Priorities and Concerns of Older Men

You aren't the man you used to be when you were 35 years old.

Now that you're perhaps at least 65 years old, how have your priorities and concerns changed over the years?

Here's a roundup of medical research about your concerns as you grow older. Do the priorities of other men look similar to yours?

According to medical research, men over 65 are primarily concerned with preserving functional independence, maintaining physical and sexual function, and sustaining social connectedness.

Yet the health issues they prioritize most are often those least addressed by clinical services.

Men over 70 consistently rank functional health -- mobility, memory, and continence -- among their greatest concerns, while discounting physical appearance as unimportant. Sustaining independence, close relationships, and the ability to remain socially and physically active emerge as the most important priorities

The healthcare system's mismatch between men's priorities and the services actually offered underscores the need for increased attention to the health of older men.

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Health and Functional Concerns

In a survey of 2,325 community-dwelling men aged 55–97, the top health concerns were mobility impairment (64%), memory loss (64%), and medication side effects (63%).

Yet there is a disconnect between older men and our "health care" system. These functional and quality-of-life issues -- incontinence, osteoporosis, mobility, falls, anxiety, memory loss, and depression -- received the lowest screening and counseling rates from health professionals, creating a paradox between what matters most to older men and what the healthcare system addresses.

Urinary symptoms also had a high impact on quality of life, worsened by environmental constraints such as toilet availability.

The importance of health increased from midlife onward, even as satisfaction with health declined.

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Appearance No Longer Important to Senior Men

Research indicates older men disparage appearance as an unimportant, feminized concern, emphasizing instead the salience of body functionality and health. Weight was a prominent exception -- men worry about their weight, particularly stomach size, and stay physically active to manage it.

So apparently it's really OK to buy your shirts at Costco and wear white socks while walking around Green Lake.

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Independence, Social Connection, and Belonging

Sustaining independence -- anchored by financial resources and good health -- is a core theme among oldest-old men, who describe themselves as active agents maintaining meaning and life satisfaction. Belongingness, including close relationships, established friendships, and the significance of a spouse, is equally central to their well-being.

Social connectedness prevents loneliness and social isolation while improving well-being and reducing physical and mental health risks. Older men who live with a partner are less lonely than women living together, but previously married men who now live alone are lonelier than their female counterparts.

Men's poorer-quality friendships partially explains their greater dependency on partners and reluctance to directly state loneliness. (Groups like the Greenwood Men's Group are intended to solve this problem by creating high-quality friendships among men.)

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Masculinity, Identity, and Seeking Help

Did you ever consider yourself as a Tough Guy or a He-Man?

Even if you did, hopefully you have transitioned away from that version of masculinity long ago.

Traditional masculine norms emphasizing independence, self-reliance, and imperviousness to illness remain salient well into late life and shape how older men approach health.

Illness and help-seeking are often perceived as threats to masculine identity, with men taking action for health only when their status jeopardizes independence. Men aged 70 and older do engage more frequently in health behaviors like annual exams and nutritious eating than younger men, yet both age groups rarely seek help for emotional problems.

• Stoicism, reluctance to discuss health problems, and poor doctor relationships are barriers to health action.
• Some men view health care and preventative practices as feminine pursuits and delegate decisions to spouses.
• Group health programs are perceived as feminine by nearly 78% of program coordinators, which deters male participation.
• Older men prefer problem-solving and physical activity over group exercise or workshop-style interventions.

Stoicism and reluctance to discuss personal matters are barriers to social support and health action.

Men consider retirement a particularly critical life event that could trigger psychological instability and depression.

Men are four times more likely than women to die by suicide, and endorsement of traditional "hegemonic masculinity" ideals is positively associated with both depressive and anger symptoms. This association strengthens when men perceive their health to be declining or have lost wealth.

Hegemonic masculinity is a concept that emphasizes:

• Emotional suppression: Practicing stoicism and refusing to show vulnerability, empathy, or sadness.
• Power and control: Displaying dominance in social, financial, and interpersonal dynamics.
• Physical strength and aggression: Relying on physical prowess, toughness, and sometimes violence to maintain status.
• Heteronormativity: Viewing exclusive heterosexuality and sexual conquest as essential to manhood.
• Socioeconomic status: Being the primary breadwinner, holding high-power jobs, or wielding financial authority.

This is the type of masculinity that will reduce life satisfaction in addition to making life shorter.

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Musculoskeletal and Functional Limitations

Arthritis and rheumatism is a leading self-perceived health problem causing functional limitations in men aged 60 and older. More than one of every two men report this problem.

In survey data, mobility impairment was the single greatest concern, reported by 64% of older men.

Back and neck problems are also common functional limitations.

As you get older, your ability to function decreases. According to one study, the predicted number of health problems causing functional difficulties was 1.81 times higher in men aged 80 and older compared to those aged 60.

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Urological and Sexual Health -- and Intimacy

As you go through your day, do you ever wonder: "where is the nearest toilet?"

• Benign prostatic hyperplasia (BPH) ranks fourth among the ten leading diagnosed disorders in men over 50.
• Prostate cancer is a near-universal concern among older men, expressed even by those at low risk.
• Erectile dysfunction and sexual dysfunction prevalence sharply increases with age, alongside BPH and prostate cancer.
• Only a small minority (17%-38%) of men over age 65 discuss their sexual health with a provider.
• Urinary symptoms have a high impact on quality of life, worsened by environmental constraints such as toilet availability.

In spite of these problems, intimacy and bonding -- rather than purely functional capacity -- underpins older men's understanding of why sex remains important. Men draw on intimacy to account for continued sexual expression even in the absence of a functional erection. Sexual activity is described as the "icing on the cake" of a satisfying relationship built on companionship and emotional closeness.

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Mental Health and Cognitive Decline

Memory loss is a top-tier concern for 64% of older men according to one study, on a par with mobility impairment.

Men appear to be at higher risk for mild cognitive impairment (MCI) than women, and being male is identified as a risk factor for incident MCI or dementia. Staying mentally sharp is a top concern for both men and women over 50 (71%), followed by developing Alzheimer's disease (51%).

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Cardiovascular Disease?

Here's a paradox for you!

Cardiovascular disease (CVD) is not a dominant perceived concern of men over 65, even though it remains their leading actual health threat. The evidence consistently shows that older men underestimate personal CVD risk while acknowledging its severity, with functional and quality-of-life issues taking priority in their health concerns.

We hope you're at least paying attention to your blood pressure. Hypertension affects 71% of men aged 65–74 and 80% of men over 75, making it the most prevalent modifiable CVD risk factor.

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Summary

The concerns listed above are what your peers are thinking about. How about you? How are you responding to these concerns?

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