Three basic considerations impel the greater recognition of health of ageing women as a major health and development issue for the future:

• The numbers of ageing women are increasing worldwide;
• Women’s life course beyond age 50 extends for a significant period and is increasing everywhere in the world; and
• There is a very significant scope for improving the health of ageing women and thus ensuring that they remain a resource for their families and communities.

Most ageing women are living in the developing regions of the world

Currently, more than half of the world’s women aged 60 years and over are living in developing regions, 198 million compared with 135 million in the developed regions. And the percentage of older women living in developing regions will grow dramatically in the future, since two-thirds of the women in the age group 45-59 currently live in developing countries as compared with only one third in the developed countries.

There are significant differences in life expectancy of women and men

In the developed nations of the world, women live on average six to eight years longer than men. Life expectancy for women now exceeds 80 years in at least 35 countries and is approaching this threshold in several other countries. However, the life expectancy of women in countries at different levels of development is markedly different, ranging from just over 50 years in the least developed countries through the 60s and 70s in those undergoing rapid economic development.

But life expectancy at birth alone can be misleading, disguising the duration of women’s lives in developing countries. For women in developing countries who survive the early lifespan stages to reach middle age, life expectancy approaches that of women in developed countries. At age 65, women in developing countries now have about three quarters of the remaining life expectancy of their counterparts in developed countries, and the gap will narrow in the future as mortality steadily declines at younger ages.

Longer lives are not necessarily healthier lives

Since the likelihood of disability increases with age, it is hardly surprising that national surveys reveal increasing numbers of disabled women among the older populations. In a few developed countries, however, recent data reveals that the rates of disability among the older population are steadily declining. The available data, on the other hand, is still insufficient to assess the real extent of disability among the world's older women.

The term "healthy life expectancy" has been developed to describe the number of years one can expect to live in relatively good health. Healthy life expectancy is not necessarily life expectancy free of disease. Rather, the concept of healthy life expectancy as normally used refers to life expectancy without limitation of functions that may be the consequence of one or more chronic conditions.

More than forty-five countries now have estimates of healthy life expectancy. One general conclusion is warranted based on these studies: women can generally expect to spend more years of their lives with some functional limitations than men. This is valid for developed as well as developing countries.

Among the types of disability, mobility disability, in particular walking disability, is currently acknowledged as one of the most important quality of life and public health concerns of older women. Slow walking speed is a risk factor for falls and other accidents, resulting in fractures, further disability and loss of independence. In developing countries, loosing the ability to walk may be associated with even greater risks of adverse outcomes as walking is often the most common means of transportation.