Download Prevalence of Sexual Activity in Older Adults

Prevalence of Sexual Activity in
Older Adults
Gerontology 410
Lecture number 2
Jan 2008
Sexual Surveys
• Vancouver Sun Oct 6th 2007-A Peek into the
Bedrooms of the Region-an Angus Reid Poll
• The report suggests a generational divide at age 55
and up. More than half of those surveyed report not
having sex in the last 30 days with about 14% still
having sex about six times a month. Those coming of
age during the fifties and sixties have had fewer sex
partners over the course of their lives increasing as
we move to those who came of age during the
Trudeau years.
Surveys
• 1,571 people were surveyed in the poll living in the
lower Mainland. Results show that the 35-54 year
old group have exposure to sex before marriage,
casual sex, multiple partners, someone at work. This
is a small percentage of those surveyed in this age
group with 75% falling below the average responses.
Women are twice as likely to admit a same sex
encounter. There seems to be a good deal of
confabulation effect in the figures according to the
pollsters.
Surveys
• For the 55 plus group, 75% had sex during their
teenage years and 5% before they were 16. Today
they are having sex less frequently and 50% are not
sexual at all. Only 7% said they were having Internet
sex. The group surveyed having sex 11 times or
more a month is about 4% of the sample, with
satisfaction levels at about 56%. They are less likely
to have casual sex, or use gadgets. However they are
more likely to have sex with a married person who is
not their spouse.
Surveys
• The poll showed people having sex on average about
4 times a month in married or committed
relationships.
• 66% would like more men more than women. About
60% are satisfied with their sex lives and this is
directly related to household income. 79% of those
surveyed count sex as important even though we
have a large number of seniors interviewed who
were essentially asexual.
Surveys
• What should the surveys measure? In Males, the
reasons for declining activity, cultural expectations,
interest, desirability and attitudes. In Women, sexual
activity with younger partners, sexual drive,
lessening of social constraints, freedom from
reproductive concerns, lessening of desire and value
as a wife. We must also look at sexual activity among
the widowed and divorced. Some studies have
looked at the type of activity such as non-coital,
versus intercourse and its negative relationship with
self-esteem.
Surveys
• Caucasian women perceive higher levels of sexual
disinterest in their partners than do the males of the
same group.
• What will impact Prevalence? In older women,
painful intercourse, dyspareunia (painful sexual
intercourse due to multiple causes. Some are
psychosocial in nature due to prior traumatic
experiences),diminished desire, lack of interest. In
older men erectile dysfunction, loss of desire, lack of
orgasm, prostate disease.
Surveys
• Older adults may curtail their sexual behavior simply
because they have not had the options presented.
Cardiovascular disease can manifest itself as HTN,
CAD, dysrhythmias, heart failure, diminished vascular
function and therefore diminishes sexual function in
men, and most likely in women. Endocrine and
metabolic disorders common in the elderly will also
impact sexual function and therefore sexual
prevalence. Incontinence is also a factor in both
sexes.
Surveys
• The surgical treatment for prostate cancer, the
medication for a variety of urinary diseases,
depression, will cause sexual dysfunction. We have a
families of drugs such as neuroleptics, tranquilizers
and anti-depressants which impact both desire and
function. Chronic obstructive pulmonary disease will
affect stamina and interfere with sexual pleasure and
activity.
• Psychosocial factors which affect both sexual
behavior and sexual activity
Surveys
• Body image and perceived sexual attractiveness due
to age associations
• Negative cultural stereotypes
• Restrictive beliefs about aging and sexuality
• Belief that intercourse is the only sexual activity
available.
• Role changes due to disability or illness
• Mood disorders and substance abuse.
Surveys
• Special Populations
• Long Term Care Residents-Very few empirical studies,
but indications are that residents are sexually active
but lack opportunity, privacy and a partner. In
addition factors of poor health, feeling sexually
inadequate and undesirable and guilt for having
sexual feelings all contribute to overall prevalence of
sexual activity. Staff still feel uncomfortable
discussing, assisting the disabled, or negotiating an
appropriate environment for sexual activity.
Surveys
• Residents who may have explicit sexual materials in
their rooms may not be approved
• Residents who need access for counseling or
evaluation of their sexual problems may not have
access to resources. Even with staff education and
more permissive attitudes there is little evidence on
the impact of resident behavior.
• The prevalence of sexual activity for those residents
with dementia will be discussed separately but the
focus is around three key issues.
Surveys
•
•
•
•
Awareness of the relationship
Ability to avoid exploitation
Awareness of the potential risks
Overarching these concerns is the issue of informed
consent and the discomfort partners feel towards a
spouse with cognitive impairment as the nature of
the relationship has often undergone significant
changes.
Summary
• Most older adults report a steady level of interest in
sexual activity, satisfaction with that activity
(accounting for individual differences) and an
understanding that changes in health functioning
and socio-cultural attitudes may affect their sexual
patterns. Issues such as psychological well-being, role
changes and institutionalization are key factors.
• Many surveys are of well-educated, healthy
individuals and not sub-groups such as ethnic
minorities, different socio-economic groups,
gay/lesbian and bisexual older adults.