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A Study of Sexuality and Health among Older Adults in the United States
Open accessAbstract
BACKGROUND: Despite the aging of the population, little is known about the sexual behaviors and sexual function of older people. METHODS: We report the prevalence of sexual activity, behaviors, and problems in a national probability sample of 3005 U.S. adults (1550 women and 1455 men) 57 to 85 years of age, and we describe the association of these variables with age and health status. RESULTS: The unweighted survey response rate for this probability sample was 74.8%, and the weighted response rate was 75.5%. The prevalence of sexual activity declined with age (73% among respondents who were 57 to 64 years of age, 53% among respondents who were 65 to 74 years of age, and 26% among respondents who were 75 to 85 years of age); women were significantly less likely than men at all ages to report sexual activity. Among respondents who were sexually active, about half of both men and women reported at least one bothersome sexual problem. The most prevalent sexual problems among women were low desire (43%), difficulty with vaginal lubrication (39%), and inability to climax (34%). Among men, the most prevalent sexual problems were erectile difficulties (37%). Fourteen percent of all men reported using medication or supplements to improve sexual function. Men and women who rated their health as being poor were less likely to be sexually active and, among respondents who were sexually active, were more likely to report sexual problems. A total of 38% of men and 22% of women reported having discussed sex with a physician since the age of 50 years. CONCLUSIONS: Many older adults are sexually active. Women are less likely than men to have a spousal or other intimate relationship and to be sexually active. Sexual problems are frequent among older adults, but these problems are infrequently discussed with physicians.
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In the citing paper
“In the past few years, however, a number of well-publicized studies have investigated the sexual activity of those as old as 94.”
From Medicalization and the Refashioning of Age-Related Limits on Sexuality (2012) · cites this paper as Lindau et al., 2007
Experimental — accuracy not yet measuredIn the citing paper
“Thus, interpretation of the results of this study is dif fi cult, because diabetes a risk factor for sexual dysfunction.”
From Incidence and Prevalence of Sexual Dysfunction in Women and Men: A Consensus Statement from the Fourth International Consultation on Sexual Medicine 2015 (2016) · cites this paper as [31]
In the citing paper
“The only study by Lindau et al 31 presenting a relatively higher prevalence of arousal dif fi culties (ie, lubrication) of 41.9% was conducted in patients with diagnosed and undiagnosed diabetes.”
From Incidence and Prevalence of Sexual Dysfunction in Women and Men: A Consensus Statement from the Fourth International Consultation on Sexual Medicine 2015 (2016) · cites this paper as [31]
In the citing paper
“Nevertheless, in Australia, 19 Sweden, 17 the United States, 16,22,31 and Canada 32 the prevalence of orgasmic dysfunction seems to be approximately 16% to 25%”
From Incidence and Prevalence of Sexual Dysfunction in Women and Men: A Consensus Statement from the Fourth International Consultation on Sexual Medicine 2015 (2016) · cites this paper as [31]
In the citing paper
“Orgasmic dysfunction also was higher for older women in the Iranian and U.S. samples.”
From Incidence and Prevalence of Sexual Dysfunction in Women and Men: A Consensus Statement from the Fourth International Consultation on Sexual Medicine 2015 (2016) · cites this paper as [31]
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“Undiagnosed or untreated sexual problems are associated with depression or social isolation (Lindau et al. 2007).”
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Lin, T., Fischer, H., Johnson, M. K., & Ebner, N. C. (2019) · Cognition & Emotion · doi:10.1080/02699931.2019.1694491 · Cited by 23
“In contrast, as people age, forming new friendships and finding a partner are typically not primary social goals (Fredrickson & Carstensen, 1990; Lindau et al., 2007).”
BackgroundLu, M., Zeng, W., Jü, R., Li, S., & Yang, X. (2020) · Urogynecology · doi:10.1097/spv.0000000000000900 · Cited by 22
Olfaction Is Associated With Sexual Motivation and Satisfaction in Older Men and Women
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New horizons in erectile and endothelial dysfunction research and therapies
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Altschuler, J., & Rhee, S. (2015) · Journal of Women & Aging · doi:10.1080/08952841.2014.954499 · Cited by 22
“…with sexual communication (Winningham et al., 2004; Zablotsky & Kennedy, 2003), lack of knowledge (Altschuler, Katz, & Tynan, 2004), lack of perceived relevance due to menopause (Lindau et al., 2007), reliance on monogamy for protection (Savasta, 2004; Stampley, Mallory, & Gabrielson, 2005).”
