Prevalence of sexual activity and associated factors in men aged 75 to 95 years: a cohort study.
BACKGROUND
Knowledge about sexuality in elderly persons is limited, and normative data are lacking.


OBJECTIVE
To determine the proportion of older men who are sexually active and to explore factors predictive of sexual activity.


METHODS
Population-based cohort study.


METHODS
Community-dwelling men from Perth, Western Australia, Australia.


METHODS
3274 men aged 75 to 95 years.


METHODS
Questionnaires from 1996 to 1999, 2001 to 2004, and 2008 to 2009 assessed social and medical factors. Sex hormones were measured from 2001 to 2004. Sexual activity was assessed by questionnaire from 2008 to 2009.


RESULTS
A total of 2783 men (85.0%) provided data on sexual activity. Sex was considered at least somewhat important by 48.8% (95% CI, 47.0% to 50.6%), and 30.8% (CI, 29.1% to 32.5%) had had at least 1 sexual encounter in the past 12 months. Of the latter, 56.5% were satisfied with the frequency of activity, whereas 43.0% had sex less often than preferred. In cross-sectional analyses, increasing age, partner's lack of interest, partner's physical limitations, osteoporosis, prostate cancer, diabetes, antidepressant use, and β-blocker use were independently associated with reduced odds of sexual activity. Living with a partner and having a non-English-speaking background were associated with increased odds. In longitudinal analyses, higher testosterone levels were associated with increased odds of being sexually active. Other factors were similar to the cross-sectional model.


CONCLUSIONS
Response bias may have influenced findings because sexuality can be a sensitive topic. Attrition may have resulted in a healthier-than-average sample of older men.


CONCLUSIONS
One half of elderly men consider sex important, and one third report being sexually active. Men's health problems were associated with lack of sexual activity. Key modifiable risk factors include diabetes, depression, and medication use. Endogenous testosterone levels predict sexual activity, but the role of testosterone therapy remains uncertain.


BACKGROUND
National Health and Medical Research Council of Australia.
Western Australian Centre for Health and Ageing, Centre for Medical Research, Western Australian Institute for Medical Research, School of Medicine and Pharmacology, School of Psychiatry and Clinical Neurosciences, University of Western Australia, Crawley, Australia. zoe@sexologyresearch.org
Zoë
Z
Hyde
Leon
L
Flicker
Graeme J
GJ
Hankey
Osvaldo P
OP
Almeida
Kieran A
KA
McCaul
S A Paul
SA
Chubb
Bu B
BB
Yeap
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D003430:Cross-Sectional Studies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D009042:Motivation; D015995:Prevalence; D012725:Sexual Behavior / Q000523:psychology / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D013739:Testosterone / Q000097:blood; D014904:Western Australia / Q000453:epidemiology
D013739:Testosterone