1. Sex and intimacy in later life
David Lee

2. Why is this research important
Sexual activity and intimacy are integral features of being human
Humans are unique in having sex not simply for reproduction
Partnered intimate relationships provide tangible health benefits
Sex, love and intimacy are key factors
How can we understand human health and wellbeing if we ignore sex?

3. Benefits to people in later life
Unbiased picture of what older men and women consider as normal & healthy sexuality
Health and lifestyle advice to individuals and/or their partners to ‘support’ their sex lives
Is there a need to provide more specialist healthcare services aimed at older people?
How sexuality relates to health and wellbeing… inform more broadly based interventions to promote positive and healthy ageing

4. Benefits to people in later life
Unbiased picture of what older men and women consider as normal & healthy sexuality
Health and lifestyle advice to individuals and/or their partners to ‘support’ their sex lives
Is there a need to provide more specialist healthcare services aimed at older people?
How sexuality relates to health and wellbeing… inform more broadly based interventions to promote positive and healthy ageing
Avoid unnecessarily medicalising the issue…
Sex and sexuality will mean different things to different people…

5. English Longitudinal Study of Ageing (ELSA)
Representative survey of people aged 50+
Interviews every two years since 2002, with a physical assessment carried out every four years
Lifestyle, health, physical function, cognition, biomarkers, wellbeing, economics, housing, employment, expectations, social relationships, civic/cultural participation
Data linkages: mortality, cancer, Hospital Episode Statistics, NI contributions, benefits & tax credits

6. Sexual relationships and activities questionnaire
Sexual attitudes, activities, problems, satisfaction, relationships
Questionnaires cognitively tested and piloted before main stage data collection
7000+ responders (56% female)
Individual item non-response was low
Data on over 2000 cohabiting couples
SRA-Q

7. Sexual activity and self-reported health

8. Attitudes to sex and long-term relationships
Satisfactory sexual relations are essential to the maintenance of a long-term relationship
Men
Women

9. Attitudes to sex and physical/mental health
Being sexually active is physically and psychologically beneficial to older people
Men
Women

10. Sexual desire and sexual intercourse
Thinking about sex
Sexual intercourse
(among those sexually active in past year)

11. Sexual problems and concerns
Concerned about problem

12. Sexual activities and wellbeing
Frequency of kissing, fondling & petting
Frequency of sexual intercourse
Taking into account age, self-rated health, depression and partner status

13. Sexuality in couples
May differ - but both partners sexual trajectories interact in a partnership
Health as a ‘jointly’ produced outcome
Importance of an emotionally and physically satisfying relationship?
Sexuality is an important connection between partners  measurable benefits?

14. General health and intercourse frequency
Male partner’s intercourse frequency
Female partner’s intercourse frequency
Taking into account age and depression

15. Summary
A significant proportion of older people remain sexually active
Association between long-term conditions and sexual health strongest among men
Better sexual functioning is positively associated with measures of wellbeing
Men report highest levels of sexual concerns
‘Coupled’ associations between health and sexuality show gender specific patterns

16. Implications
Sexual health needs of older people should not be overlooked or ignored
Ageist barriers and stereotypes need to be debunked
Gender differences have implications for individual care within the context of an intimate partnership
Management of older couples’ sexual health to improve wellbeing and quality-of-life best served by involving both partners

17. Where next?
The SRA-Q is included in the latest wave of ELSA
We can begin to examine changes in sexual health in the same people over time
Plans to expand the reach of the SRA-Q
Potential inclusion in sister studies to ELSA in low- and middle-income countries
Utilise the SRA-Q or adapted versions to examine sexual health in less heteronormative populations

18. Thank you!
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