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Sexuality and Quality of Life in Aging: Implications for Practice
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“Research on sexuality and older age has shown that sexual needs persist throughout the lifecycle, and that older people can express their sexual interests through many different sexual activities (Lindau et al., 2007; Palacios-Cena et al., 2012) which, in turn, may benefit their health and well-being (Weeks, 2002).”
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“Intimate relationships in later life are also predicted by physical and psychological health (Lindau et al., 2007), including a variety of physical health conditions (DeLamater & Sill, 2005), as well as self-rated physical and mental health (Karraker & DeLamater, 2013; Karraker, DeLamater, &…”
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“Some studies suggest that changes in women’s physical and mental health may play an important role in determining whether they remain engaged in and satisfied with sexual activity as they age.(3,5) However, it was inferred that women with diseases implying fewer physical impediments related to pain, able to carry out…”
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“…people tend to focus on the effects of physical health on sexuality in older age or on sexual difficulties (Laumann et al. 2005; Lee et al. 2016; Lindau et al. 2007; Moreira et al. 2008; Nicolosi et al. 2004) and have rarely examined issues relating to STIs, safer-sex practices or broader…”
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“%) were sexually active in the previous year (Lindau et al., 2007).”
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ResultGrowing Older Out of the Closet: A Descriptive Study of Older LGB Persons Living in Lisbon, Portugal
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“Greater than half of the sample is sexually active (consistent with the findings of Lindau et al., 2007 with a large national probability sample of primarily heterosexual older adults), with no significant differences between men and women.”
ResultThe Cambridge Handbook of the International Psychology of Women
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“As reported by Lindau and colleagues [45], although older women state that they have multiple sexual concerns such as a lack of sexual desire, these problems are seldom discussed with their physicians, who, as suggested by the aforementioned authors, should make an effort to become involved in their patients’ educatio…”
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Background“Feeling Poor”: Perceived Economic Position and Environmental Mastery Among Older Americans
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“The final unweighted response rate was 74.8% (Lindau et al., 2007).”
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“Physician–patient communication concerning sexuality is generally poor [12].”
BackgroundThe Jahnigen Scholars Program: A Model for Faculty Career Development
Katz, P. R., Burton, J. R., Drach, G. W., O’Leary, J. P., Strasser, D. C., Eisner, J., Haranas, E., Silverman, R., & Lundebjerg, N. E. (2009) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.2009.02551.x · Cited by 20
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“…a number of variables that could conceivably be associated with comfort discussing sex with a doctor and marital quality, based on existing theory and research (Burman & Margolin, 1992; Das, 2007; Laumann et al., 1994; Lindau et al., 2006; Lindau et al., 2007; Warner & Kelley-Moore, 2012).”
BackgroundResultDiminution du désir sexuel et déficit en testostérone chez l’homme
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“Although aging may be associated with a decline in sexual activity, many women and men remain sexually active into their 70s and 80s [23, 31–33].”
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“Assuming a prevalence of sexual ideation of 50% (based on Lindau et al [16]), our analysis achieved 90% power to detect a difference of 10% in sexual ideation with a significance level (α) of 0.”
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“Core contributions to the sex therapy field, the sensate focus exercises developed by Masters and Johnson (1970), continue to represent the sex therapy strategy most adopted by non-sex therapy clinicians in their work with couples.”
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Social Capital and Sexual Risk-Taking Behaviors Among Older Adults in the United States
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“This corroborates previous finding that sexual desire, frequencies, and partners are typically greater for older men than women (Lindau et al., 2007; Patel et al., 2003).”
BackgroundResultInfluentialHealth-Related Lifestyle Factors and Sexual Functioning and Behavior in Older Adults
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“Sexual activity and fulfilment is an important component of quality of life in older adults (Lindau et al., 2007; Mitchell et al., 2013).”
