A/81/133 to it. 49 They may not have access to housing that offer calmer environments where residents are of a similar age. 50 F. Macro policies failing older women 21. Unilateral coercive measures might result in a country being unable to meet older women’s needs. For example, because of the sanctions imposed by the United States of America on Cuba, older women suffer from chronic shortages of medicines, adequate nutrition or hygiene supplies in care facilities. 51 22. Discriminatory macroeconomic policies, including austerity measures, regressive taxation, sovereign debt burdens, trade liberalization, privatization and restrictive monetary policies, systematically underinvest in healthcare, education, social protection and care infrastructure, disproportionately affecting older women. These policies reinforce patriarchal divisions of labour by increasing women’s unpaid and underpaid care responsibilities, limiting their access to decent work, assets, pensions and wealth accumulation, thereby producing cumulative economic disadvantage in old age. As a result, older women experience heightened poverty, dependency, social exclusion and greater exposure to different forms of violence and abuse. Debt distress faced by developing countries, coupled with externally imposed austerity measures, undermines social spending, disproportionately affecting older women. 52 Moreover, funding cuts in foreign aid and humanitarian assistance further undermine efforts to prevent and respond to violence against women, including older women. 53 G. Isolation and exploitation of dependency relationships 23. Loneliness is linked to increased risks of suicide, 54 cardiovascular disease, cognitive decline and frailty, through mechanisms such as chronic stress, poor sleep quality and immune dysregulation. 55 Some older women withdraw into isolation, characterized by negative feelings towards others, which in turn leads to an increased vulnerability to further abuse. 56 24. When caregivers are also gatekeepers to accessing services, they may perpetrate abuse, 57 and economic dependence on the aggressor discourages reporting. 58 At the same time, many older women feel compelled to shoulder extensive caregiving responsibilities and even face a double caregiving burden when they have to take care of both their grandchildren and their elderly parents. 59 Grandmothers who become sole caregivers for grandchildren due to the long-term labour migration of parents, as is the case in Cambodia, often prioritize their grandchildren’s needs, while being left with little or no resources for themselves. 60 __________________ 49 Submission by Relationships Australia. See https://journals.sagepub.com/doi/10.1177/10778012251351915 . 51 Submission by Cuido60. 52 Submission by the Center for Economic, Social and Cultural Rights. 53 See https://www.helpage.org/news/older-people-at-the-edge-of-humanitarian-response/. 54 See https://pubmed.ncbi.nlm.nih.gov/20836914/. 55 See https://link.springer.com/article/10.1186/s12877-025-05846-4. 56 See https://link.springer.com/article/10.1186/s12877-025-05889-7. 57 Submission by Kathryn Falb. 58 Submission by Mexico. 59 Submission by María Rosa Avila. 60 See https://wellcomeopenresearch.org/articles/11-246/v1. 50 26-09992 7/26