Aging and Disability

Aging can be defined as the process of growing older. People growing older with long-standing disabilities are said to “age with disability,” whereas people who do not experience disability until later in life are said to “age into disability” (Molton & Jensen, 2020; Verbrugge & Yang, 2002). Both the average age and longevity of people with spinal cord injury, cerebral palsy, and other physical disabilities are increasing. These positive changes are due to the aging of the general population as well as medical, rehabilitation, and technical advances (Goetz et al., n.d.; Molton & Yorkstown, 2017). Clearly, women with physical disabilities are enjoying longer lives and are becoming part of the ever-increasing population of older women in the United States (Federal Interagency, 2016; McLaren et al., 2021). Nevertheless, as women with physical disabilities age, they are at risk for multiple health complications not necessarily experienced by older women without disabilities.

Characteristics of Women Aging with Disability

Findings from a national population-based study (Chevarly et al., 2006) revealed that women ages 65 and over with three or more physical limitations differed dramatically from women of the same age without physical limitations in the following important ways:

• Social situation (e.g., less likely to be married, more likely to be living alone)
• Socioeconomic position (e.g., less likely to be employed, lower levels of education, more likely to be living in poverty)
• Access or utilization of health care services (e.g., less likely to have private health insurance, less likely to receive regular mammograms and pelvic exams)

Onset of New Problems

The challenges of maintaining good health in later years are in many ways more difficult for women who have long-standing disabilities. Women and other people with disabilities may experience age-related health conditions earlier than their able-bodied peers, a phenomenon referred to as premature or “accelerated aging” (Campbell et al., 1999). Women with physical disabilities may experience new health problems and greater functional impairment. For example, these aging-related changes can impact their sexuality and sexual activity as discussed in our Aging and Sexuality subpage.

Aging-related conditions often co-exist and interact with secondary health conditions, which are preventable or changeable complications of physical impairment. Secondary health conditions can negatively impact one’s quality of life (Simeonsson, et al., 1999). The combined effects of the chronological aging process, the underlying disabling condition, and secondary health conditions introduce multiple barriers to maintaining health while aging with disability.

Nosek and her colleagues (Nosek et al., 2006) conducted a groundbreaking study on secondary conditions in 443 community-living women with physical disabilities. That study showed that pain, fatigue, spasticity, weakness, sleep problems, vision impairment, and circulatory problems were especially common secondary conditions experienced by study participants. The researchers concluded that the women with physical disabilities in this study experienced substantial problems with secondary health conditions.

Health Promotion for Women Aging with Physical Disability

In addition to the notable need for research on women aging with long-term or life-long physical disability, health promotion programs for women in this population may help address the growing health needs of this population. Robinson-Whelen and colleagues from the Center for Research on Women with Disabilities (Robinson-Whelen et al., 2006) developed and tested a peer-led group health promotion program designed to meet the needs of women aging with physical disability. Some of the topics included physical activity, nutrition, menopause, osteoporosis, managing depression, incontinence, fall prevention, and medication self-management. Additionally, goal setting was an important part of every session. The evaluation of the eight-session program showed that women who participated in the program reported improvements on measures of health behaviors and physical health.

Tips for Healthy Aging

Here are suggestions based on our health promotion programs for women aging with physical disabilities:

• Take charge of your health and wellness.
• Maintain a healthy diet and engage in regular exercise that works well for you.
• Walk or otherwise bear weight as much as possible.
• Do your balance exercises or ask your doctor for a referral to a physical therapist who can teach you safe exercises for balance.
• Take actions to prevent falls! For example, if you have a personal helper, be sure they are trained to do transfers safely. For many more tips on preventing falls, visit our Fall Prevention subpage.
• Be an active participant in your health care.
• Learn about your medication (e. g., how it should affect you, possible side effects, what to do if you forget to take it) and contact your healthcare provider or pharmacist if you experience any medication problems.
• Maintain regular check-ups with your health care provider and be sure to receive recommended health screenings.
• When making a health care appointment, ask how much time will be needed and if the exam room or equipment is accessible. For more information on these issues, visit our Access to Healthcare page.
• Stay connected with others and develop and maintain good relationships.
• Recognize that your need for assistance may change as you age and be open to changes in assistive equipment and personal care.
• Reach out to trusted family, friends, and others for help and support. Remember it’s okay to ask for help from trusted people.
• Have a safety plan in the event someone hurts you. For detailed information about safety planning, visit the section on Safety Planning in our Interpersonal Violence web page.
• Find and stay engaged in activities that you enjoy or that give you a sense of fulfillment.
• Find ways to manage stress that work for you, such as meditation, yoga, or other relaxation practices.

Center for Research on Women with Disabilities. (n.d.). Osteoporosis.

University of Washington RRTC on Healthy Aging (n.d.) Factsheets: Aging Well with a Physical Disability. Accessed December 22, 2021.

University of Washington RRTC on Healthy Aging (n.d.) Factsheet: Age, Hearing Loss, and Communication: What Are My Rights? Accessed December 22, 2021.

University of Washington RRTC on Healthy Aging (n.d.) Factsheet: How to Manage Disability- Related Pain as You Age. Accessed December 22, 2021.

University of Washington RRTC on Healthy Aging (n.d.) Factsheet: Aging with a Disability: Tips for Your Sex Life. Accessed December 22, 2021.

Geotz et al. (n.d.) Aging with and into Disability: Current Status and Future Directions. Accessed December 22, 2021

McLaren C, Rosenblum D, DeDona M, et al. (2021). Spotlight on women with disabilities. Washington (DC): Department of Labor, Office on Disability Employment Policy.

Molton IR, Jensen MP. Aging and disability: biopsychosocial perspectives. Phys Med Rehabil Clin N Am. 2010 May;21(2):253-65. doi: 10.1016/j.pmr.2009.12.012. PMID: 20494275.

Molton IR, Yorkston KM. Growing Older With a Physical Disability: A Special Application of the Successful Aging Paradigm. J Gerontol B Psychol Sci Soc Sci. 2017 Mar 1;72(2):290-299. doi: 10.1093/geronb/gbw122. PMID: 27702838.

National League of Nursing (2016). Aging with a Disability.

Nosek, M. A. (2000). Overcoming the odds: The health of women with physical disabilities in the United States. Archives of Physical Medicine and Rehabilitation, 81, 135–138.

Robinson-Whelen, S., Hughes, R. B., Taylor, H. B., Colvard, M., Mastel-Smith, B., & Nosek, M. A. (2006). Improving the health and health behaviors of women aging with physical disabilities: A peer-led health promotion program. Women’s Health Issues, 16, 334-345.Simeonsson, R. J., & Leskinen, M. (1999). Disability secondary conditions and quality of life: Conceptual issues. In R. J. Simeonsson & L. N. Devitt (Eds.), Issues in disability and health. The role of secondary conditions and quality of life (pp. 51–72). Chapel Hill: University of North Carolina at Chapel Hill.

U.S. Department of Health and Human Services. (2000). Healthy People 2010: Understanding and improving health and objectives for improving health. 2nd ed. Washington, DC: U.S. Government Printing Office.

University of Washington RRTC on Healthy Aging (n.d.) Factsheets: Aging Well with a Physical Disability. Accessed December 20, 2021.

Verbrugge, L. M., & Yang, L. (2002). Aging with Disability and Disability with Aging. Journal of Disability Policy Studies, 12(4), 253-257.