Who’s got the aging edge?

As we age, the old saying goes, men get more distinguished; women just get older.

In truth, the aging process affects men and women in much the same way. But there are some intriguing as well as some obvious differences, whether we’re talking outer or inner package.

Basically, it’s a tradeoff. Any advantages men enjoy in the looks and health department are offset by women’s in other ways.

Comparing triplets
To explore the issue, we recruited a few key players. Inspired by an ongoing study launched by Sweden’s Karolinksa Institute, now in its ninth year, which uses male-female twins to investigate sex differences in longevity, we decided to go one better and scout out triplets:

• Bev, a retired government clerk from Toronto
• Her sister, Joan, a former cook-waitress, also from Toronto
• Their brother, Richard, a realtor from Oshawa, Ontario.

All turn 66 this October.

Medical insight
And to gain some insight into the couple front, we turned to Dave Adams, 58, and his wife, Barb, 59, who, after respective careers as a teacher and a nurse, now run the Tice Inn at Cape Onion, a thriving bed and breakfast on Newfoundland’s northernmost point.

Lending medical expertise—not to mention an acerbic edge—to our findings (“Sure, men and women age differently in certain ways. So what?”) is Dr. Michael Gordon, vice-president of medical services and head of geriatric and internal medicine at the Baycrest Centre for Geriatric Care in Toronto.

Hair issues
Men get balder, to put it bluntly. Male pattern baldness (receding hairline, moderate to extensive loss of hair on the crown) afflicts two-thirds of men.

Female pattern baldness (general thinning of hair all over the head) affects less than one-fifth of women.

Triplets Bev, Joan and Richard follow the typical pattern. Bev still has a thick head of hair, which she tinted a pale apricot in her working days but has since let go grey.

“At work, I was surrounded by young people and felt I had to keep up. But after I retired, I thought why should I bother? Also, it was too expensive. Now, I put my money into pedicures.”

Bev’s sister Joan has the same great tresses, lightened to strawberry-blond.

“I’m bald,” says brother Richard, who started losing his hair at 16. “It bothered me at first, but I stopped worrying as soon as I got married.”

Next page: Coping abilities

Coping abilities
You win one, lose one here, guys: while older women are more prone to depression than their male counterparts—a situation that’s been attributed in part to hormonal fluctuations during their lifetime—they are better at coping with it.

For one thing, women tend to take better care of themselves and seek medical help more frequently, which increases their chances of getting help for depression—a condition which, ironically, is one of the least diagnosed but also one of the most treatable.

Women are also better than men at making and maintaining connections with others—family members, friends, community resources.

“Their richer social network lends strength and support,” says Dr. Gordon.

And although it may have been stressful throughout their lives, having played multiple roles can be beneficial in later life.

Dealing with stress
“A woman’s whole world isn’t invested in work,” Gordon says, unlike the men who defined themselves as breadwinners and have trouble in retirement.

“Even in the most liberated households, women invest more of themselves in child-rearing. They develop a wider range of personal interests and they seem to know instinctively that dependency on a person is separate from loving a person. All of this helps them cope better,” says Gordon.

“I’ve always been able to deal with stress better than Dave,” says Barb Adams. “I’ve got multiple sclerosis and if I have a relapse, I can get depressed. But I always come out of it.”

The sociability factor in their Newfoundland B & B, on the other hand, is flipped.

“Dave is an extrovert beyond extroverts, the social master of our relationship,” says Barb.

“He can’t be alone very long. Sometimes, his desire for sociability wears me out.”

Dave concedes that he makes most of the couple’s contacts and thrives on the “stimulating and interesting” congeniality at the B & B. Still, they say, their different attitudes tend to complement each other.

Share positive attitude
Although life has evolved in different ways for Bev, Joan and Richard, the siblings share the same positive attitude toward life.

Bev divorced her alcoholic husband at 24, moved in with her parents and stayed. On her own since her mother died last year (her father died 12 years ago), she says it helps her comfort level to have the man she’s been keeping company with for 35 years living right next door.

