31. Care for the elderly woman

The majority of older people are female, due to the higher maximum lifespan of the aging female. Despite their higher life expectancy, older women suffer from more diseases and impairments, which together form the second leading cause of the increasing portion of health services directed towards aging female patients. In old age, a problem-based, generalist approach can be complementary to a disease-specific approach. In this chapter, we present such a generalist approach to complement the disease-specific approach presented in the rest of the book. We clarify the various interactions between aging and diseases, as well as between gynaecology and age-related impairments in the physical, psychological, social domains. The chapter starts with a discussion of the most important mechanisms and theories of aging, relating them to the aging female genital system, along with gynaecological interventions. After reading this chapter, readers should be able to describe the most important general characteristics of the aged female patient: increasing heterogeneity, multimorbidity, high incidence of geriatric syndromes and the atypical presentation of common diseases. The chapter also explains specific aspects of communication with and general examination of elderly women. It will help readers to understand and apply specific features of the diagnostic and therapeutic approach to frail older women. Finally, after studying the text, readers should be able use principles of care that will improve the effectiveness and efficiency of gynaecology for older women.