Women live longer on average than men in the United States and in nearly every country in the world. But in the United States, the gender gap among older adults has shifted during the past century. At the turn of the 20th century, there were 102 older men (ages 65 and older) per 100 older women. By 1990, the sex ratio among the older adult population had fallen to 67, its lowest recorded level.5 Since then, the sex ratio among adults ages 65 and older has rebounded and is projected to increase to 81 by 2020 and to 86 by 2060.
A changing sex ratio has implications for caregiving in old age. Historically, older adults have relied heavily on family caregivers to provide support and care when they needed assistance. However, fewer children and high divorce rates among baby boomers mean that more may live alone in old age without either the financial and social support or informal caregiving provided by a spouse or child. Spousal care could potentially help fill this gap; with more men surviving to old age, more potential partners may be available to provide informal care for older adults.
Nearly 10 percent of older adults live in poverty. Older women are almost twice as likely to be living in poverty as older men. Racially and ethnically diverse older adults are more likely to be poor than White older adults.
Older age at birth can also increase the chance of other chromosomal conditions. Trisomy 18 (Edward syndrome) is the second most common chromosomal condition at the time of birth (about 1 in 3,000 live births), and trisomy 13 (Patau syndrome) occurs in about 1 in 6,000 live births. The most common sex chromosome condition is 47, XXY (Klinefelter syndrome), which occurs in about 1 in 500 males (ACOG et al., 2020).
Some researchers have expressed concerns that most of the research on birth outcomes at advanced maternal age focuses on fetal and infant outcomes, and not enough attention is given to risks for the pregnant person. To examine the risk of maternal death and severe complications, a recent study looked back at over 800,000 births to single babies in Washington State between 2003 and 2013 (Lisonkova et al. 2017). All live births and stillbirths to pregnant people aged 15-60 years were included in the dataset.
People could participate in the study if they would be 35 years or older on their due date, had never given birth to a live baby, and were pregnant with a single baby in head-first position. People were not included if they had gestational diabetes or were pregnant with the help of in vitro fertilization from donor eggs.
The biophysical profile is a 5-part test that was first used in the year 1980. It consists of a nonstress test and an ultrasound that looks at large fetal movements, fetal muscle tone, fetal breathing, and amniotic fluid volume. The BPP is scored out of 10 points, with 2 points awarded for presence of each feature, and 0 for the absence. A score of 8 or 10 is normal, a score of 6 is questionable and calls for further testing or delivery, and a score of 4, 2, or 0 is abnormal and usually calls for immediate birth. Many providers today do not perform a nonstress test if the ultrasound part of the BPP is normal; it is thought that the nonstress test does not add any predictive power to the BPP (Lalor et al. 2008).
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Meeting online is more common among younger adults and those who live in urban and suburban areas, as well as those who are lesbian, gay or bisexual (LGB). About one-in-five partnered adults ages 18 to 29 (21%) say they met their partner online, compared with 15% or fewer among their older counterparts. And while 28% of partnered LGB adults say they met their partner online, 11% of those who are straight say the same.
With each period, several hundred eggs are lost. Only the healthiest follicles will become mature eggs. The body breaks down and absorbs the rest. Males, on the other hand, continue to create new sperm for most of their adult lives.
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