BackgroundSexual Dysfunction in Men and Women
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Sex after 60? You've got to be joking! Senior sexuality in comedy film
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“A largeUS study of approximately 3000 participants demonstrated that being ‘old’ does not herald the end of sexual desires, interest or activity (Lindau et al., 2007).”
BackgroundClinical Manual of Sexual Disorders
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Climacteric symptoms in middle-aged women with chronic somatic diseases
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“In fact, the extant literature (both older and newer) clearly indicates that older adults are not only interested in sexual activity (Busse et al., 1985; DeLamater & Sill, 2005; Lindau et al., 2007) but also engage in sexual activity (Bretschneider & McCoy, 1988; Clements, 1996; Diokno, Brown, & Herzog, 1990; Jacoby,…”
BackgroundA Study on Body Image, Sexual Satisfaction, and Marital Adjustment in Middle-Aged Married Women
Babayan, S., Saeed, B. B., & Aminpour, M. (2018) · Journal of Adult Development · doi:10.1007/s10804-018-9292-2 · Cited by 19
Flotyńska, J., Uruska, A. A., Michalska, A., Araszkiewicz, A., & Zozulińska‐Ziółkiewicz, D. (2019) · Journal of Sex & Marital Therapy · doi:10.1080/0092623x.2019.1610121 · Cited by 19
“There are common risk factors associated with SD among women, which include ageing (Lindau et al., 2007), cardiovascular diseases (Eyada & Atwa, 2007), diabetes mellitus (Abu Ali, Al Hajeri, Khader, Shegem, & Ajlouni, 2008; McCabe et al., 2016), hypertension (Doumas et al., 2006), genitourinary…”
BackgroundCarvalheira, A. A., Graham, C. A., Štulhofer, A., & Træen, B. (2019) · European Journal of Ageing · doi:10.1007/s10433-019-00540-y · Cited by 20
Quality of life and patient reported symptoms after colorectal cancer in a Swedish population
Sjövall, A., Lagergren, P., Johar, A. M., & Buchli, C. (2022) · Colorectal Disease · doi:10.1111/codi.16332 · Cited by 19
“It has been shown, however, that sexual activity decreases and sexual problems increase with age [40] and CRC is mainly a disease of the elderly.”
BackgroundSexual health and wellbeing and the menopause: An EMAS clinical guide
Paschou, S. Α., Athanasiadou, K. I., Hafford‐Letchfield, T., Hinchliff, S., Mauskar, M., REES, M. C. P., Simon, J. A., Armeni, E., Erel, C. T., Fistonić, I., et al. (2024) · Maturitas · doi:10.1016/j.maturitas.2024.108055 · Cited by 21
Kenny, J. M., Mulenga, V., Hoskins, S., Scholten, F., & Gibb, D. M. (2012) · AIDS · doi:10.1097/qad.0b013e32835bddfc · Cited by 19
“Older people may have a delayed HIV diagnosis and delay in starting ART; they are also less likely to use HIV testing and counselling services (reduced awareness of the existence of services), due to increased stigma (especially women), poorer access or because they do not perceive themselves to be at risk of HIV [106…”
BackgroundVieillissement sexuel : mythes et réalités biologiques
Bondil, P. (2008) · Sexologies · doi:10.1016/j.sexol.2008.06.001 · Cited by 19
Turki, Y. A. A. (2009) · International Journal of Impotence Research · doi:10.1038/ijir.2009.36 · Cited by 19
Attitudes and Stereotypes Regarding Older Women and HIV Risk
Beaulaurier, R. L., Fortuna, K. L., Lind, D., & Emlet, C. A. (2014) · Journal of Women & Aging · doi:10.1080/08952841.2014.933648 · Cited by 19
“Many older adults remain sexually active into their 80s (Addis et al., 2006; Lindau et al., 2007; Schick et al., 2010).”
BackgroundInfluentialSexual life of women in the climacterium: A community-based study
Andac, T., & Aslan, E. (2017) · Health Care For Women International · doi:10.1080/07399332.2017.1352588 · Cited by 21
“in a study on 1550 women and 1455 men aged 57–85 years found that the most common sexual problems in the women were loss of desire (43%), loss of lubrication (39%), and difficulty in reaching orgasm (34%) (Lindau et al., 2007).”
