Sexuality and affection among elderly German men and women in long-term relationships: results of a prospective population-based study

Reciprocal associations between depressive symptoms and satisfaction with sexual life in older adults: the roles of gender and importance attached to sexuality

OBJECTIVES

To gain insight into the longitudinal, reciprocal associations between depressive symptoms and sexual satisfaction as well as the potential moderating roles of gender and perceived importance of sexuality.

METHOD

We analyzed longitudinal data from 2113 participants of the Longitudinal Ageing Study Amsterdam (LASA) with an initial age range of 54-93 years, using Generalized Estimating Equations (GEE).

RESULTS

There were no significant associations between baseline depressive symptoms and change in sexual satisfaction, nor between baseline sexual satisfaction and change in depressive symptoms. Gender and perceived importance of sexuality were moderators: in men higher depression scores were associated with a decrease in sexual satisfaction, whereas in women higher depression scores were associated with an increase in sexual satisfaction. In participants for whom sexual life was important, higher depression scores were associated with a decrease in sexual satisfaction. In participants for whom sexual life was not important, higher depression scores were associated with an increase in sexual satisfaction.

CONCLUSION

The associations between baseline depressive symptoms and change in sexual satisfaction as well as between baseline sexual satisfaction and change in depressive symptoms varied according to gender and importance ascribed to sexuality. Potential explanations might lie in the different roles sexual activity plays in sexual satisfaction in men and women.

Sexual activity and satisfaction in older adults from a Brazilian cohort study

Objectives: Although the majority of older adults experience sexual satisfaction regardless of their sexual activity, there are few studies that address sexuality in aging, especially in Latin America. The objective of this study was to assess the prevalence of sexual activity and satisfaction among older adults in two time-points, as well as their sociodemographic and health predictors.Method: We analyze data from 1,464 older adults aged 60 years or over from the Health, Well-Being, and Aging (SABE) cohort study conducted in Brazil. Multivariable regression models were used to determinate the factors associated with sexual activity and sexual satisfaction, stratified by gender. Results: Among older adults, the prevalence of sexual activity was 48%, while the vast majority reported feeling sexually satisfied (80%). Men had more sexual activity than women, while women presented greater sexual satisfaction than men. After the follow-up, older adults that were married were more likely to have sexual activity. In women, being older than 71 years was associated with lower sexual activity. In men, those with mobility problems and depression were less likely to have sexual activity. Regarding sexual satisfaction, having depression remained a leading factor for lower sexual satisfaction in men.Conclusion: Despite beliefs, a high percentage of older adults reported being sexually active and feeling sexually satisfied. Our results highlight the gender difference in the predictors of sexual activity and sexual satisfaction. Since sexuality is important for well-being throughout life, preventing factors that decrease sexual activity and sexual satisfaction in aging could help improve the quality of life of older adults.

Psycho-Social Factors Associated with Intimacy Needs in Divorced and Widowed Older Chinese Women

The rapidly ageing population, the growing rate of divorce, and the longer life expectancy of women compared with men have resulted in a large proportion of older Chinese women being alone. The sexual health and intimacy needs of this group of women are ignored due to traditional Chinese cultural values that undermine older adults' needs for sex and intimacy, and the subordinate position of women in society. The present study used a quantitative survey method to investigate bio-psycho-social factors associated with divorced and widowed older Chinese women's sexual health and intimacy needs in two cities in Shanghai and Wuhan. The conceptual framework of this study was guided by cognitive stress theory, attachment theory, gender theory, socioemotional selectivity theory, objectification theory, and activity theory. We adopted a model involving demographic, biological, psychological, and social factors to unearth the mechanism influencing divorced and widowed older Chinese women's sexual health and intimacy needs. Data were collected between October 2020 and March 2021 via face-to-face surveys. A convenience sample of 278 (N = 278) divorced and widowed older Chinese women was recruited (166 in Shanghai and 112 in Wuhan). Sexual health and intimacy needs were associated with current relationship status, financial status, physical health, attachment style, neuroticism, mental health, social support, prior marital conflict, and gender norm attitude. Sexual behaviour was associated with age, number of children, financial status, physical health, attachment style, neuroticism, prior marital conflict, gender norm attitude, sexual knowledge, sexual attitude, and intimacy attitude as predictors. Most participants in this study seemed to have found new intimate partners with whom to continue participating in sexual activities after their divorce or widowhood. The present study is one of the first examples of empirical research to examine the sexual health and intimacy needs of older Chinese women who are divorced or widowed. The findings generated by this study will inform the design and implementation of appropriate social programs for this demographic, and provide invaluable insight for social workers, educators, sex therapists, healthcare professionals, community workers, and policymakers working with this population.

