Sex, health, and years of sexually active life gained due to good health: evidence from two US population based cross sectional surveys of ageing
BMJ 2010; 340 doi: https://doi.org/10.1136/bmj.c810 (Published 10 March 2010) Cite this as: BMJ 2010;340:c810
- 1Department of Obstetrics and Gynaecology, University of Chicago, 5841 S Maryland Avenue, MC2050, Chicago, IL 60637, USA, and Chicago Core on Biomeasures in Population-Based Aging Research, University of Chicago Centre on Demography and Economics of Aging
- 2Department of Medicine, Section of Geriatrics, University of Chicago
- Correspondence to: S Tessler Lindau slindau{at}uchicago.edu
- Accepted 22 December 2009
Abstract
Objectives To examine the relation between health and several dimensions of sexuality and to estimate years of sexually active life across sex and health groups in middle aged and older adults.
Design Cross sectional study.
Setting Two samples representative of the US population: MIDUS (the national survey of midlife development in the United States, 1995-6) and NSHAP (the national social life, health and ageing project, 2005-6).
Participants 3032 adults aged 25 to 74 (1561 women, 1471 men) from the midlife cohort (MIDUS) and 3005 adults aged 57 to 85 (1550 women, 1455 men) from the later life cohort (NSHAP).
Main outcome measures Sexual activity, quality of sexual life, interest in sex, and average remaining years of sexually active life, referred to as sexually active life expectancy.
Results Overall, men were more likely than women to be sexually active, report a good quality sex life, and be interested in sex. These gender differences increased with age and were greatest among the 75 to 85 year old group: 38.9% of men compared with 16.8% of women were sexually active, 70.8% versus 50.9% of those who were sexually active had a good quality sex life, and 41.2% versus 11.4% were interested in sex. Men and women reporting very good or excellent health were more likely to be sexually active compared with their peers in poor or fair health: age adjusted odds ratio 2.2 (P<0.01) for men and 1.6 (P<0.05) for women in the midlife study and 4.6 (P<0.001) for men and 2.8 (P<0.001) for women in the later life study. Among sexually active people, good health was also significantly associated with frequent sex (once or more weekly) in men (adjusted odds ratio 1.6 to 2.1), with a good quality sex life among men and women in the midlife cohort (adjusted odds ratio 1.7), and with interest in sex. People in very good or excellent health were 1.5 to 1.8 times more likely to report an interest in sex than those in poorer health. At age 30, sexually active life expectancy was 34.7 years for men and 30.7 years for women compared with 14.9 to 15.3 years for men and 10.6 years for women at age 55. This gender disparity attenuated for people with a spouse or other intimate partner. At age 55, men in very good or excellent health on average gained 5-7 years of sexually active life compared with their peers in poor or fair health. Women in very good or excellent health gained 3-6 years compared with women in poor or fair health.
Conclusion Sexual activity, good quality sexual life, and interest in sex were higher for men than for women and this gender gap widened with age. Sexual activity, quality of sexual life, and interest in sex were positively associated with health in middle age and later life. Sexually active life expectancy was longer for men, but men lost more years of sexually active life as a result of poor health than women.
Footnotes
We thank Andreea Mihai, Jessica Schwartz, and Katherine Githens for research assistance. Their effort was supported by funding received for the Center on Demography and Economics of Aging Chicago Core on Biomarkers in Population-Based Health and Aging Research from the National Institutes of Health/National Institute on Aging (5P30 AG 012857) and institutional resources from the University of Chicago.
Contributors: Both authors originated and designed the study, interpreted the results, commented on drafts of the article, and act as guarantors. NG carried out the statistical analyses and calculations.
Funding: This study was partially supported by the National Institute on Aging/Rutgers University pilot award, the University of Chicago Population Research Centre pilot grant (NIH/NICHD R24 HD051152-01), the University of Chicago Centre on Demography and Economics of Aging pilot grant (NIH/NIA 5P30 AG 012857), and Population Research Centre grant from the National Institute of Child Health and Human Development (R24 HD051152-04). NG was supported by, and STL partially supported by, the National Institutes of Health, National Institute on Aging University of Chicago—NORC Centre on Demography and Economics of Aging Core on Biomarkers in Population-Based Health and Aging Research (5 P30 AG 012857). STL was also supported by 1K23AG032870-01A1. The funders had no role in the study design. The authors retained full independence in the collection (NSHAP), analysis, and interpretation of the data (NSHAP and MIDUS), the writing of this report, and in the decision to submit this article for publication. The authors were not involved in the collection of the MIDUS data.
Competing interests: All authors have completed the Unified Competing Interest form at http://www.icmje.org/coi_disclosure.pdf (available on request from the corresponding author) and declare that (1) no company has had involvement in the submitted work; (2) no authors have relationships with any companies that might have an interest in the submitted work in the previous 3 years; (3) their spouses, partners, or children have no financial relationships that may be relevant to the submitted work; and (4) no authors have any non-financial interests that may be relevant to the submitted work.
Ethical approval: The NSHAP data analysis was carried out under expedited approval from the University of Chicago institutional review board (No 16950A, 4/24/09). The MIDUS data analysis was carried out under exempt protocol from the University of Chicago institutional review board (No 13996E, 6/2/05). This research was carried out with deidentified, publicly available data with approval of the University of Chicago institutional review board. For neither study did the authors have access to any personally identifiable information or information that would link the data to individuals’ identities. All data are reported in aggregate to eliminate the possibility of deductive identification of individuals.
Data sharing: Data for the National Social Life Health and Aging Project are available at www.icpsr.umich.edu/NACDA/news.html#nshap. Data for the MIDUS study are available to researchers at webapp.icpsr.umich.edu/icpsrweb/ICPSR/studies/02760. Calculation of sexually active life expectancy used publicly available life tables and the Excel spreadsheet available at http://reves.site.ined.fr/en/resources/computation_online/sullivan/. Statistical codes are available from NG at ngavrilova{at}babies.bsd.uchicago.edu.
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