Women substantially outnumber men among older Americans. Among the noninstitutionalized U.S. population age 65-74, for every 100 men there are 120 women. Among those age 75-84, for every 100 men there are nearly 150 women, and among those age >/=85, for every 100 men there are nearly 220 women. Among the population of nursing home residents, the sex ratios are even more dramatic. For those age 65-74 who reside in U.S. nursing homes, for every 100 men there are 132 women. Among residents of nursing homes age 75-84, for every 100 men there are 246 women, and among those age >/=85, for every 100 men there are 425 women. Unless gender-based differences in mortality narrow, the age-related demographic shifts that are occurring in the United States will remain overwhelmingly female. In considering any health-related issue in the geriatric patient population, a special focus on women is absolutely required. This is especially true with regard to pharmacotherapy in the geriatric population.