Sexual Activity and Physical Tenderness in Older Adults: Prevalence and Associated Characteristics From a Belgian Study

BACKGROUND

Despite the World Health Organization calling for sexuality to be recognized as an aspect of well-being, no studies have explored sexual activity and physical tenderness in older adults aged ≥ 75 years in Belgium or those aged ≥ 85 years worldwide.

AIM

To assess the prevalence and predictors of sexual activity and physical tenderness in a sample of older adults.

METHODS

Using data from a Belgian cross-sectional study on sexual violence (UN-MENAMAIS), information on sexual activity, physical tenderness, and associated characteristics was collected during structured face-to-face interviews with older adults living in the community, assisted living facilities, or nursing homes. Cluster random probability sampling with a random route-finding approach was used to select the participants.

OUTCOMES

Current sexual activity and physical tenderness in the previous 12 months, sociodemographic characteristics, chronological age, subjective age, number of sexual partners, sexual satisfaction, attitudes toward sexuality in later life, quality of life, and lifetime sexual victimisation.

RESULTS

Among the 511 participants included, 50.3% were in a relationship, mainly living with their partner; 31.3% indicated they were sexually active; and 47.3% of sexually inactive participants reported having experienced forms of physical tenderness in the previous 12 months. Sexual activity was associated with the presence of a partner, satisfaction with sexual life, permissive attitudes regarding sexuality in later life, a younger age, and a lack of disability. Physical tenderness was associated with the presence of a partner, community residency, and permissive attitudes regarding sexuality in later life.

CLINICAL IMPLICATIONS

Raising awareness among the general population, healthcare professionals, and older adults about sexuality in later life could contribute to ending this taboo and should therefore be a priority for society.

STRENGTHS AND LIMITATIONS

Our study fills a gap in the literature regarding sexual activity and physical tenderness in older adults aged ≥ 70 years, including respondents aged up to 99 years. Additionally, we explored different forms of sexual expression beyond intercourse, and face-to-face interviews contributed to the quality of the collected data. The main limitation of this study was the sample size, although the findings were similar to recent statistical indicators in Belgium.

CONCLUSION

One in 3 older adults aged ≥ 70 years living in Belgium are sexually active. These findings provide an opportunity to inform the general public and older adults about later life sexuality and to educate healthcare professionals about aging sexuality to increase discussions and avoid assumptions of asexuality in later life. Cismaru-Inescu A, Hahaut B, Adam S et al. Sexual Activity and Physical Tenderness in Older Adults: Prevalence and Associated Characteristics From a Belgian Study. J Sex Med 2022;19:569-580.

Physical Intimacy in Older Couples' Everyday Lives: Its Frequency and Links with Affect and Salivary Cortisol

OBJECTIVES

Physical intimacy is important for communicating affection in romantic relationships. Theoretical and empirical work highlights linkages between physical intimacy, affect, and physiological stress among young and middle-aged adults, but not older adults. We examine physical intimacy and its associations with positive and negative affect and cortisol levels in the daily lives of older couples.

METHOD

We applied actor-partner multilevel models to repeated daily life assessments of physical intimacy (experienced and wished) and affect obtained six times a day over seven consecutive days from 120 older heterosexual German couples (Mage= 71.6, SDage= 5.94). Physiological stress was indexed as total daily cortisol output, the area under the curve with respect to ground (AUCg).

RESULTS

Physical intimacy experienced and wished were reported at the vast majority of occasions, but to different degrees at different times. Within persons, in moments when participants experienced more physical intimacy, older women reported less negative affect, whereas older men reported more positive affect. Between persons, higher overall levels of physical intimacy experienced were associated with higher positive affect and less negative affect among women and with lower daily cortisol output among men. A stronger wish for intimacy was related to more negative affect among both women and men, and to higher daily cortisol output among men.

DISCUSSION

Physical intimacy is linked with mood and stress hormones in the daily life of older couples. We consider routes for future inquiry on physical intimacy among older adults.

