Sexual Activity and Physical Tenderness in Older Adults: Cross-Sectional Prevalence and Associated Characteristics

Abstract

Background Despite a common misconception, older adults engage in sexual behavior. However, there is limited sexual behavior research in older adults, which is often restricted to small samples, to cohorts recruiting adults from 45 years old, and to questions regarding only sexual intercourse. Aim To assess the cross-sectional prevalence of and characteristics associated with sexual activity and physical tenderness in community-dwelling older adults. Methods From the Rotterdam Study, sexual activity and physical tenderness were assessed in 2,374 dementia-free, community-dwelling men and women at least 65 years old from 2009 through 2012 in the Netherlands. Analyses were stratified by sex and partner status. Outcomes Sexual activity and physical tenderness (eg, fondling or kissing) in the last 6 months. Potential associated characteristics included measurements of demographics, socioeconomic position, health behavior, and health status. Results The vast majority of partnered participants (men, n = 858; women, n = 724) had experienced physical tenderness in the previous 6 months (83.7% of men and 82.9% of women) and nearly half had engaged in sexual activity (49.5% and 40.4% respectively). Very few unpartnered women (n = 675) had engaged in sexual activity (1.3%) or physical tenderness (5.2%), whereas prevalence rates were slightly higher for unpartnered men (n = 117; 13.7% or 17.1%). Engaging in sexual behavior was generally associated with younger age, greater social support, healthier behaviors, and better physical and psychological health. Clinical Implications Findings show that older adults engage in sexual activity. It is important not to assume that an older person is not interested in sexual pleasure or that an older person is unhappy with not having a sexual partner. Offering an opportunity for open discussion of sexuality and medical assistance without imposing is a difficult balance. We encourage health care professionals to proactively address sexuality and extend knowledge about safe sex and sexual function to older adults. Strengths and Limitations Thus far, this is one of the largest samples of sexual behavior assessment in adults older than 60 years. Limitations of this study are common in sexual behavior research, including low sexual behavior engagement among unpartnered older adults and a small sample of unpartnered men, which restricted sex- and age-specific implications. Conclusion Almost half of partnered older adults engaged in sexual activity and more than two thirds engaged in physical tenderness, but very few unpartnered older adults engaged in these behaviors. The greatest barrier to being sexually active at an older age is lack of a partner, which particularly affects women. Sexuality is an important aspect of active aging.

Emotional intimacy and sexual well-being in aging European couples: a cross-cultural mediation analysis

“…Secondly, studies have suggested that for many older adults, physical closeness and intimacy may be more important than sexual activity per se (Sandberg 2013;Müller et al 2014;Lee et al 2016;Fileborn et al 2017;Freak-Poli et al 2017). Based on findings from a large study of midlife and older adults' definitions of sexual wellness, Symes et al (2018) concluded that conceptualizing and measuring sexual wellness in this population requires a multidimensional approach that includes psychological, social, and attitudinal aspects in addition to sexual function and activity-related ones.…”

Seeking help for sexual difficulties: findings from a study with older adults in four European countries

“…In the past year, 30.4% had given or received oral sex and 2.9% had had anal sex with a female partner (Mercer et al 2013). While cultural factors and social mores shape sexual attitudes and behaviours (McLaren 2005), similar results about the sexual activity of older adults have been reported in the USA (Herbenick et al 2010), Australia (Heywood et al 2018), the Netherlands (Freak-Poli et al 2017), and Spain (Palacios-Ceña et al 2012). These findings indicate similairity in the levels of sexual activity of older adults, potentially on a global scale.…”

“…A substantial body of research indicates that the majority of older adults are sexually active and enjoy a range of sexual activities (DeLamater and Koepsel 2015;Fileborn et al 2015;Freak-Poli et al 2017). Sexual activity and intimacy have been found to contribute to the quality of life of older women and men in countries across the world (see Traeen et al 2017a, b).…”

The Rotterdam Study: 2018 update on objectives, design and main results

“…Sexual activity Almost half of partnered older adults engage in sexual activity and over two-thirds engage in physical tenderness, but very few unpartnered older adults engage in sexual behaviour [ 345 ]. The greatest barrier to being sexually active at older age is lack of sexual partner availability, for which women are particularly disadvantaged.…”