BackgroundThe relationship between sexual activity and sexual attitudes among breast cancer survivors in China
Yan, R., Yu, J., Tanimoto, T. E., Ozaki, A., Lu, X., Che, B., Zhang, Y., Chen, P., & Wang, J. (2020) · Cancer Medicine · doi:10.1002/cam4.2874 · Cited by 19
Understanding the Role of Voluntary Counseling and Testing (VCT) in HIV Prevention in Nantong, China
Xu, Z., Ma, P., Chu, M., Chen, Y., Miao, J., Xia, H., & Zhuang, X. (2020) · BioMed Research International · doi:10.1155/2020/5740654 · Cited by 19
“In fact, evidence showed that many older people remained sexually active despite the public preconception about a lack of sexual behaviors in this group [27].”
BackgroundInsufficient Assessment of Sexual Dysfunction: A Problem in Gynecological Practice
Briedīte, I., Ancāne, G., Ancāns, A., & Erts, R. (2013) · Medicina · doi:10.3390/medicina49070049 · Cited by 21
Astle, S. M., Anders, K. M., McAllister, P., Hanna‐Walker, V. R., & Yelland, E. L. (2023) · The Journal of Sex Research · doi:10.1080/00224499.2023.2244937 · Cited by 22
“…and sexual self-schema of aging adults is also crucial, especially as many individuals in late adulthood remain sexually active and interested in engaging in sexual activity (Hubbard et al., 2003; Lindau et al., 2007) and experience benefits from doing so (Hartmans et al., 2014; Syme, 2014).”
Taylor, T., Weedon, J., Golub, E. T., Karpiak, S. E., Gandhi, M., Cohen, M. H., Levine, A. M., MINKOFF, H. L., Adedimeji, A., Goparaju, L., et al. (2014) · AIDS and Behavior · doi:10.1007/s10461-014-0901-1 · Cited by 18
“038); HIV?/detectable women versus HIV-uninfected women (F [1,3966] = 3.”
InfluentialTang, Z., Cui, K., Luan, Y., Ruan, Y., Wang, T., Yang, J., Wang, S., Liu, J., & Wang, D. (2018) · Andrology · doi:10.1111/andr.12512 · Cited by 18
“ED is a common age-associated disease that affects the male quality of life worldwide (Lindau et al., 2007).”
BackgroundZhang, C.-L., Quan, Y., Li, H., Li, H., Bai, W.-J., Xu, T., & Zhang, X.-W. (2022) · Asian Journal of Andrology · doi:10.4103/aja20223 · Cited by 18
Ren, N., Li, Y., Wan, Z., Wang, R., Zhang, W., Dzakah, E. E., Zhang, J., Li, A., & Fan, S. (2022) · JMIR Public Health and Surveillance · doi:10.2196/35785 · Cited by 18
“The continuous improvement of the quality of life and the neglect of the sexual needs of older people by their families will lead to unsafe sexual behaviors [6,36].”
Sexual Satisfaction Among Sexual Minority and Heterosexual Middle-Aged and Older Adults
Buczak‐Stec, E., König, H., & Hajek, A. (2023) · Innovation in Aging · doi:10.1093/geroni/igad010 · Cited by 18
“Individuals in older age are engaging in sexual activity (Lindau et al., 2007), and are satisfied with their sex life (Stentagg et al., 2021).”
Portellos, A., Lynch, C., & Joosten, A. V. (2023) · British Journal of Occupational Therapy · doi:10.1177/03080226231164277 · Cited by 23
Motivations for sexual risk behaviors among older men in Shanghai, China: a qualitative study
Zhou, Y., Ding, Y., Kai-kan, G., Lu, X., Gao, M., & He, N. (2014) · BMC Public Health · doi:10.1186/1471-2458-14-802 · Cited by 18
“Older men were more likely to be sexually active than older women [4].”