Dyadic Satisfaction and Shared Affectivity Are Associated with Psycho-Sexual Functioning in Elderly Men and Women

Objectives The quality of sexual life of elderly people represents an understudied topic of sexual medicine and of psycho-sexology. Hence, we aimed to evaluate the association of specific psycho-relational variables, such as intimacy, increased affective gestures towards a partner (AGtP), daily shared activities, and dyadic satisfaction, with the psychosexual wellbeing of elderly people, expressed in terms of sexual satisfaction. Methods: A cohort of elderly people was selected from a sample of a broader study evaluating the role of sexual activity in protecting the emotional wellbeing of a population subjected to quarantine due to the COVID-19 pandemic. Specifically, the presence of sexual dysfunctions, the emotional wellbeing (i.e., absence of anxiety and/or depression), and the quality of the partners’ relationships were studied. For the study’s purpose, the Sexual Health Inventory for Males (SHIM), the Female Sexual Function Index (FSFI), the Orgasmometer and the Orgasmometer-F, the Generalized Anxiety Disorder scale (GAD-7), the Patient Health Questionnaire (PHQ-9), and the Dyadic Adjustment Scale were adopted. Results: A group of 124 elderly subjects (≥60) was selected for the study’s purposes. Among these, 84% were males (120/124), and 16% were females (20/124). All the subjects declared to be in a stable relationship and to be sexually active during the first lockdown period. Gender differences were found for the Dyadic Satisfaction subscale (males: 37.04 ± 6.57; females: 32.85 ± 10.04; p < 0.05) and the Orgasmometer (males: 7.64 ± 1.30; females: 6.60 ± 2.46; p < 0.01). Linear regression analysis showed the association between higher Orgasmometer scores and: (i) the absence of sexual dysfunctions (β = −1.213; SE = 0.271; p < 0.0001), (ii) higher dyadic satisfaction (β = 0.042; SE = 0.019; p < 0.05), and (iii) reduced shared activities with partner (β = −0.463; SE = 0.143; p < 0.01) and increased affective gestures towards partner (DAS measured AGtP) (β = 0.595; SE = 0.065; p < 0.0001). Post hoc analysis of ANCOVA with the Bonferroni correction method showed a significant difference in the Orgasmometer scores between subjects with and without sexual dysfunction (mean difference: 2.102; SE = 0.340; pBonf < 0.001), with healthy subjects reporting higher scores compared to dysfunctional ones. Conclusions: It is reasonable to suppose that, beyond the presence of sexual dysfunctions, the sexual health of elderly people may benefit from the quality of the relationship, and, specifically, from the presence of affective gestures towards the partner and the dyadic satisfaction. To the contrary, the quantity of time spent together, sharing specific activities, may be considered a factor worsening relational and sexual health. These data should be considered during the evaluation of sexual health among elderly people.

Multidimensional Sexual Well-being Scale for Older Adults: Validity Evidence from a Polish Sample

Here, we report the results of a Polish adaptation of the Multidimensional Sexual Well-being Scale (MSWBS) for older adults. The MSWBS is a short self-report scale for assessing the five dimensions of an individual's sexual well-being: frequency of caressing, sexual intimacy, sexual compliance, sexual satisfaction, and sexual distress. The aim of our adaptation was to examine the utility of the scale in a country with conservative views on the sexuality of older people, which will help health care providers and researchers to better understand the sexual needs of older people. The study included 507 participants, aged 60-92. We found the reliability of the scale to be satisfactory (Cronbach's alpha = .71-.87). Confirmatory factor analysis (CFA) showed a good fit of the data to a five-factor model. This study demonstrates that the MSWBS-PL is connected to general life satisfaction and diversity of sexual activity, confirming the scale's validity.Supplemental data for this article is available online at https://doi.org/10.1080/0092623X.2021.1991535.

Prevalence and Predictors of Sexual Difficulties and Associated Distress Among Partnered, Sexually Active Older Women in Norway, Denmark, Belgium, and Portugal

There has been little comparative, cross-cultural research on sexual difficulties and associated distress, and factors associated with these, among older women. Therefore, the aim of this study was to investigate prevalence rates of sexual difficulties, distress related to these difficulties, and associated sociodemographic, relational, and health factors, among sexually active older women (60-75 years) in committed relationships across four European countries (Norway, Denmark, Belgium, and Portugal). These data could inform us about what differentiates women who do and do not experience distressing sexual difficulties and facilitate the identification of older women who might benefit from clinical interventions as well as the development of new interventions. In total, 1057 women (357 Norwegian; 322 Danish; 237 Belgian; 141 Portuguese) completed a cross-sectional questionnaire assessing six sexual difficulties-vaginal dryness, orgasmic difficulties, lacking interest in sex, lacking enjoyment in sex, pain during sex, and no excitement/arousal during sex-and associated distress. We found a high prevalence of sexual difficulties lasting 3 months or longer in the past year (between 23.5 and 50.2%, depending on the specific difficulty). With the exception of vaginal dryness and pain during sex, however, the majority of women reporting sexual difficulties (50.0% to 86.1%, depending on the specific difficulty) reported no or mild distress. There were relatively few cross-country differences, either in the prevalence of sexual difficulties or related distress. Few sociodemographic or health variables were associated with distressing sexual difficulties, but higher sexual intimacy, higher emotional intimacy, and better mental health were associated with less distress about some sexual difficulties. The findings underline the importance of healthcare professionals asking older women about sexual function and especially associated distress, and suggest that careful attention to the psychological and relationship context of these sexual difficulties is needed, as these could be important targets in the treatment process.

