Table Of ContentPractical Issues in Geriatrics
Series Editor: Stefania Maggi
Lee Smith
Igor Grabovac Editors
Sexual
Behaviour
and Health in
Older Adults
Practical Issues in Geriatrics
Series Editor
Stefania Maggi
Aging Branch
CNR-Neuroscience Institute
Padua, Italy
This practically oriented series presents state of the art knowledge on the principal
diseases encountered in older persons and addresses all aspects of management,
including current multidisciplinary diagnostic and therapeutic approaches. It is
intended as an educational tool that will enhance the everyday clinical practice of
both young geriatricians and residents and also assist other specialists who deal
with aged patients. Each volume is designed to provide comprehensive information
on the topic that it covers, and whenever appropriate the text is complemented by
additional material of high educational and practical value, including informative
video-clips, standardized diagnostic flow charts and descriptive clinical cases.
Practical Issues in Geriatrics will be of value to the scientific and professional
community worldwide, improving understanding of the many clinical and social
issues in Geriatrics and assisting in the delivery of optimal clinical care.
Lee Smith • Igor Grabovac
Editors
Sexual Behaviour and
Health in Older Adults
Editors
Lee Smith Igor Grabovac
Center for Health Performance and Department of Social and Preventive
Wellbeing Medicine
Anglia Ruskin University Centre for Public Health, Medical
Cambridge, UK University of Vienna
Vienna, Austria
ISSN 2509-6060 ISSN 2509-6079 (electronic)
Practical Issues in Geriatrics
ISBN 978-3-031-21028-0 ISBN 978-3-031-21029-7 (eBook)
https://doi.org/10.1007/978-3-031-21029-7
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Preface
Aging is a global phenomenon. It has been well established that the population of
persons over 60 years of age is rapidly growing, making this age group the fastest
growing population worldwide. However, longer life expectancy does not also mean
that people are living healthier lives. This is seen as a rise in prevalence of chronic
diseases as well as neurocognitive issues such as dementia. Overall, years spent in
good health have stayed relatively constant, meaning that the additional years
gained by the rise in life expectancy are spent in poor health. Therefore, the focus of
health practitioners as well as policy makers should turn to health promoting and
preventive interventions focusing on improving physical, mental, and social health
with an emphasis on healthy aging. This also needs to include sexual health and
well-being.
It is a common misconception that older adults do not engage in sexual activities.
However, epidemiological studies, including analyses of various nationally repre-
sentative data, show that older adults engage in sexual activities on a regular basis.
What does change with aging is the frequency of sexual activities and activities
performed, with shared intimacy including kissing, petting, and mutual masturba-
tion being more common than oral, vaginal, or anal intercourse. More common
knowledge is that of physical, mental, and social health influencing sexual activity
in older adults; however less research is done to show if and how sexual activities
influence health. Emerging research in this field indicates that sexual activities have
a wide variety of positive effects on the health and well-being of older adults.
This book is primarily aimed at specialists in geriatrics and all those interested in
gerontology and working with older adults. Additionally, it would be of interest to
all healthcare professionals working with older adults, as well as those doing
research in aging and sexual health. The book is comprised of 15 chapters which
showcase how vibrant and active the fields of sexual health and geriatrics are con-
firming that good work in these fields is only possible through multidisciplinary
approaches. This book has been achieved by a group of coauthors from a variety of
fields including general medicine, geriatrics and gerontology, psychology, public
health, nursing, occupational therapy, social science, sport and nutritional science.
The chapters cover a variety of issues from epidemiological analyses and aging in
general to specifics on how health influences sexual activities and vice versa.
Additionally, the book contains chapters focusing on implementation and practical
work outlining barriers and facilitators for sexual activity in older adults as well as
v
vi Preface
questions of promotion of these topics in everyday work and practical issues on
communication with patients.
What has been a common theme throughout the book is the lack of research in
this field, given the misconceptions and assumptions of asexuality in older adults. It
is our hope that the first edition of this book provides an overview of the topic and
inspires a new generation of practitioners and researchers to do more projects and
continue to contribute to this field.
Cambridge, UK Lee Smith
Vienna, Austria Igor Grabovac
Acknowledgments
The authors wish to thank all the coauthors, who selflessly contributed their time
and expertise for this book. On a personal note, we also would like to thank our
families for their constant support.
Professor Lee Smith & Dr. Igor Grabovac
vii
Contents
1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Sandra Haider and Igor Grabovac
2 Levels and Trends of Sexual Activity in Older Adults . . . . . . . . . . . . . . 9
Guillermo F. López-Sánchez, José M. Oliva-Lozano, José
M. Muyor, and Lee Smith
3 Sexual Activity and Physical Health Benefits in Older Adults . . . . . . . 15
Pinar Soysal and Esin Avsar
4 Sexual Activity and Mental Health Benefits in Older Adults . . . . . . . . 25
Tobias Schiffler, Hanna M. Mües, and Igor Grabovac
5 Sexual Activity and Psychosocial Benefits in Older
Adults: Challenges and Ways Forward . . . . . . . . . . . . . . . . . . . . . . . . . . 45
Siniša Grabovac and Radhika Seiler-Ramadas
6 ‘We’re Still Here, We’re Still Queer, We’re Still
Doing It’: Sex and Sexual Health in Older LGBTQ+ Adults . . . . . . . . 59
Joshua W. Katz, Lee Smith, and Daragh T. McDermott
7 Risky Sexual Activity and Its Impact on Mental
and Physical Health in Older Adults . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77
Daragh T. McDermott and Igor Grabovac
8 Lifelong Sexual Practice and Its Influence on Health
in Later Life . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 93
Benny Rana, Lin Yang, and Siniša Grabovac
9 Medication Use and Sexual Activity in Older Adults . . . . . . . . . . . . . . 105
Damiano Pizzol, Petre Cristian Ilie, and Nicola Veronese
10 Barriers to Sexual Activity in Older Adults . . . . . . . . . . . . . . . . . . . . . . 113
Nicola Veronese and Damiano Pizzol
11 Lifestyle Factors Supporting and Maintaining Sexual
Activity in Older Adults . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 119
Sandra Haider, Angela Schwarzinger, and Thomas Ernst Dorner
ix
x Contents
12 Promotion of Sex in Older Adults . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 139
Hanna M. Mües, Kathrin Kirchheiner, and Igor Grabovac
13 Future Directions for Research and Practice in Sexual
Health for Older Adults . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 157
Igor Grabovac
14 Concluding Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 169
Igor Grabovac and Lee Smith
15 Glossary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 175
Lisa Lehner and Charlotte Rösel
