Women’s Health Span: Preventing Late-Life Disability and Enhancing Longevity

Many of us spend most of the day in a sitting position, either reading, watching TV, driving, working on our computers or our ubiquitous cell phones. And this has been deemed responsible for a condition called tech neck, which I am guilty and a victim of tech-neck.

which is that we spend too much of our time in a abnormal position that were not intended to be in. And positioning oneself more properly if you are sitting in front of a computer or reading with proper support can both prevent and treat this condition if we've already experienced it.

Have you made it past menopause, or are you going through it now? I'm Dr. Pat McShane, and on the Women's Health Span Voices podcast, I'll guide you through the health challenges of the menoppausal years and beyond, guiding the way to thriving in this powerful era of your womanhood.

Hello and welcome. I'm Dr. Pat McShane and this is Women's HealthSpan Voices. We talk a lot on this podcast about the difference between health span and life span, but we don't explicitly talk so much about disability, which is the condition between the time that we are healthy, having our health span, and the times that actually pass, that die.

And I thought we could talk a little bit more in depth about this today. I suspect, like me, many of you have had situations with temporary disability, let's say after a fracture or surgery or a fairly severe illness that put you down for the count for a certain length of time.

And it's not something that we seek. We are happy when we get through it. But in fact, many of us don't get though it, and by the time we hit 65, it is estimated that almost half of women, about 45%, will be suffering from some form of disability.

Obviously, disability is something that makes us more likely to experience loss of independence, and that may mean being taken care of by another person in our own home or in a nursing home, or assisted living facility.

I recently saw a disturbing study that noted that the life expectancy in this was in the US had grown between 1990 and 2023. And the live expectancy for women, American women had gone from 65 to about 74. But the time that people spent in good health had only gone up by seven years during that time.

So we, in fact, are experiencing longer times of disability. The study I just cited, as well as prior observations, note that women are more likely to spend more of their later years in a disabled condition.

and this is called the mortality morbidity paradox. In other words, we live longer but not as healthy as men. And there's probably several reasons for that.

One is that women tend to start their later years with less muscle mass. And of course, during our entire lifetime, we have less muscles mass than men because of our hormones and often because our type of work that we engage in and other kinds of leisure time activities.

So we start at a lower baseline with both muscle and bone than our male contemporaries. And when we go through menopause, the lack of estrogen and testosterone causes us to lose muscle, and bones more rapidly than men.

These situations are probably the basis for a lot of our loss of muscle and our lost of ability and independence. The causes of disability in women have been tracked by a number of different public health agencies.

And the main three are musculoskeletal issues, cardiovascular issues including stroke, and neurological conditions. So I thought today we would go through some of the preventable issues here, because some this of course is not preventible, but much of it turns out that it is preventble.

And we'll break down a couple of these topics, especially the ones that we haven't covered so much in these podcasts before, namely osteoarthritis and back and neck problems.

Let's start with osteoarthritis, which is considered wear and tear arthritis. It's not an autoimmune disease per se, such as rheumatoid arthritis or the other kinds of arthritis that women are particularly likely to suffer from, especially earlier in their life.

But it's the kind of thing that impacts on our knees and our hips and low back and small joints in our hands, et cetera. So wear and tear is a pretty good description of this.

And one of the issues that predisposes people to a higher chance of osteoarthritis is overweight or obesity, of course, especially in the weight bearing joints, our hips and our knees.

So weight maintenance is something that we can do to try to prevent this situation as best as we A good diet is another way to prevent this avoidance of smoking and staying active.

When we do some activity, it's good to warm up a little bit and cool down a bit. Stretching can be helpful as well. In doing some of my research, I came across recommendations to make sure that we have good footwear and are wearing good protective gear when it is an activity that involves something like a helmet or wrist guards, etc.

In my series, there was a recent podcast about the musculoskeletal syndrome of menopause. And that's the condition where upon losing our estrogen, we seem to have an onset of a bunch of different musculo skeletal conditions such as shoulder, frozen shoulder or shoulder arthritis.

This is something that may be addressed with hormone replacement with your physician. I didn't find this recommendation anywhere in my research but my personal recommendation is that if you're starting a new kind of activity that you might take lessons or get a coach because at certainly my age I don't wish to do an intentional or an avoidable injury that could have been avoided with good coaching.

Another recommendation is to seek counsel besides your physicians with a physical therapist because they can often give you balancing muscles to try to avoid pain or disability that you may experience.

Moving on to another musculoskeletal condition, which is low back and neck pain, spine issues, the recommendations here are very similar to avoid osteoarthritis with a few different specific recommendations.