It doesn’t bother her that she didn’t have children—“you can’t miss what you never had.”

Joan, who has two children and five grandchildren, was dumped by her husband about 25 years ago and “hated men for a while.”

Jobs in a variety of service industries kept her occupied but she was “glad to get off her feet” when she retired last December. Now, she keeps busy looking after her grandkids while their parents work.

Richard, who is happily married, with three children and six grandchildren, says that his social life is pretty much confined to going out with his wife—“we both love live theatre” –and visiting family.

In contrast to his sisters, he plans to keep on working indefinitely. “I think it’s healthier to keep busy.”

Next page: Skin issues

Skin issues
Men are the lucky ones here: their skin is thicker, which allows fewer damaging UV rays to penetrate, making it less prone to lining and wrinkling and reducing the risk of melanoma.

However, the gap between the rates of men’s and women’s melanoma is narrowing, as an increasing number of men are basking in the sun and not taking preventive measures.

Awareness plays a role in prevention and treatment of melanoma. In women, cancerous lesions tend to appear on their lower legs. In men, on their lower backs, which makes them less noticeable.

Both men’s and women’s upper backs are also susceptible, as are men’s chests and abdomens.

Melanoma preventable
Worth noting: 80 per cent of melanoma cases are caused by sun exposure, which makes it the most preventable cancer—and the most curable, if caught in time.

The whole issue is a sore spot with Dr. Gordon.

“How we age is mostly up to genetics and how we take care of ourselves,” he says. “Why on earth would someone who has a genetic predisposition to skin cancer go out and roast in the sun?”

“I stopped sunbathing when skin cancer started making headlines,” says Bev, who, in her younger days at the cottage, used to slather herself with oil and “broil.”

Joan was the same, but both sisters escaped the consequences and today boast smooth, blemish-free skin.

Although Richard had the typical male attitude of the time—“I had no desire to lie out in the sun. I went fishing instead”—he still developed brown spots on his balding head from not wearing a hat.

“They weren’t cancerous, but I had them removed four years ago just to be on the safe side.”

Losing weight
The possibility of obesity escalates with aging. Those pesky fat cells mature along with the rest of our body parts and become harder to get rid of.

None of the triplets has had a problem with weight; in fact, for Bev, it was a positive experience: “I gained weight during menopause, then I lost it all except on my boobs. I could throw my padded bras away.”

Joan, at four foot 11, is a trim 98 pounds.

Richard, who was a “skinny little runt” in his youth, wouldn’t mind losing five pounds around his middle, but is otherwise unconcerned.

For many of us, however, fighting the aptly named middle-aged spread is an ongoing struggle.

Men have advantage
The difference between the sexes: men accumulate fat primarily on their chests, backs and abdomens. Women tend to pack it on in their buttocks, arms and thighs.

However, since men start out with the advantage of having less body fat than women, they can eat more proportionately because they require more calories for every pound of body weight. Women can be forgiven for being a tad jealous.

“My weight’s a constant battle,” says Barb Adams. “It all settles around the middle—from belly to boobs. To keep it down, I have to eat like a sparrow.”

Women more flexible
“I don’t have a weight problem,” says Dave, who attributes this to good nutrition, exercise and his metabolism, which he claims actually increased from age 40 on.

He does admit to having love handles “but they just come with being 50-plus.”

More bad news for women: the kind of fat they accumulate is slower to respond to diet and exercise.

Some good news: they are more efficient fat oxidizers—meaning they derive proportionately more energy from fat than men—which makes them respond better to the endurance exercises that appeal to older people, such as walking.

Women are also more flexible, an asset for a complete fitness regimen, which experts say should include stretching and strength routines as well as weight-bearing exercises, at whatever age.

Men have the advantage in more intense cardiovascular activities, such as running, because they have a greater lung capacity. 

Sexual challenges
Experts wax rhapsodic about the joys of sex into middle age and beyond—even into your 80s—though some people aren’t buying it. None of the triplets, for example, is sexually active and they couldn’t care less.
 
