Ageism and the feminization of old age: A Systematic review

Increases in life expectancy and declining birth rates have intensified the demographic weight of older adults, particularly women. This population frequently faces intersecting age and gender-based discrimination, resulting in greater health burdens and lower quality of life compared to men.

To examine gender-based disparities affecting older adults, particularly older women, intending to uncover underlying mechanisms and contribute to the formulation of more equitable, gender-responsive, and age-sensitive public health policies.

This systematic review followed PRISMA guidelines and was registered in PROSPERO (CRD420251104219).

Six databases were searched (2014-2024) for studies in English or Spanish on gender- and age-based health inequalities in older adults. Eligible systematic reviews, observational, and experimental studies were quality-assessed (PRISMA, STROBE, CONSORT), and findings were synthesized qualitatively.

Fourteen studies met the inclusion criteria. Across contexts, older women consistently exhibited higher prevalence of disability, frailty, depression, and poorer self-rated health, frequently linked to lower educational attainment and income. In contrast, older men showed lower prevalence of these conditions but faced higher mortality risks from frailty and suicide. Men also tended to report better subjective quality of life.

While women live longer, they often experience greater illness and functional limitations. Socioeconomic disadvantages explain part of these gaps, but a considerable proportion remains unexplained. These findings highlight the urgent need for gender- and age-sensitive public health strategies to reduce inequities in later life.