The link between cognitive function and sexuality in older adults

September 21, 2018

Science Daily/American Geriatrics Society

Researchers learn more about the relationship between sexual behavior, function, and cognition (people's ability to think and make decisions).

Experts agree that we know very little about sexuality among people living at home with AD or other cognitive problems. Older adults who have cognitive problems that impact the way they think and make decisions may ask physicians to help managing sexual problems. And caregivers may ask physicians about sexuality in the older adults for whom they provide care.

One frequently asked question is: Do older adults always have the capacity to consent to sexual activity?

Researchers have previously shown that the majority of people aged 57 to 85 have a spouse or other intimate partner and, among those with a partner, most are sexually active. Having an active sexual life is linked to better physical and mental health, higher quality of life, and lower rates of loneliness.

To learn more about the connection between sexuality and cognitive status, researchers designed a new study. They analyzed data from the National Social Life, Health, and Aging Project to learn more about the relationship between sexual behavior, function, and cognition (people's ability to think and make decisions). Their study was published in the Journal of the American Geriatrics Society.

Based on their study, the researchers reported that:

- 83 percent of men and 57 percent of women had an intimate partner. The more impaired participants' abilities to think and make decisions were, the less likely they were to have an intimate partner.

- Women with lower cognitive scores were less likely than men with lower cognitive scores to have intimate partners.

- Nearly half of all men with dementia were sexually active, as were 18 percent of women.

- Among people with an intimate partner, the majority of men (59 percent) and women (51 percent) with dementia were sexually active. More than 40 percent of partnered men and women ages 80 to 91 living with dementia were sexually active.

- More than 1 in 10 people living with a partner reported feeling threatened or frightened by a partner. This finding was similar among women and men and across different levels of cognitive problems. Experts and guidelines call on physicians to screen for elder abuse (the mistreatment of older people, which can take many forms, including physical, emotional, and sexual abuse, financial exploitation, and neglect), including sexual abuse, but definitions of abuse and standards of consent for sex vary widely.

The researchers estimate that, among people living at home who are aged 62 and older, at least 1.8 million men and 1.4 million women with suspected or diagnosed dementia are sexually active. This number will more than double by 2050. However, rarely do these people (especially women) receive a physician's counseling about sexual changes that may occur with dementia or other medical conditions.

The researchers suggested that these findings can inform improved counseling, treatment, and person-centered decision-making by physicians and other healthcare providers caring for people with dementia or Alzheimer's disease.

Sexual activity is an important aspect of human function throughout your lifetime, said the researchers. They added that respectful care for older adults, including people with cognitive impairments, requires an understanding of sexual norms and problems -- and effective strategies to manage sexual concerns with dignity.

https://www.sciencedaily.com/releases/2018/09/180921113453.htm

Sex after 65: Poll finds links to health, gender differences, lack of communication

Majority are satisfied with their sex lives; nearly 1 in 5 older men use medications or supplements, U-M/AARP National Poll on Healthy Aging finds

May 3, 2018

Science Daily/Michigan Medicine - University of Michigan

A new poll busts stereotypes about the sex lives of older Americans -- and reveals gender and health-related divides on key aspects of sexual health, while highlighting the need for more people to talk with their health providers about sexual issues.

Forty percent of people between the ages of 65 and 80 are sexually active, according to the new findings from the National Poll on Healthy Aging. Nearly three-quarters of people in this age range have a romantic partner and 54 percent of those with a partner are sexually active.

Whether or not they have an active sex life, nearly two-thirds of older adults say they're interested in sex, and more than half say sex is important to their quality of life.

And when asked if they are satisfied with their current sex life, 73 percent of the nationally representative sample of 1,002 people polled said they were. The poll was conducted by the University of Michigan Institute for Healthcare Policy and Innovation, and sponsored by AARP and Michigan Medicine, U-M's academic medical center.

The poll explored how older adults might seek help or advice for sexual problems, and if they've talked with their doctors about their sexual health.

In all, 18 percent of older men and 3 percent of older women say they've taken medications or supplements to improve sexual function in the past two years. But only 17 percent of older adults said they have talked with their doctor or other health care provider about sexual health in the past two years. Most who had engaged in such discussions said they brought the topic up, suggesting the need for more proactive conversations by clinicians with their older patients.

"Sexual health among older adults doesn't get much attention but is linked closely to quality of life, health and well-being," says U-M's Erica Solway, Ph.D., co-associate director of the poll. "It's important for older adults and the clinicians who care for them to talk about these issues and about how age-related changes in physical health, relationships, lifestyles and responsibilities such as caregiving, affect them."

Gender, age and health status divides

Solway notes that the poll finds some sharp differences along health, age and gender lines.

For instance, compared with the 45 percent of respondents with excellent, very good, or good health who reported they were sexually active, only 22 percent of those who said they are in fair or poor health were sexually active. Only 28 percent of those with fair or poor health said they were extremely or very satisfied with their sex lives.

There are also differences within age groups. Those between the ages of 65 and 70 were nearly twice as likely as those in their late 70s to be sexually active. One-third of those in their late 60s said they were extremely or very interested in sex, compared with 19 percent of those in their late 70s.

The gender gaps that emerged reveal some differences that may create challenges for relationships. For instance, women were less likely than men to be sexually active -- 31 percent overall, compared with 51 percent of men -- but were more likely to be extremely or very satisfied with their sex lives. And while 84 percent of older men said sex was an important part of a romantic relationship, 69 percent of older women agreed with that statement.

But the biggest gender difference was the percentage of those who said they were extremely or very interested in sex. Half of men aged 65 to 80 said they had this level of interest, compared with just 12 percent of women in the same age range.

"This survey just confirms that the need for and interest in sexual intimacy doesn't stop at a certain age," says Alison Bryant, Ph.D., senior vice president of research for AARP. "Although most older adults say that they would talk with their doctor about sexual concerns, health care providers should routinely be asking all of their older patients about their sexual health and not assume that bringing up the issue will offend or embarrass them."

A key takeaway from the poll, Solway notes, is that there appears to be opportunity for more proactive conversations between providers and their older patients about sexual health.

In all, 62 percent of the older adults polled said that if they were having a problem with their sexual health, they would talk with their health provider about it, yet only 17 percent had actually done so in the past two years. The majority (88 percent) of those who had talked with their provider about their sexual health said they were comfortable doing so.

The poll results are based on answers from a nationally representative sample of 1,002 people ages 65 to 80. The poll respondents answered a wide range of questions online. Questions were written, and data interpreted and compiled, by the IHPI team. Laptops and Internet access were provided to poll respondents who did not already have it.

A full report of the findings and methodology is available at http://www.healthyagingpoll.org, along with past National Poll on Healthy Aging reports.

https://www.sciencedaily.com/releases/2018/05/180503085606.htm