Older Women: Longer Lives, More Years in Less Than Full Health and Lower Incomes

Women live longer than men almost everywhere, but they also spend more years with illness or disability. Worldwide in 2023, a woman aged 60 could expect 22.8 more years of life against 19.6 for a man, yet about 6.2 of those years would not be in full health, compared with 4.9 for men^[1][2]. Older women also do more of the unpaid care into their seventies, have lower incomes in retirement and are more likely to live below the poverty line.

Later life for many women is shaped by everything that came before it: years of caring for children, parents and partners, part-time or unpaid work, lower pay, and long-term health conditions. In older age these threads meet. Women are more likely to outlive a partner, to manage long-term conditions on a small income, and to go on caring for others well into their seventies. This study brings together what international and national statistics show about older women’s health, care, income and safety, and where the evidence is missing. The gaps it describes are gaps in income support, services and protection, not in women themselves.

Women live longer, but also spend more years in less than full health

The World Health Organization’s global estimates for 2023 put life expectancy at age 60 at 22.8 years for women and 19.6 years for men. Healthy life expectancy, the years a person can expect to live in full health, was 16.6 years for women at 60 and 14.7 years for men^[1][2]. Subtracting one from the other, the average woman of 60 faces about 6.2 years in less than full health, the average man about 4.9. Women’s longer lives are real, but so are the extra years lived with illness or limitation.

A similar pattern shows up in Europe, on a different measure and at birth rather than at 60. In the European Union in 2023, life expectancy at birth was 84.0 years for women and 78.7 years for men, but healthy life years at birth, which Eurostat measures as years without limitation in usual activities, were almost the same: 63.3 for women and 62.8 for men. Women spent 75.4% of their lives free from activity limitation, against 79.8% for men^[5].

The picture depends on what is measured. A comparison of 24 countries and regions using harmonised ageing surveys from 2014 to 2019 found that women had more disability-free life expectancy than men in most places, by 3.0 to 3.5 years in most European countries, across a range from a slight male advantage in Portugal to almost five years in South Korea. Chronic disease-free life expectancy, by contrast, showed a female disadvantage in most countries, including Portugal (2.3 years), Mexico (1.9) and South Korea (1.6)^[6]. In other words, women tend to live more years with a chronic condition, even where they stay free of disability for longer. A 2026 meta-analysis of multimorbidity, living with two or more long-term conditions, found a pooled prevalence ratio of 1.12 for women compared with men, although its abstract does not break this down by age^[7].

Dementia is part of this. WHO states that women are “disproportionately affected by dementia, both directly and indirectly”: women experience higher disability-adjusted life years and mortality due to dementia, and they also provide 70% of the care hours for people living with it^[8]. Our study of unpaid dementia carers sets out that care in detail.

Women give most unpaid care in mid-life and early old age; in the oldest age groups, men catch up

Caring is one of the clearest ways gender shapes later life. WHO estimates that women give 70% of the care hours for people living with dementia worldwide^[8]. National census data show how that care is spread across the life course. In England’s 2021 Census, 10.3% of females provided unpaid care, against 7.6% of males. Women aged 55 to 59 were the most likely of any group to be carers, at 19.9%, and women were statistically significantly more likely than men to provide care in every age group up to 75 to 79^[9].

The census also shows something often missed. From the age of 80 onwards, men in England were significantly more likely than women to provide unpaid care, and the heaviest caring fell on the oldest men: the share giving 50 or more hours a week peaked at 7.4% among men aged 85 to 89, while for women it peaked at 5.6% among those aged 75 to 79^[9]. The census does not say why. Much of this very late-life care is likely to be for a partner, but the published figures do not record who is being cared for, so that remains an explanation to test rather than a finding.

So the evidence does not support a simple picture of older women as carers and older men as cared for. It shows women more likely than men to be carers through their fifties, sixties and seventies, and very old people of both sexes caring intensively for partners. Both need support. The effects of caring on carers’ own health, work and money are covered in our study of older unpaid carers.

