Gender, self-care and functional status among older persons with coronary heart disease: a national perspective

The risk and burdens of cardiovascular diseases rise in late life and shift from men to women at age 65. This study uses baseline data from the National Survey of Self-Care and Aging to assess the association of self-care and functional status of older men and women with coronary heart disease (CHD). We first compare men and women with and without CHD, then base subsequent analyses on 597 persons with CHD. Three types of self-care (behavior changes, environmental adaptations, medical equipment use) were examined, and functional status was measured as difficulty with basic, mobility, and instrumental ADLs. Regardless of gender, persons with CHD had more functional impairment and used more self-care than those without the disease. Women were more impaired and engaged in more self-care than men. Equipment use was associated with higher functioning for men and women. Behavioral changes were significant only for men, as were advanced age, non-white ethnicity, more depressive symptoms, and low physical activity for women. Education, intervention, and supportive care for older adults with CHD should consider the role of specific types of self-care in disease management and prevention of decline as well as gender differences in use of various self-care strategies.