The World Health Organization recognizes the gender as an ageing determinant. Thus, apart from biological differences, there is a need of a gender approach in health that includes an analysis of how differences in gender roles affect the health status.

To assess the functional status in two areas of the elderly’s life (mental and physical health), analyzing the impact of gender as a determinant of health in aging.

Quantitative and descriptive study. Probabilistic sample stratified by age, gender and area of residence, constituted by 1153 older persons aged ≥75 years (N=16474), consisting of 422 men (36.6%) and 731 women (63.4%). The instrument for data collection was the Questionário de Avaliação Funcional Multidimensional para Idosos/Older Americans Resources and Services (QAFMI/OARS).

With regard to gender differences in the areas of physical and mental health the results evaluated with the QAFMI/OARS model stand women with worse scores in this two functional areas. Although men, and especially the older age group, mentioned that have had more need for a physician visit. Related to mental health the self-evaluation is worse in women, and also in the assessment of the QAFMI/OARS model, were it was a notorious difference between genders, observing a decline in mental health among women.

The feminization of aging implies an adequate public policies and the organization of health services, and social support, based on the understanding of the differences between aging as a man and as woman.