progressively getting older by gender, but only well after the retirement years
B. Examples of conditions demonstrating these IP behaviors are as follows:
- degenerative age-related nervous system disorders, excluding parkinsonism
- diabetes with chronic disease complication (250.4-250.9)
- chronic bronchitis (491.*)
- emphysema (494.*)
- pleurisy (511.*)
- atrial fibrillation
- cardiovascular accident (stroke)
- endocardial valve disorders (424.*)
- acute renal failure
- hypertension (402.*-with cardiopathology, 403.*-with renal pathology, 404.*-both)
- Disseminated intravavascular coagulation (DIC)
What these findings tell us is obvious. Except for the much later years in life, when women begin to far outnumber and outlive men, men and women have quite a number of diseases or conditions that are less sex-related during the older years. Employment has become a part of the past, and so the problems that occur due to the work place are removed from the day to day stress we experience–these include the major midlife crises such as GERD, IBS, Crohn’s etc.. Since they are for the most part “retired”, women and men tend to experience and deal with similar problems during this stage in life. In theory at least, the hierarchically defined social matrix that was once a part of everyday life in the workplace is now less evident–as a result we have less or different higher authorities to deal with, and if and when they do exist, we are less concerned with their particular wants and needs as people, not bosses, supervisors or managers.
This also means that the stress of working for a boss or manager has been for the most part replaced by the stresses of having to deal with something else in life. Usually, the major stressor in life tends to treat or mistraeat people equally and fairly across genders, namely, the state or federal offices we must answer to each and every time we receive a letter regarding our social security payments, medicare or supplemental plan coverage. The major stresses that once occurred quite frequently about work related needs and requirements have been effectively replaced by the required visits to the Social Security office and the stresses attached to the next or last medical visit or results of some medical screening procedure or lab visit.
During these later decades in life, everything equals out when it comes to health, except for that which we enter into this period of life with, such as history of drinking and liver disease, the amount of smoking we’ve engaged in over the years, the influences dietary and lack of exercise patterns have had on our heart and blood vessels, the amount of calcium we have lost in our bones and wear and tear we have placed upon our joints. During these last years we tend to travel the same route following the same bends and turns, enduring the same elevation changes, or ditches to be jumped in life. During this time it is the condition of our body and its diseased state once we begin this part of the trip that defines when and where we end up.
With essential hypertension for example (remember, these are prevalences above, not cases), we see a slight assymetry in the working class years. The first decade or two of diagnosis has men slightly more than women. Once retirement years begin, the two genders begin to equalize. In the later stages or three degrees of higher severity of HTN and accompanying systems diseases, the last of the above three pyramids, we see an equalization, with more equalization demonstrate as the condition worsens.
In the following pyramids, we see how the differences between endocardial ICDs and any form of functional change following cardiac surgery demonstrate gender equality, whereas myocardial and pericardial ICDs demonstrate inequality throughout much of one’s life, until the age of 70 is reached in some cases.
In contrast with the nearly perfect symmetry of the endocardium, with the next four cardiac inflammatory diseases or the myocardium and pericardium we find several types of asymmetery. The first with myocarditis is so obvious, and for a fairly narrow age, that ontology becomes something in need of exploration. Acute pericarditis has some matching features throughout much of life, before equalling out during old age. Adhesive pericarditis is very asymmetric. For the fourth graph, post-operative complications appear fairly equally distributed.
This same gender equality is seen for renal failure and its predecessors. Even though acute and chronic renal failure can have very different causes and methods of pathogenesis, the end results end up equalizing over time when it comes to their impacts upon the older population.
It is no surprise therefore that a lot of medical conditions we endure in the aging process have the symmetry they express in these population pyramids. Some things about getting older are not as unique as we think they are once we begin experiencing them. The only thing that is unique is how we deal with them from this point on.