Women’s pensions are about a quarter lower, and more older women live in poverty

Years spent caring, in part-time work or on lower pay are carried forward into retirement income. Across the 27 countries of the European Union, women aged 65 and over who received a pension had average pension incomes 23.9% lower than men’s in the 2025 survey year. The gap has narrowed slowly, from 25.9% in 2022. If it kept narrowing at the 2022–2025 pace, about two-thirds of a percentage point a year, it would take more than three decades to close; that is simple arithmetic, not a forecast. For the younger group aged 65 to 74 it was 23.3%, only a little smaller^[3].

Lower incomes show up in poverty rates too. In the EU in 2025, 18.3% of women aged 65 and over were at risk of poverty, meaning their household income was below 60% of their country’s median, compared with 13.6% of men the same age^[10]. The gap is wider still at lower thresholds.

Source: Eurostat, EU-SILC dataset ilc_li02^[10]. Incomes are “equivalised”, adjusted for household size, and refer to the whole household, so a woman living with a partner shares his income in this measure.

That last point matters. Because household measures pool income, they can understate how financially exposed women are within a couple, and how sharply their position can change on widowhood or separation. The gender pension gap, which compares individuals’ own pensions, is a better guide to women’s independent income. We could not verify OECD or North American figures on this for this study; the European figures are the best we could check at source. Our study of older people on low incomes looks at poverty in later life more broadly.

About one in seven older women report abuse in a single year, most often psychological

Violence and abuse against women do not stop at a certain age. The most comprehensive estimate specific to older women is a systematic review and meta-analysis of 50 community studies from around the world, covering women aged 60 and over. It found a pooled past-year prevalence of any abuse of 14.1%, about one in seven. Psychological abuse was the most common form, at 11.8%, followed by neglect (4.1%), financial abuse (3.8%), sexual abuse (2.2%) and physical abuse (1.9%)^[4].

For comparison, WHO reports that around one in six people aged 60 and over, of both sexes, experienced some form of abuse in community settings in the past year, a figure of 15.7% from an earlier review^[11]. The two reviews used different studies and methods, so the figures should not be read as showing that older women are less likely to be abused than older men. What both show is that abuse of older people is common, and that it is more often psychological, financial or neglect than physical.

Abuse in care settings is harder to measure from older people themselves. WHO cites studies in which 64.2% of staff in institutions reported having perpetrated some form of abuse in the past year^[11]. Because women live longer and spend more years with disability, many of the people who depend on residential and home care in very old age are women, so the quality and oversight of that care matters greatly to them. Every country has, or should have, routes for raising safeguarding concerns about an older person, through adult social care, health services, regulators or the police.

What the evidence asks of us

The figures point to a small number of clear priorities for governments, health and care services, funders and the organisations that work with older women.

• Plan health services for the years women actually live. If women at 60 can expect more than six years in less than full health, and more years with chronic disease, then services for long-term conditions, rehabilitation, integrated care and long-term care need to be planned around them. Integrated care and long-term care are two of the four action areas of the United Nations Decade of Healthy Ageing (2021–2030)^[12].
• Count older women properly. The Decade calls for data to be “produced and disaggregated to better understand issues affecting their health and well-being”^[12]. Many sources used here report sex but not age, or age but not sex, and the research on abuse of older women relies largely on studies more than a decade old. National surveys on health, income and violence should report results for women and men in older age bands, including the over-80s.
• Value care in retirement income. A gender pension gap of about a quarter across the EU^[3] reflects working lives shaped by unpaid care. Public pension and social protection systems can recognise caring years and protect women whose income depends on a partner’s income.
• Support carers at every age. In England, women are more likely than men to be carers into their late seventies, and the oldest men carry some of the heaviest loads^[9]. Carers’ assessments, breaks and practical help should reach carers in their seventies and eighties, not only those of working age.
• Treat abuse of older women as violence against women. With about one in seven older women reporting abuse in a year^[4], services for domestic abuse and for safeguarding older people both need to reach older women, and to recognise psychological and financial abuse as well as physical harm. That means taking older women’s reports seriously; combatting ageism is another of the Decade’s four action areas^[12].

Language: this piece uses “older people” and “older women”, the terms most organisations working with and led by older women use, and avoids labels that define people by age alone. Where a source reports by sex (“females”, “males”), we follow its categories; most official statistics used here do not record gender identity separately from sex.