For those who do want to stay sexually active, aging presents some challenges, which differ significantly for men and women.

With men, it’s usually difficulty in achieving an erection. There are both psychological and physiological reasons for this, with experts speculating that the former looms larger because men feel anxiety and pressure as their bodies age.

Whatever the cause, there’s a solution you’ve undoubtedly heard about, unless you’ve been living in a cave: Viagra. This magic bullet is highly effective and has few side effects.

But it may not combine well with other medications. Men need to consult with a physician to see if it’s right for them.

With women, sexual problems in later life are largely physical and usually related to menopause: among them, a thinning and shortening of the vaginal canal and decreased lubrication.

Needless to say, these changes can make sexual intercourse uncomfortable, even painful.

Happily, there’s also a one-word elixir for women: lubrication—and lots of it. There are lots of products available in your friendly neighbourhood drugstore.

Barb Adams says that while she and her husband still enjoy an active (though “less energetic”) sex life, she has to use a lubricant. (Any problems for Dave? “Nope.”)

Next page: Women live longer

The Centre for Canadian Studies at Mount Allison University in New Brunswick reports in Aging and the Canadian Population that at age 65, a woman can expect to live another 19 years; a man 15.

This means that there are more widows over 65 than widowers, though Dr. Gordon says that because of their social skills and wider range of interests, “women do better as widows than men do as widowers.”

Interestingly, there’s a growing trend for older Canadians, especially women, to choose to live alone.

More serious differences
Let’s skip quickly over the bad news. Among the more serious health differences between aging men and women: women are at risk for breast cancer, men for prostate cancer, with their vulnerability to these diseases about equal.

Women are four times more likely to get osteoporosis than men, with more than half of women over 65 suffering from the condition.

However, recent studies show that it’s also prevalent in elderly men, and those who fracture their bones as a result have a higher mortality rate than women.

Heart disease is higher in men but is the number one killer of both men and women, spiking in men at 55 and women at 65.

About twice as many men as women get lung cancer, but it’s the leading cause of cancer death for both.

No survivors
Sheesh! To paraphrase Woody Allen, one thing we know for sure about life is that none of us will get out of it alive.

That being said, we may as well make the most of the journey, and older Canadians seem determined to do so.

The Mount Allison study says that while women report more illnesses than men—the theory being they’re more attuned to their bodies and deem it more socially acceptable to seek medical help—they still view their health positively, and that both men and women on the plus side of 65 on the whole view their health as good or excellent.

The triplets are a case in point. Bev and Joan have no health problems to speak of and although neither is crazy about getting older, they both think of themselves in the pink of condition.

 “I feel 16,” says Bev, “and I hope I live to be 100.”

“Looking after grandkids keeps you young,” says Joan.

Richard takes medication for clogged arteries, high cholesterol and high blood pressure, plus “pills for my stomach so I can take all the other other pills.”

Still, he says cheerfully, “I’m perfectly healthy.”

Other life factors
As to how long good health will last, most people think that it’s a combination of genes and luck.

But a landmark Harvard study led by George Vaillant, M.D., the results of which are documented in Aging Well (publisher, 2002) conclude that other factors, which apply to both sexes, are more influential:

• Not smoking
• Having a good attitude
• Maintaining a healthy weight
• Exercising regularly
• Maintaining strong social relationships.

A sense of humour helps too, Gordon says, but points out that “you either have it or you don’t.”

On a more sobering note, he says that the possibility of dementia, particularly Alzheimer’s, is the biggest challenge aging men and women have to face.

“Some people suggest that the more stimulation to the brain, the more reserve power there is, but I know people who were intellectuals who got it anyway.”

His skepticism aside, Gordon tells a story about one of his patients, a Holocaust survivor, who decided to exercise his grey cells by writing about his experiences.

“His children thought he was crazy, but finally they understood: he was on a mission. He felt that if he didn’t get his story down, it would be lost forever. It gave him a whole new lease on life.”