Dread getting older? Women around the world seem to worry about aging more than men do, according to the 2010 Bupa Health Pulse, a 12-country survey by the British health care company Bupa. China is the most fearful country, and its top concern -- perhaps unsurprisingly, given family size limits -- is, "Who will take care of me?" The French seem least concerned about aging -- a third of respondents there say "old" starts after age 80.
And in the U.S.? Psychiatrists and life-cycle experts agree that what women fear most about aging seems different from what men fear most about aging.
Among women's top fears ...
Women's Aging Fear #1: Losing Attractiveness/Becoming "Invisible"
Let's see . . . wrinkles. Saggy breasts. Gray hair. Permanent post-baby belly. Dry skin. Weight gain. Each change wrought by time and gravity renders most women a bit more invisible in a culture that prizes dewy youth. Enter the booms in plastic surgery, laser skin resurfacing, and "anti-aging" cosmetics.
And it never ends. Fear about appearance persists right into the 70s and 80s -- when women add hearing aids, walkers, canes, and stooped posture to the dreaded "visible markers of being old," says geriatrician Laurie Jacobs, director of the Jack and Pearl Resnick Gerontology Center at the Albert Einstein College of Medicine in New York City.
"Women are always, unfortunately, more concerned about whether they appear old," she says. "Your sense of appearance is associated with your functional status."
Fear fighter: Self-care. You can't control others' views, but you can do a lot to stave off the infirmary and cultivate an inner beauty that transcends the outer packaging. Get enough sleep, reform your diet, exercise, laugh, stay engaged with the world. "You're as young as you feel" may be a cliché, but it's true.
Women's Aging Fear #2: Being Left Alone
A spouse's death figures high among women's fears, as does seeing their children dying first or losing old friends when they relocate for retirement, move to be closer to family, or become sick or die. "Social losses are very painful," says Eva Kahana, professor of sociology at Case Western Reserve University, who directs its 20-year Successful Aging Study.
"Men are 'fight-and-flighters.' If they can't do something, that's stressful," says stress expert and Harvard instructor Eva Selhub, senior physician at the Benson-Henry Institute for Mind/Body Medicine. "Women are 'tenders and befrienders.' If they can't have as many people in their lives, that's what's stressful to them."
"The fear of being alone is more harsh for women," adds Selhub. "Men seem to more easily find a younger model. You're more likely to see a 70-year-old man with a 30-year-old woman than to see the reverse."
Fear fighter: Know that even if you have fewer overall connections as you get older, they gain intimacy and importance -- and that's true for both women and men. "We think of old people as loners, but they're really not," Kahana says. "And though it's often emphasized how men and women are different, after age 70, we see both genders becoming less self-centered and more connected to others."
Women's Aging Fear #3: Becoming a Bag Lady
Bernie Madoff, the real estate collapse, and the Great Recession 2.0 have only fueled a classic female fear of aging: financial destitution. "Men tend to be more financially secure, make more money, and have a bigger pension and Social Security checks," says Ken Robbins, a geriatric psychiatrist at the University of Wisconsin. "Widows are often left with dramatically less money."
Today's younger women may also carry mental images of their mothers' and grandmothers' financial illiteracy. Even if an ignorance-is-bliss policy regarding family finances isn't true in their own families, uncertainty about the future and a sense of never having enough can be haunting.
Fear fighter: Experts expect this fear to diminish among women as more boomers, Gen-Xers, and younger members of both genders gain confidence about managing their money. That's not to say everyone will ever have enough of it -- so squirreling away even small amounts each month for savings or retirement funds pays off big later.
Women's Aging Fear #4: Cancer
Maybe it's those ubiquitous pink ribbons. Cancer, particularly breast cancer, tops the health concerns women fear most, according to a 2005 study by the Society for Women's Health Research. Ironically, lung cancer is twice as deadly as breast cancer for women, but seventh on their list of fears. Respondents were also more fearful of ovarian cancer than colon cancer, although the latter kills more.
"The more mammograms and colonoscopies we're asked to have done as we get older, the more we become afraid of our bodies breaking down," says the Benson-Henry Institute for Mind/Body Medicine's Eva Selhub, who also wrote The Love Response.
Fear fighter: Cancer is rightfully scary. Keeping up a healthful lifestyle and getting routine screenings are two good offenses. So is putting the actual scariest health threat for women in perspective: Heart disease (named by only one in 10 women in the same survey as her top fear) is actually the number-one killer of women in the U.S.
Women's Aging Fear #5: Being Dependent on Others
Both men and women alike dread "becoming a burden," according to the Successful Aging Study's Eva Kahana. But for many women, who have traditionally been the caregivers, the prospect of a role reversal is especially uncomfortable.
"A woman may see her spouse as not being interested or skilled about taking care of her, if the time comes, knowing he knows almost nothing about caregiving," Robbins says. "She doesn't want to interfere with the lives of her adult children, either."
Fear fighter: Plan ahead. Ironically, many women who don't wish to be a burden become exactly that because they haven't done basic advance healthcare planning. Assign someone now to have health care power of attorney in the event you become incapacitated. Make a living will specifying your preferences about life support. Look into long-term care insurance. Somebody might thank you later -- maybe you.