Most older Americans are sexually active despite experiencing sexual problems. A new study said to be representative of all older Americans gives a comprehensive and detailed account of their intimate lives.

The study is published in the August 23rd issue of the New England Journal of Medicine and is the work of Drs Stacy Tessler Lindau and Linda Waite and colleagues from the University of Chicago.

A key finding of the study was that physical health, not age, was most strongly linked to sexual problems.

This and other findings are from the National Social Life, Health and Aging Project (NSHAP), sponsored by the National Institutes of Health (NIH). The NSHAP is the first comprehensive population-based study of social and health factors on a nationwide scale and aims to shed light on the wellbeing of older Americans (57 to 85 year olds). The home based survey examines physical health, illness, cognitive health, emotional health, use of medication, sensory function, social connectedness, and health behaviours.

Richard J. Hode, Director of the National Institute on Aging (NIA), a component of the NIH, said:

“Despite the aging of the population, little had been known about the intimate lives of older adults.”

“This study expands our knowledge by reporting, on a national scale, data about sexual functioning and health among older adults,” he added.

NSHAP assesses the prevalence of sexual activity, sexual problems and conditions such as arthritis, heart conditions, diabetes, and high blood pressure. It looks at the relationship between health problems and other limitations and sexual activity and whether people talk to their doctors about sexual problems as they get older.

Dr Richard Suzman, Director of the Behavioral and Social Research Program at the NIA said that the study broke new ground in social and behavioural research, and revealed an aspect of the lives of older Americans that:

“Suggests a previously uncharacterized vitality and interest in sexuality that carries well into advanced age, which perhaps has not been appreciated as an important part of late life.”

The study surveyed 3,005 male and female participants aged from 57 to 85 years. It asked questions about their marital or other relationship status, how often they engaged in sexual activity and of what type, during the previous 12 months.

It also asked questions about physical health and how often they spoke to their doctor about sex, and those who were sexually active were also asked about any problems they experienced in relation to sex.

According to the results, many older adults are sexually active, but around half of the respondents reported they were experiencing at least one sexual problem and about one third reported two.

The specific results showed that:

  • Overall, older adults are sexually active.A large proportion said they had been sexually active in the last 12 months.
  • But the percentage who reported this declined with age.
  • 73 per cent of 57 to 64 year olds said they had been sexually active in the last 12 months.
  • This figure went down to 53 per cent for the 65 to 74 year olds, and 26 per cent of the 75 to 85 year olds.
  • Older women were significantly less likely to report sexual activity than older men.
  • Older women were also less likely to be in intimate relationships. This was due in part to being widowed and the fact that on average, men died earlier.
  • Healthier people were more likely to report being sexually active.
  • 81 per cent of men and 51 per cent of women who said they enjoyed excellent or very good health reported being sexually active in the previous 12 months.
  • These figures went down to 47 per cent of men and 26 per cent of women who reported being in fair or poor health.
  • Diabetes and high blood pressure were the illnesses most strongly linked to sexual problems.
  • About half of sexually active older adults mentioned at least one “bothersome” problem.
  • 37 per cent of sexually active men said they had erectile problems.
  • The problems reported most by women were low desire (43 per cent), problems with vaginal lubrication (39 per cent), and inability to climax (34 per cent).
  • Most older adults have not talked to their doctors about sex.
  • Only 38 per cent of men and 22 per cent of women reported having spoken to their doctor about sex since the age of 50.

The authors concluded that:

“Many older adults are sexually active. Women are less likely than men to have a spousal or other intimate relationship and to be sexually active. Sexual problems are frequent among older adults, but these problems are infrequently discussed with physicians.”

Lindau expects the findings will make it easier for doctors to talk to their older patients about sexual health, since they found older Americans were quite receptive to the subject when they completed the survey.

“We found, despite the high prevalence of problems, that most older adults have never discussed sex with a physician,” said Lindau.

“From a medical and a public health perspective, we have an opportunity and an obligation to do better patient education and counseling about health-related and potentially preventable and treatable sexual problems,” she explained.

It is hoped the study will also help to improve health education about sexually transmitted diseases in older Americans. Sexual activity in this group increases the risk of HIV for instance; about 15 per cent of new HIV diagnoses are in the over 50s. Another reason for the rise in HIV prevalence among older Americans is that younger people with HIV are living longer before developing AIDS.

“A Study of Sexuality and Health among Older Adults in the United States.”
Lindau, Stacy Tessler, Schumm, L. Philip, Laumann, Edward O., Levinson, Wendy, O’Muircheartaigh, Colm A., Waite, Linda J.
N Engl J Med 2007 357: 762-774
Volume 357:762-774; August 23, 2007; Number 8.

Click here for Abstract.

Click here for more information about the National Social Life, Health and Aging Project.

Written by: Catharine Paddock