Gender disparity of successful aging in Taiwan.

The purpose of this longitudinal study was to examine the association of gender on successful aging during a 6-year follow-up study. Data were drawn from the 1989, 1993, 1996, and 1999 Survey of Health and Living Status of the Elderly in Taiwan, a national representative population survey of 4,049 participants aged 60 years or older; 43% were women. Successful aging indicators were defined as physical (absence of disease and physical disability), mental (normal cognitive function and absence of depression), and social (good social support and participation in productive activities). Gender differences related to successful aging during the 6 years were analyzed with Cox proportional hazards regression model. Significant disparities were found between elderly men and women in activities of daily living (ADL), instrumental activities of daily living (IADL), cognitive function, depressive symptoms, social support and productive activities. When the data included individuals who were deceased, elderly women showed better maintenance of ADL and less vulnerability to IADL impairment than elderly men. However, when the analysis included only survivors during the follow-up, the elderly were more likely to be impaired in IADL and cognitive function, have depressive symptoms, and lack engagement in productive activities. Cumulative disadvantage was associated with health disparities in elderly women. This research demonstrates the need to develop gender-sensitive policies.