Sexual Activity After 60: A Systematic Review of Associated Factors

Abstract

Sexuality and the desire for affection and intimacy are important human features across the lifespan. To evaluate and synthesize the existing literature on factors associated with continued sexual activity in adults at least 60 years of age. Three databases were used to select articles, 57 of which met the selection criteria. Methodologic quality was assessed and data were extracted from these studies by two independent reviewers according to standards proposed by the Cochrane Collaboration. Studies were evaluated for quality, included sexual activities, and identified associated factors. Sexual activity was positively associated with past frequency of sexual behavior and partner's interest in sexual activity. Decreased sexual activity (and/or cessation) was associated with the presence of erectile dysfunction and partner's illness. Noteworthy were significant inconsistencies of findings across studies and contrasting findings of generally assumed factors associated with sexual activity in later years (eg, physical and mental health). However, increasing methodologic quality was observed in studies that were more recent. Probable reasons for disparate findings are discussed and recommendations for methodologic improvements are outlined, focusing on population diversity, construct definitions, measurement, and sampling techniques. The literature on sexual activity in older adults is vastly heterogeneous with methodologic caveats and inconsistent results evidenced across studies. Vigilant attention to methodology is essential because sexual activity in later life is multidetermined with amplified individual variability in older vs younger cohorts.