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Sexuality and health among older adults in the United States

Article reviewed

Stacy T Lindau, L Philip Schumm, Edward O. Laumann, Wendy Levinson, Colm A. O’Muircheartaigh, Linda J. Waite. A Study of Sexuality and Health Among Older Adults in the United States. NEJM  357;8. August 23, 2007.

Purpose of study

Little is known about sexuality among older persons in the United States, despite an aging population. Physiologic changes affect sexual responses of men and women, and sexual problems can be the first warning signs or consequences of serious illness. Limited data have shown that some women and men maintain sexual relationships and desire throughout their lives, but these data derive primarily from studies that are small, do not include very old persons, and rely on convenience samples. 

A nationally representative, population-based study was needed to educate health care professionals on the sexual norms and problems of older adults. The National Social Life, Health and Aging Project (NSHAP) was designed to provide data on the sexual activity, behaviors, and problems of older adults.

Methods

The study population included a sample of community-dwelling persons between the ages of 57 and 85 years, from across the United States.

The population was screened in 2004, and in-home interviews were performed from 2005 to 2006.  A total of 3005 participants (1550 women, 1455 men) were involved in the study.  Each participant answered a questionnaire that included co-habitation information, sexual history (last 5 years), sexual preferences and frequency of intercourse.  Participants were asked to rate their physical health using a standard 5-point scale.  In addition, anthropometric measurements, along with blood, salivary and vaginal mucosal specimens, were taken to assess physical and sensory function.

Key findings

Sexual activity declined with age and in general, was lower among women than among men (73% among 57 - 64 yoa, 53% among 65 - 74 yoa, and 26% among 75 - 85 yoa).

Among respondents who were sexually active, about half of both men and women reported at least one sexual problem. Among women, low desire (43%), vaginal lubrication (39%) and inability to climax (34%) were the most common issues; in men, erectile difficulties (37%) were the most common issue. In fact, 14% of male participants used supplements or medication to improve sexual function.

Overall, 38% of men and 22% of women reported having discussed sex with a physician since the age of 50.

Implications for practice

Older adults are sexually active and sexual problems are frequent among this age group, but are infrequently discussed. Increased knowledge among clinicians about sexuality at older ages can improve patient education and counseling, as well as increase the identification of prevalent health-related and treatable sexual problems, including sexually transmitted infections.

For further information

Link to Pubmed abstract: http://www.ncbi.nlm.nih.gov/pubmed/17715410

Acknowledgements

Dr. Richard Lester, Medical Head, STI/HIV Control, Clinical Prevention Services, BCCDC

Categories: Journal club

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