Sexuality and elderly with chronic diseases: A review of the existing literature.
BACKGROUND
Increased life expectancy and the growing phenomenon of aging can lead to increased burden of chronic diseases (CDs) which adversely affects the overall health of elderly, their sexuality in particular. Sexual life of an aged population is overlooked in many of the societies. In the present narrative review, we aim to assess the impact of CDs on sexual function of elderly people.


METHODS
We used internet databases including PubMed, EMBASE, ISI Web of Science, Google Scholar, SID, Iran Medex, Magiran, IPPF, and UNFPA without time limit. Ninety-eight out of 174 relevant articles were selected which met the inclusion criteria: those articles were research-based in English or Persian (original or review articles) and textbooks; specified one or more CDs and sexual function of the cases; elderly people over the age of sixty, men and women; and coordination between articles and research goals. We excluded qualitative and case studies. We reported the most related CDs with sexual function in literature review and used the biological and psychological impact of the CDs on sexual function of elderly population based on the conceptual model of Verschurenet al. (2010).


RESULTS
The results of the studies were classified into the themes including physical, psychological, and cultural and social. Diabetes, cardiovascular, cancerous, and chronic respiratory diseases and also some medications can reduce sexual capacity and desire in particular resulting in negative impact on the quality of elderly sexual life. CDs may influence sexual expressions and responses which adversely affect one's mood and energy so that can cause depression and grief, as well as loss of self-confidence, self-esteem, and self-concept in elderly adults. The factors affecting sexuality of an elderly with CDs include cultural and mythical beliefs about age and illnesses, fear, and embarrass of changed physical appearance. The research conducted among elderly population examining the adverse influence of CDs on aged people's sexual life in general, sexual function and performance, and intimate interaction.


CONCLUSIONS
It is considered that programs on sexual health needs of aged population for the health-care workers can prove beneficial in improving sexual health.
Sexologist, The Iranian National Centre for Addiction Studies (INCAS), Institution of Risk Behaviors Reduction, Tehran University of Medical Sciences, Tehran, Iran.
Effat
E
Merghati-Khoei
Department of Midwifery, Instructor, Iranshahr University of Medical Sciences, Iranshahr, Iran.
Arezoo
A
Pirak
Department of Midwifery, Reproductive Health PhD, Assistant Professor, Faculty Member of Nursing and Midwifery, Alborz University of Medical Sciences, Karaj, Iran.
Mansoureh
M
Yazdkhasti
Department of Reproductive Health, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran; Department of Midwifery, Instructor, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran.
Parvaneh
P
Rezasoltani
Aging; chronic diseases; review; sexuality