title: Sexual Health and Well-being Among Older Men and Women in England: Findings from the English Longitudinal Study of Ageing.
abstract: We describe levels of sexual activity, problems with sexual functioning, and concerns about sexual health among older adults in the English Longitudinal Study of Ageing (ELSA), and associations with age, health, and partnership factors. Specifically, a total of 6,201 core ELSA participants (56 % women) aged 50 to >90 completed a comprehensive Sexual Relationships and Activities questionnaire (SRA-Q) included in ELSA Wave 6 (2012/13). The prevalence of reporting any sexual activity in the last year declined with age, with women less likely than men at all ages to report being sexually active. Poorer health was associated with lower levels of sexual activity and a higher prevalence of problems with sexual functioning, particularly among men. Difficulties most frequently reported by sexually active women related to becoming sexually aroused (32 %) and achieving orgasm (27 %), while for men it was erectile function (39 %). Sexual health concerns most commonly reported by women related to their level of sexual desire (11 %) and frequency of sexual activities (8 %). Among men it was level of sexual desire (15 %) and erectile difficulties (14 %). While the likelihood of reporting sexual health concerns tended to decrease with age in women, the opposite was seen in men. Poor sexual functioning and disagreements with a partner about initiating and/or feeling obligated to have sex were associated with greater concerns about and dissatisfaction with overall sex life. Levels of sexual activity decline with increasing age, although a sizable minority of men and women remain sexually active until the eighth and ninth decades of life. Problems with sexual functioning were relatively common, but overall levels of sexual health concerns were much lower. Sexually active men reported higher levels of concern with their sexual health and sexual dissatisfaction than women at all ages. Older peoples' sexual health should be managed, not just in the context of their age, gender, and general health, but also within their existing sexual relationship.
authors.affiliation: Cathie Marsh Institute for Social Research, The University of Manchester, Humanities Bridgeford Street, Oxford Road, Manchester, M13 9PL, UK. david.m.lee@manchester.ac.uk.
authors.forename: David M
authors.initials: DM
authors.lastname: Lee
authors.affiliation: Cathie Marsh Institute for Social Research, The University of Manchester, Humanities Bridgeford Street, Oxford Road, Manchester, M13 9PL, UK.
authors.forename: James
authors.initials: J
authors.lastname: Nazroo
authors.affiliation: Institute of Psychological Sciences, University of Leeds, Leeds, UK.
authors.forename: Daryl B
authors.initials: DB
authors.lastname: O'Connor
authors.affiliation: NatCen Social Research, London, UK.
authors.forename: Margaret
authors.initials: M
authors.lastname: Blake
authors.affiliation: Institute of Brain, Behaviour and Mental Health, The University of Manchester, Salford, UK.
authors.forename: Neil
authors.initials: N
authors.lastname: Pendleton
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology / Q000523:psychology; D003075:Coitus; D004739:England / Q000453:epidemiology; D005260:Female; D006801:Humans; D007989:Libido; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D015995:Prevalence; D060728:Reproductive Health; D012725:Sexual Behavior / Q000706:statistics & numerical data*; D012735:Sexual Dysfunction, Physiological / Q000453:epidemiology*; D012747:Sexual Partners; D019529:Sexuality / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires
keywords: Aging; Chronic illness; ELSA; Population-based; Sexual function; Sexual health