Intimacy Among Older Americans

New Light is being shed on the intimate lives of older Americans.
Older Adults Are Active Despite Increased Sexual Problems with Age
A majority of older Americans are sexually active and view intimacy
as an important part of life, despite a high rate of "bothersome"
sexual problems.

Bothersome problems include chronic health conditions such as
arthritis, diabetes and hypertension; relationships between physical
health problems or limitations generally and sexual activity; and
physician communication about sexuality at older ages. Physical
health was more strongly associated with many
sexual problems than age alone.

Even sexually transmitted diseases are still a concern among older Americans. For instance, approximately 15 percent of newly diagnosed HIV infections are among Americans over age 50.

This portrait of the older Americans' lives 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.

In general, older adults are sexually active. A large portion of
respondents said they were sexually active in the preceding 12
months, but the percentage declined with age -- from 73 percent of
those age 57 to 64, to 53 percent of those age 65 to 74, to 26
percent of those age 75 to 85. Older women, however, were
significantly less likely to report sexual activity than older men
and less likely to be in intimate relationships, due in part to
women's status as widows and the earlier mortality, on average, of
men.

Healthier people are more likely to report being sexually active.
Eighty-one percent of men and 51 percent of women reporting excellent
or very good health said they had been sexually active in the past 12
months. Of those in fair or poor health, a considerably lower
percentage (47 percent of men and 26 percent of women) reported
activity in the previous year. Diabetes and hypertension were
strongly associated with some sexual concerns.

About half of sexually active older adults report at least one
"bothersome" sexual problem. Thirty-seven percent of sexually active
men said they had erectile difficulties. Women most often reported the following:

• low desire (43 percent),
• difficulty with vaginal lubrication (39 percent), and
• inability to climax (34 percent).

Most older adults have not discussed sex with their doctors. Despite
the high prevalence of sexual problems, only 38 percent of men and 22
percent of women said they had discussed sex with a physician since
age 50.

This information highlights the importance of not dismissing sexual concerns as relevant to older Americans. Additionally, physicians need to be more proactive with their older patients.