Many of us spend most of the day in a sitting position, either reading, watching TV, driving, working on our computers or our ubiquitous cell phones. And this has been deemed responsible for a condition called tech neck, which I am guilty and a victim of tech-neck.

which is that we spend too much of our time in a abnormal position that were not intended to be in. And positioning oneself more properly if you are sitting in front of a computer or reading with proper support can both prevent and treat this condition if have already experienced it.

So that's one specific recommendation for back and neck and spine issues. The corollary of that is avoid prolonged sitting, standing in particular. Many of us carry bags over our shoulder, often just one shoulder.

And that's inadvisable because we're not quite properly aligned with that position. Same thing with backpacks, carrying them too low, carry them higher up and your back will be grateful to you.

I imagine most of you who have experienced neck or back pain have tried heat or cold ice is often very, very helpful. A firm mattress is another recommendation that I found online.

And just getting enough good sleep in general is very important. Pillows may help for neck problems. One of my favorite recommendations that I found was to get a massage, which I do on a frequent basis.

And again, see a physical therapist. This can make a huge difference because often we have evolved an imbalance of our muscles over the many years that the neck or back pain has been coming on to us.

A little bit of rebalancing with specific exercises and postures can Another major piece of avoidance of musculoskeletal injuries is making sure that your bone density is as good as it can be.

And I hope to have a podcast very soon from an expert on bone-density maintenance. But this, of course, is very, very prevalent in older women and, again, may be a reason to consider hormone replacement therapy, especially in the early perimenopausal years.

so osteoporosis is responsible for major falls and major fractures and shortening of our stature and often leads to severe and profound disability. Some recent podcasts that I have put out include avoidance of falls, and of course falling not due to osteo porosis per se but environmental or other kinds of physical issues is very, very common and often leads to profound injuries that may be life threatening or certainly disabling.

Similarly, avoiding diabetes because diabetes is often followed by neuropathy or loss of nerve sensation in your lower extremities and this can lead to falls and other kinds of disabilities.

Hearing is something that I talked about in a recent podcast and lack of good hearing support has been linked with increased risk of falls, and that's something Same thing for vision.

And sometimes our visual problems are unavoidable and not preventable, but often they are. If we get in to see an ophthalmologist or an optometrist early on, we can identify and often reverse visual loss, which then makes us less likely to suffer falls and to just be disabled regarding nighttime driving and other things for which we need good vision.

One of our usual suspects is sleep, and I recently had a marvelous guest on a podcast to go through all the basic approach to getting good sleep. And of course, if you're tired and fatigued and your balance isn't quite right from lack of sleep that could cause musculoskeletal injuries as well.

Let's briefly talk about cardiovascular disease. And in, again, previous podcasts, we've talked about Life's Essential Eight, which are the recommendations made by the American Heart Association to help us to stay as healthy as possible.

And again, it's estimated that a huge percentage of cardiovascular illnesses, including stroke, are avoidable if we're doing the kinds of things that I just mentioned, as far as a healthy lifestyle, avoiding smoking, good diet, weight maintenance.

We didn't mention alcohol, but that's on the list as well. And then avoidance of diabetes, treating blood pressure problems, and sleep. I might have left one off the list there, but they're the kinds of things that we talk about all the time on these podcasts.

So again, the way to avoid cardiovascular disease as much as possible is to stay tuned in with your primary care practitioners and do the things you can do on your own to keep your health as good as And that turns out to cross over into the neuroprotection sphere as well, because we often think of dementia, which is one of the major causes of disability, as type 3 diabetes.

And again, the metabolic and cardiovascular issues that affect our heart and may cause stroke are similar to the things that may caused dementia. So those are some final recommendations.

Another issue that is showing up on the list from the World Health Organization and other American public health organizations is anxiety and depression.

And that usually makes the top 10 list of disability causing conditions for women in the developed world as well as other parts of the world. So getting evaluated and treated for these conditions is something that I would highly recommend.

And one thing that, again, doesn't show up on most of the material that study before I make these podcasts, but that i've seen in other places, is being out in nature.

That can be very, very therapeutic for a lot of people. Especially morning sunshine, if humanly possible. And one final thing is our social life. And I know we've talked in prior podcasts about loneliness and social isolation.

It turns out these conditions, feeling lonely and being socially isolated, are as high of a risk factor as smoking for cardiovascular disease, for example.

Probably others as well, although they're not as So maintaining your social relationships and being out there doing things that are meaningful. This is how we can live out our health span as long as possible and have it meet up with our lifespan.

And to quote a quote that I often use, to die young as late as possibly. So I hope this is helpful information for you and thanks for being with us and I hoped to see you again soon.

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