Aims: Gender differences in healthy ageing remain poorly understood, particularly in the context of quality of life (QoL). We aimed to examine gender differences in QoL among older Australian adults and identify biopsychosocial factors that may explain these differences. Understanding these factors can guide interventions to optimise healthy ageing.
Methods: We analysed baseline data from the STAtins in Reducing Events in the Elderly (STAREE) trial, a randomized placebo-controlled trial investigating the effects of atorvastatin on disability-free survival and major cardiovascular events in Australians aged ≥70 years without cardiovascular disease or major disability. Health-related QoL was assessed using the Short-Form-36 (SF-36). We used multivariable linear regression modelling to explore gender differences in QoL and the contribution of modifiable and non-modifiable biopsychosocial factors to these differences.
Results: Among 9,971 participants (mean age 74.7±4.5 years), women (52%) reported poorer QoL across four domains: physical functioning (PF), vitality (VT), mental health (MH) and bodily pain (BP) (all p<0.05). Bodily pain accounted for 30% of the gender differences in PF and MH, and 60% in VT. Analgesic use reduced these associations by <20%. The addition of common comorbidities, living situation, and education resulted in a loss of the gender differences seen in VT and MH but not PF or BP.
Conclusions: Older Australian women without overt cardiovascular disease experience poorer QoL than men, with pain being a major explanatory factor. More work is required to understand how clinicians can improve pain management strategies to address this disparity and improve QoL in older women.