BackgroundInfluentialCardiovascular Risk Factors in Men With Ischemic Heart Disease and Erectile Dysfunction
Pauker-Sharon, Y., Arbel, Y., Finkelstein, A., Halkin, A., Herz, I., Banai, S., & Justo, D. (2013) · Urology · doi:10.1016/j.urology.2013.03.034 · Cited by 18
Abara, W. E., Smith, L., Zhang, S., Fairchild, A. J., Heiman, H. J., & Rust, G. S. (2014) · American Journal of Public Health · doi:10.2105/ajph.2014.302227 · Cited by 19
Características e tendência da AIDS entre idosos no Estado do Espírito Santo
Toledo, L. D. S. G., Maciel, E. L. N., Rodrigues, L. C. D. M., Sá, R. T., & Fregona, G. C. (2010) · Revista da Sociedade Brasileira de Medicina Tropical · doi:10.1590/s0037-86822010000300010 · Cited by 18
“TABELA 1 - Distribuição dos casos de AIDS entre adultos mais jovens (20-39) e adultos mais velhos (50 anos e mais) no Estado do Espírito Santo, segundo variáveis sociodemográficas.”
BackgroundSexual function in women after urinary incontinence and/or pelvic organ prolapse surgery
Bilgiç, D., Beji, N. K., & Yalçın, Ö. (2013) · Journal of Clinical Nursing · doi:10.1111/jocn.12496 · Cited by 18
Sexual dysfunction in the older man
Albersen, M., Shindel, A., & Lue, T. F. (2009) · Reviews in Clinical Gerontology · doi:10.1017/s0959259809990384 · Cited by 18
Fisher, W. A., Gruenwald, I., Jannini, E. A., Lev‐Sagie, A., Löwenstein, L., Pyke, R. E., Reisman, Y., Revicki, D. A., & Aurioles, E. R. (2017) · The Journal of Sexual Medicine · doi:10.1016/j.jsxm.2016.08.016 · Cited by 18
Addressing sexual health in geriatrics education
Brennan‐Ing, M., Seidel, L., Ansell, P., Raik, B. L., Greenberg, D. F., Nicastri, C., Breznay, J., Karpiak, S. E., & Adelman, R. D. (2017) · Gerontology & Geriatrics Education · doi:10.1080/02701960.2017.1340885 · Cited by 18
“Diabetes is also significantly related to the likelihood of erectile dysfunction (Lindau et al., 2007).”
BackgroundInfluentialMonteiro, A., von Humboldt, S., & Leal, I. M. P. (2017) · Psychology Community & Health · doi:10.5964/pch.v6i1.216 · Cited by 18
“These results corroborate studies (Lindau et al., 2007; Steinke, 1997) that identified masturbation and handholding as sexual behaviour in older adults as well as their continued engagement in sexual activities (American Association of Retired Persons, 2005).”
BackgroundResult
Metadata
- Authors
- Lindau, S. T., Schumm, L. P., Laumann, E. O., Levinson, W., O'Muircheartaigh, C. A., & Waite, L. J.
- Affiliations
- University of Chicago (US)
- University of Toronto (CA)
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 2007-08-23
- Volume
- 357
- Issue
- 8
- Pages
- 762-774
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- PMC
- PMC2426743
- OpenAlex
- W2107749577
- Cited by
- 2,211
- References
- 40
- Citations by year
- 2026: 59 · 2025: 74 · 2024: 70 · 2023: 92 · 2022: 100 · 2021: 109 · 2020: 196 · 2019: 121 · 2018: 118 · 2017: 127 · 2016: 158 · 2015: 151 · 2014: 147 · 2013: 139 · 2012: 108
- FWCI
- 66.75
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- New England Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Pfizer
- Johns Hopkins University
- National Institutes of Health
- Johns Hopkins Bloomberg School of Public Health
- Nutrition Obesity Research Center, University of North Carolina
- National Institute on Aging (AG021487, R01AG021487)
- Office of Behavioral and Social Sciences Research (AG021487, 5R01AG021487)
- Office of AIDS Research
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Sexual function and dysfunction studies
- Social Sciences › Psychology › Clinical Psychology › Sexuality, Behavior, and Technology
- Social Sciences › Sociology and Political Science › Marriage and Sexual Relationships
- Keywords
- sexuality in old age, sexual activity, sexual dysfunction, sexual desire, erectile dysfunction, vaginal lubrication, health status, age differences, gender differences, sexual health
- MeSH terms
- Aged, Aged, 80 and over, Aging, Coitus, Female, Health Status, Humans, Male, Middle Aged, Sexual Behavior, Sexual Dysfunction, Physiological, United States, Logistic Models, Sexuality
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