Why we're publishing this

We compiled this evidence because older women, and the organisations that work with them, deserve the research in one place, cleanly sourced and ready to put in front of a minister, a commissioner, a funder or a journalist. Older women are too often treated as a footnote both in research on ageing and in research on women. The case here is theirs; our part is to set out what the data show and to be honest about where the data run out.

How to read this data

The global life expectancy and healthy life expectancy figures are WHO modelled estimates for 2023, and the “years not in full health” figures are our own subtraction of one from the other. The European figures come from Eurostat and the EU Statistics on Income and Living Conditions survey: healthy life years measure self-reported limitation in usual activities, and poverty rates are based on household income, so they do not show how income is shared within a couple. The 24-country comparison uses harmonised ageing surveys from 2014 to 2019; the multimorbidity meta-analysis covers all adult ages. The caring figures are from the 2021 Census in England and Wales and are self-reported. The abuse figures come from two separate meta-analyses of self-report surveys, one for older women and one for all older people, which are not directly comparable, and the older women’s review includes studies published only up to 2015. All of these show associations and patterns, not causes. Figures from different countries, years and methods are not directly comparable. Evidence is thinnest for low- and middle-income countries, for women over 80 and for violence by partners in later life; we could not verify figures on living alone, widowhood or OECD-wide gender gaps in retirement income at source for this study, so they are left out.

Use this data

Free to cite with attribution to Understanding Aging. Charities, women’s organisations, campaigners and journalists are welcome to reuse these figures and charts. For the underlying figures as a spreadsheet, get in touch.

Important: This article summarises published research and statistics for general information. It is not medical, care or financial advice and cannot be used to diagnose, treat or predict anything about an individual. If you have concerns about your own or someone else's memory or health, please speak to a GP or another qualified health professional.

Sources

1. World Health Organization. Life expectancy at age 60 (years), indicator WHOSIS_000015, global estimates 2023. WHO Global Health Observatory, 2025. ghoapi.azureedge.net/api/WHOSIS_000015
2. World Health Organization. Healthy life expectancy (HALE) at age 60 (years), indicator WHOSIS_000007, global estimates 2019–2023. WHO Global Health Observatory, 2025. ghoapi.azureedge.net/api/WHOSIS_000007
3. Eurostat. Average gender pension gap by age group (ilc_pnp13), EU-27, 2022–2025. Eurostat, 2026. ec.europa.eu/eurostat/api/…/data/ilc_pnp13
4. Yon Y, Mikton C, Gassoumis ZD, Wilber KH. The prevalence of self-reported elder abuse among older women in community settings: a systematic review and meta-analysis. Trauma, Violence & Abuse, 2019. europepmc.org/article/MED/29333977
5. Eurostat. Healthy life years statistics. Eurostat Statistics Explained, data extracted July 2025. ec.europa.eu/eurostat/statistics-explained/…Healthy_life_years_statistics
6. Di Lego V, Nepomuceno MR, Turra CM. Gender gaps in healthy life expectancy as indicators of inequality for disability and chronic disease: cross-sectional evidence from 24 countries, years 2014–2019. BMJ Open, 2025. europepmc.org/article/MED/41263830
7. Nguyen T, Wong WJ, Woodward M, Harris K. Sex differences in multimorbidity: a systematic review and meta-analysis. BMC Public Health, 2026. europepmc.org/article/MED/42157149
8. World Health Organization. Dementia: fact sheet. WHO, 2026. who.int/news-room/fact-sheets/detail/dementia
9. Office for National Statistics. Unpaid care by age, sex and deprivation, England and Wales: Census 2021. ONS, 2023. ons.gov.uk/…/unpaidcarebyagesexanddeprivationenglandandwales/census2021
10. Eurostat. At-risk-of-poverty rate by poverty threshold, age and sex (ilc_li02), EU-27, people aged 65 and over, 2024–2025. Eurostat, 2026. ec.europa.eu/eurostat/api/…/data/ilc_li02
11. World Health Organization. Abuse of older people: fact sheet. WHO, 2024. who.int/news-room/fact-sheets/detail/abuse-of-older-people
12. World Health Organization. UN Decade of Healthy Ageing (2021–2030). WHO. who.int/initiatives/decade-of-healthy-ageing