Skip to main content Accessibility help
  • Print publication year: 2009
  • Online publication date: December 2009

Chapter 2 - Preventive health care for older women

from Section 1 - Introduction


Prevention for the older person includes maintaining quality of life, preserving function, preventing collapse of family support systems, and maintaining independence in the community. Older women often have substantial responsibilities caring for spouses, siblings, children, and grandchildren. Significant levels of depression are seen in caregivers of Alzheimer's patients. Women access the health care system more frequently than do men. They receive more health services and prescriptions, undergo more examinations, laboratory tests, and blood pressure checks than men. Depression is the most commonly diagnosed mental illness in older adults in the primary care setting, although it often goes unnoticed. Abuse is best correlated with the emotional and financial dependence of the caregivers on the geriatric victims. By attending to the differing risk factors of older women and following a systematic periodic evaluation, physicians can assist older women in maintaining their health and functional status.

Related content

Powered by UNSILO


1. DesaiM., HennessyC.Surveillance for morbidity and mortality among older adults – United States 1995–1996. MMWR Morb Mortal Wkly Rep 1999; 48, 7–25.
2. SperoffL.Preventative healthcare for older women. Int J Fertility Menopausal Study 1996; 41, 64–68.
3. SchulzR.Caregiving for children and adults with chronic conditions. Health Psychol 1998; 17, 107–111.
4. IneichenB.Measuring the rising tide: how many dementia cases will there be by 2001?Br J Psychiatry 1987; 150, 193–200.
5. AndersenR.Prevalence of significant knee pain among older Americans. J Am Geriatric Soc 1999; 47, 1435–1438.
6. CasparM., et al. Blood pressure, diabetes, and body mass index among Chippewa and Menominee Indians. Public Health Rep 1996; 111, 37–39.
7. FontanaS., HelbergC., LoveR.The delivery of preventative services in primary care practices according to chronic disease status. Am J Public Health 1997; 87, 1190–1196.
8. FaulknerL., Schauffler, H.The effect of health insurance coverage on the appropriate use of recommended clinical preventative services. Am J Prev Med 1997; 13, 453–458.
9. SchulmanK., BerlinJ., HarlessW.The effect of race and sex on physician's recommendations for cardiac catheterization. N Engl J Med 1999; 340, 618–626.
10. CaplanL., HaynesS.Breast cancer screening in older women. Public Health Rev (Israel) 1996; 24, 193–204.
11. NosekM., HolandC.Breast and cervical cancer screening among women with physical disabilities. Arch Phys Med Rehabil 1997; 27, 37–57.
12. HarmonM.Acculturation and cervical cancer: knowledge, beliefs, and behaviors of Hispanic women. Women's Health, 1996; 24, 37–57.
13. MatthewD., McCulloughM., LarsonD.Religious commitment and health status: a review of the research and implications for family medicine. Arch Fam Med 1998; 7, 118–124.
14. WooleyD.Geriatric psychiatry in primary care: a focus on ambulatory settings. Geriatric Psychiatry 1997; 20, 241–260.
15. MamdaniM., HerrmannN., AustinP.Prevalence of antidepressant use among older people: populations based on observations. J Am Geriatric Soc 1999; 47, 1350–1353.
16. UnutzerJ., PatrickD., SimonG.Depressive symptoms and the cost of health serivices in HMO patients age 65 and older: a 4 year prospective study. J Am Med Assoc 1997; 277, 1618–1623.
17. MidanikL., et al., The effect of retirement on mental health and health behaviors. J Geronto Ser B Psychol Sci Social Sci 1995; 50, S59–S61.
18. BrayneC., SpiegelhalterD., DufouilC.Estimating the true extent of cognitive decline in the old. J Am Geriatric Soc 1999; 47, 1283–1288.
19. South-PaulJ., WoodsonC.Optimal care of older women. Postgraduate Med 1992; 91, 439–458.
20. GalloJ., AndersonL.Handbook of Geriatric Assessment, Rockville, MD: Aspen, 1988.
21. KoenigH., HaysJ., LarsonD.Does religious attendance prolong survivial? A six year follow up study of 3968 older adults. J Gerontol Ser A Biol Sci Med Sci 1999; 54, 370–376.
22. KrauseN.Neighborhood deterioration, religious coping, and change in health during late life. Gerontologist 1998; 38, 653–664.
23. KatzS., MoskowitzR., VignosP.A standardized measure of biological and psychological function. J Am Med Assoc 1963; 185, 914–919.
24. CaspersenC., ChristensonG., PollardR.Status of the 1990 physical fitness and exercise objectives: evidence from NHIS 1985. Public Health Rep 1985; 101, 587–592.
