Knowledge of Sexuality and Aging

Abstract

Findings from recent national large scale surveys including National Social Life, Health, and Aging Project (NSHAP) and the American Association of Retired Persons (AARP) Survey of Midlife and Older Adults indicate that older adults report being sexually active well into their 80s and 90s, and that middle-aged and older adults engage in a wider variety of sexual behaviors including masturbation, anal sex, and sex with multiple partners than previously believed. Predictors of sexual activity for middle-aged and older adults include their prior levels of activity and satisfaction, the availability of a partner, particularly for women, and physical health including the presence of ED among men. Approximately 10% of older men and women report a sexual orientation other than heterosexual. Six percent of men and one percent of women indicate that they have multiple sex partners, with less than five percent of these individuals usually or always using condoms. Ethnic differences also appear in which Hispanic men report more frequent participation in vaginal sex than non-Hispanic men. Many middle aged and older adults are uninformed about the typical physiological changes associated with sexuality and aging; many do not know that ED is typically treatable, that masturbation can promote improved sexual lubrication and satisfaction in women, or that many commonly prescribed medications cause significant sexual side effects. Nearly half of middle-aged and older women and men fail to seek help for sexual problems, often due to fears of embarrassment and concerns about financial cost. However, more than half of those who do seek help from a professional report improvement in sexual function. A self-test for knowledge of sexuality and aging is included, as well as clear and specific recommendations for taking an appropriate sexual history among middle-aged and older clients.

APPENDIX: Knowledge Section of the ASKAS

These items from the ASKAS appear from White (1982) with permission.

Answer Key: T = True; F = False; DK = Don’t know

Correct answers are in BOLD.

• 1. T/F/DK Sexual activity in aged persons is often dangerous to their health.

• 2. T/F/DK Males over the age of 65 typically take longer to attain an erection of their penis than do younger males.

• 3. T/F/DK Males over the age of 65 usually experience a reduction in intensity of orgasm relative to younger males.

• 4. T/F/DK The firmness of erection in aged males is often less than that of younger persons.

• 5. T/F/DK The older female (65+ years of age) has reduced vaginal lubrication secretion relative to younger females.

• 6. T/F/DK The aged female takes longer to achieve adequate vaginal lubrication relative to younger females.

• 7. T/F/DK The older female may experience painful vaginal intercourse due to reduced elasticity of the vagina and reduced vaginal lubrication.

• 8. T/F/DK Sexuality is typically a lifelong need.

• 9. T/F/DK Sexual behavior in older people increases the risk of heart attack.

• 10. T/F/DK Most males over the age of 65 are unable to engage in sexual intercourse.

• 11. T/F/DK The relatively more sexually active younger people tend to become the relatively more sexually active older people.

• 12. T/F/DK There is evidence that sexual activity in older persons has beneficial physical effects on the participants.

• 13. T/F/DK Sexual activity may be psychologically beneficial to older person participants.

• 14. T/F/DK Most older females are sexually unresponsive.

• 15. T/F/DK The sex urge typically increases with age in males over 65.

• 16. T/F/DK Prescription drugs may alter a person’s sex drive.

• 17. T/F/DK Females, after menopause, have a physiologically induced need for sexual activity.

• 18. T/F/DK Basically, changes with advanced age (65+) in sexuality involve a slowing of response time rather than a reduction of interest in sex.

• 19. T/F/DK Older males typically experience a reduced need to ejaculate and hence may maintain an erection of the penis for a longer time than younger males.

• 20. T/F/DK Older males and females cannot act as sex partners as both need younger partners for stimulation.

• 21. T/F/DK The most common determinant of the frequency of sexual activity in older couples is the interest or lack of interest of the husband in a sexual relationship with his wife.

• 22. T/F/DK Barbiturates, tranquilizers, and alcohol may lower the sexual arousal levels of aged persons and interfere with sexual responsiveness.

• 23. T/F/DK Sexual disinterest in aged persons may be a reflection of a psychological state of depression.

• 24. T/F/DK There is a decrease in frequency of sexual activity with older age in males.

• 25. T/F/DK There is a greater decrease in male sexuality with age than there is in female sexuality.

• 26. T/F/DK Heavy consumption of cigarettes may diminish sexual desire.

• 27. T/F/DK An important factor in the maintenance of sexual responsiveness in the aging male is the consistency of sexual activity throughout his life.

• 28. T/F/DK Fear of the inability to perform sexually may bring about an inability to perform sexually in older males.

• 29. T/F/DK The ending of sexual activity in old age is most likely and primarily due to social and psychological causes rather than biological and physical causes.

• 30. T/F/DK Excessive masturbation may bring about an early onset of mental confusion and dementia in the aged.

• 31. T/F/DK There is an inevitable loss of sexual satisfaction in postmenopausal women.

• 32. T/F/DK Secondary impotence (or non-physiologically caused) increases in males over the age of 60 relative to younger males.

• 33. T/F/DK Impotence in aged males may literally be effectively treated and cured in many instances.

• 34. T/F/DK In the absence of severe physical disability, males and females may maintain sexual interest and activity well into their 80s and 90s.

• 35. T/F/DK Masturbation in older males and females has beneficial effects on the maintenance of sexual responsiveness.