43. Care for the elderly woman

Most older people are female due to the longer maximum lifespan of women. Despite their longer 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 ageing female patients.

In old age, a problem-based, generalist approach can be complementary to a disease-specific approach. In this chapter, we present one such generalist approach to complement the disease-specific gynaecological approach dominantly present in the rest of the text. We clarify the various interactions between ageing and diseases, as well as between gynaecology and age-related impairments in the physical, psychological and social domains.

The chapter starts with a discussion of the most important mechanisms and theories of ageing, relating them to the ageing 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, multi-morbidity, 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.