25. OkumiyaK., et al. Effects of exercise on neurobehavioral function in community dwelling older people more than 75 years of age. J Am Geriatric Soc 1996; 44, 569–572.
26. TautonJ., et al. Exercise for the older woman: choosing the right prescription. Br J Sports Med 1997; 31, 5–10.
27. KamimotoL., et al. Surveillance for five health risks among older adults – United States 1993–1997. MMWR Morb Mort Wkly Rep 1999; 48, 89–130.
28. BignottiD., EvansJ., FlemingK., eds. The Geriatric Patient, 7th edition, ABFP Reference Guides, Lexington, KY: American Board of Family Medicine, 1999.
29. USPST Force, ed. Guide to Clinical Preventative Services, 2nd edition, Baltimore, MD: Williams and Wilkins, 1996.
30. NIH. The Sixth Report of the Joint National Committee on the Prevention, Detection, Evaluation, and Treatment of High Blood Pressure, Bethesda, MD: National Institutes of Health, 1997.
31. MandelblattJ., et al. The cost-effectiveness of screening mammography beyond 65: a systematic review for the US preventative services task force. Ann Inter Med 2003; 139, 835–842.
32. PignoneM., et al. Screening for colorectal cancer in adults at average risk: summary of the evidence for the US preventative services task force. Ann Inter Med 2002; 137, 132–141.
33. USPST Force, ed. Screening for Colorectal Cancer: Recommedations and Rationale, Rockville, MD: Agency for Healthcare Research and Quality, 2002.
34. ZhangY., KielD., KregerB.Bone mass and the risk of breast cancer among post menopausal women. N Engl J Med 1997; 336, 611–617.
35. O'MalleyM.Screening for breast cancer with breast self examination. J Am Med Assoc 1987; 257, 2197–2203.
36. MarwillS., BarryP.Patient factors associated with breast cancer screening among older women. J Am Geriatric Soc 1996; 44, 1210–1214.
37. MandelJ., BondJ., ChurchT.Reducing mortality from colorectal cancers by screening for fecal occult blood. N Engl J Med 1993; 328, 1365–1371.
38. SheikhJ. I., YesavageJ. A., BrooksJ. O. III, et al. Proposed factor structure of the geriatric depression scale. Int Psychogeriatric 1991; 2, 23–28.
39. HoylM., AlessiC., HarkerJ.Development and testing of a five item verson of the geriatric depression scale. J Am Geriatric Soc 1999; 47, 873–878.
40. ButlerS., AshfordJ. W., SnowdonD.Age, education, and changes in the mini mental status exam scores of older women: findings from the Nun Study. J Am Geriatric Soc 1996; 44, 657–681.
41. KinosianB., GlickH., GarlandG.Cholesterol and health disease: predicating risks by level and ratios. Ann Intern Med 1994; 121, 641–647.
42. PignoneM., et al. Screening and treating adults for lipid disorders. Am J Prev Med 2001; 20(3s), 77–89.
43. RosenthalM., et al. Thyroid failure in the elderly: microsomal antibodies as discriminant for therapy. J Am Med Assoc 1987; 258, 209–213.
44. KanisJ. A., MeltonL. J. III, ChristiansenC., et al. The diagnosis of osteoporosis. J Bone Miner Res 1994; 8, 1137–1141.
45. YatesJ., et al. Rapid loss of hip fracture protection after estrogen cessation: evidence from the national osteoporosis risk assessment. J Obstetr Gynecol 2004; 103, 440–446.
46.Screening and management of abdominal aortic aneurysm: the best evidence. Am Fam Physician 2006; 73, 1198.
47. ChobianianA., BakrisG.The seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure: the JNC 7 report. J Am Med Assoc 2003; 289, 2560.
48. ColN., PaukerP., Goldberg, R.Individualizing therapy to prevent long term consequences of estrogen deficiency in post menopausal women. Arch Intern Med 1999; 59, 1458–1466.
49. HartL.The minimum effective dose of estrogen for prevention of postmenopausal bone loss. Obsetr Gynecol 1984; 63, 759–763.
50. AloiaJ., VaswaniA., YehJ.Calcium supplementation with and without hormone replacement therapy to prevent postmenopausal bone loss. Ann Intern Med 1994; 120, 419–439.
51. WattsN.Treatment of osteoporosis with bisphosphonates. Endocrinol Metabolism Clin N Am 1998; 27, 419–439.
52. USPST Force. Hormone Therapy for the Prevention of Chronic Conditions in Postmenopausal Women: Recommendation Statement, Rockville, MD: Agency for Healthcare Research and Quality, 2005.
53. RoussowJ., PrenticeR.Postmenopausal hormone therapy and risk of cardiovascular disease by age and years since menopause. J Am Med Assoc 2007; 297, 1465–1477.
54. MatthewsK., et al. Estrogen replacement therapy and cognitive decline in older community women. J Am Geriatric Soc 1999; 47, 518–523.