by Karla Gale

Last Updated: 2007-08-22 17:00:26 -0400 (Reuters Health)

NEW YORK (Reuters Health) – Many older adults maintain an active sex life, often into their 80s, according to results of a national survey published in the August 23rd issue of the New England Journal of Medicine.

Furthermore, among respondents who were sexually active, the frequency of sexual activity was comparable to that reported among adults 18 to 59 years of age, lead author Dr. Stacy Tessler Lindau, from the University of Chicago, and co-investigators found.

However, ill health and lack of an intimate relationship are major impediments to sexual activity among individuals as they grow older.

"There is a void of information regarding changes in sexuality as we age," Dr. Lindau said in a teleconference with reporters. As a result, she added, physicians are hampered in their efforts to counsel patients about how their health care decisions will affect their sex lives.

To fill that void, Dr. Lindau’s group designed the National Social Life, Health, and Aging Project to gather "comprehensive, nationally representative, population-based data" about health and sexual behavior among older adults.

Professional interviewers spoke with 3005 US residents (1550 women and 1455 men), ages 57 to 85, asking them if they had engaged in vaginal intercourse, oral sex, and masturbation over the previous 12 months.

The investigators observed "high concordance between partners…in terms of the frequency of their sexual activity, both for vaginal intercourse and oral sex," providing validity to their analysis of survey responses.

Survey results showed that 73% of respondents aged 57 to 64 years of age were sexually active, as were 53% of those 65 to 74 years old, and 26% of those 75 to 85 years old.

Nevertheless, even in the oldest age group, 54% of those who were sexually active reported having sex at least 2 or 3 times per month, a frequency comparable to that documented in a similar survey among younger adults.

"The frequency of sex does not change a lot across age groups," Dr. Lindau said.

About half of the men and a quarter of the women reported masturbating in the previous year. As in the other sexual behaviors, the frequency of masturbation declined as people aged, primarily because of ill health.

Women were less likely than men to be sexually active, "because of physical problems of their partner, their own lack of interest, or lack of opportunity," co-author Dr. Linda Waite, also from the University of Chicago, said during the conference. The disparity is related to men often having younger sexual partners, Dr. Waite added. "Women usually spend their final years as widows, while men tend to be married when they die."

The survey was not designed to identify sexual orientation, Dr. Lindau told Reuters Health. Even so, "we asked about the gender of their sex partner in the past 12 months," and three men and five women reported relationships with people of the same sex.

She does not believe that those eight individuals were representative of the population of homosexual and bisexual older adults. "It poses a scientific challenge," Dr. Lindau continued. "We know exceedingly little about this population, but we need to know more in order to provide the best health care for people in these relationships."

Overall, there was a high prevalence of sexual problems among sexually active men and women, but very few spoke to a physician about the issue.

According to Dr. Lindau, subjects said that they were willing to discuss sexual function with physicians, but only if they are asked. "Physicians need to initiate these discussions in order for them to occur," she added.

Dr. Georgeanne Patmios, from the National Institute on Aging, which supported the study, told reporters that the failure of patients and physicians to communicate creates a "public health issue, since sexual problems may be a warning sign or consequence of underlying health conditions."

"Until now, physicians have lacked normative, nationally representative information about older adult sexuality on which to base discussions with older patients," she added.

In concluding the conference, Dr. Patmios noted that the National Social Life, Health, and Aging Project "will help growing numbers of older Americans and their physicians to better understand sexuality as we age and its association with health."

N Engl J Med 2007;357:762-774.