Defining sexuality in later life: A systematic review

OBJECTIVE

To identify whether a consistent definition of sexuality is used across research articles to describe sexuality in later life for heterosexual men and women.

METHODS

A systematic review was conducted that examined how researchers define sexuality for heterosexual adults. Peer-reviewed journal articles on sexuality published between 1999 and 2018 were examined for the presence of sexuality definitions. Sexuality themes discussed in each article were recorded, and results were tabulated.

RESULTS

Few articles explicitly provide a definition of 'sexuality' as it pertains to later life. Definitions from articles that defined sexuality explicitly were inconsistent across studies. Topics included in implicit and explicit definitions of sexuality were disparate across studies and included a diverse range of sexuality dimensions.

CONCLUSION

Greater consistency is needed in how "sexuality" in later life is defined across studies and should be informed by data so that it accurately reflects the sexual experiences of older adults.

An overview of sexual behaviour research in later life-Quantitative and qualitative findings

AIM

This article provides an overview of current sexual behaviour research in later life by describing associated factors, including the physical and psychological benefits.

METHODS

Recent systematic reviews were interrogated for findings on sexual behaviour research in adults aged 60+.

RESULTS

Regardless of research methods employed, all studies showed that there were a range of physical and psychological benefits to remaining sexually active in later life. While quantitative studies placed an emphasis on measuring penile-vaginal intercourse, they provided no definitive conclusion about the benefits due to 'inconsistent results' across studies. Qualitative studies described the myriad ways in which older adults redefine what constitutes sexual activity despite the onset of dysfunction and disability.

CONCLUSION

While the different research methods show that engaging in sexual behaviour has physical and psychological benefits at all adult ages, there is limited conclusive evidence about what the overall benefits might be in later life.

It's not age that prevents sexual activity later in life

OBJECTIVE

To describe key factors that facilitate sexual behaviour in later life.

METHODS

Re-analysis of data from a study of 2,374 Dutch older adults.

RESULTS

Partner availability, gender and health are likely to be more important factors influencing sexual behaviour engagement than the factor of age in later life. Lack of partner availability, traditional gender roles and poor health are associated with older age. However, current generations of older adults will be more capable, less ashamed of their sexual desires and engage in more sexual behaviour than prior generations.

CONCLUSION

This analysis observed that sexual activity is associated with partner availability and better health, rather than age, countering stereotypes of decline in sexual behaviour and normalising sexual activity and desire in later life.

Correction to: Emotional intimacy and sexual well-being in aging European couples: a cross-cultural mediation analysis

[This corrects the article DOI: 10.1007/s10433-019-00509-x.].

Emotional intimacy and sexual well-being in aging European couples: a cross-cultural mediation analysis

Sexual health research tends to focus on problematic aspects of sexuality. This also applies to research on sexuality in older men and women, where attention has been primarily on the negative impact of aging. To contribute to the emerging interest in positive (successful) sexual aging, we aimed to: (1) further validate a recently developed 5-dimensional measure of sexual well-being (Štulhofer et al. in J Happiness Stud, 2018. 10.1007/s10902-018-0049-1) and (2) explore the structure of associations among emotional intimacy, frequency of sexual intercourse, and sexual well-being in older European couples. Using data from a 2016 community-based survey of 218 Norwegian, 207 Danish, 135 Belgian, and 117 Portuguese couples aged 60-75 years, we applied actor-partner interdependence structural modeling approach to confirm the validity of the sexual well-being measure in couples and explore a path analytic model in which the frequency of sexual intercourse was hypothesized to mediate the association between emotional intimacy and sexual well-being. Although we observed consistent and significant actor effects, with emotional intimacy and frequency of sexual intercourse predicting both male and female partners' sexual well-being across countries, the proposed mediation was observed only in Norwegian and Portuguese men and Norwegian and Belgian women. Partner effects were gender-specific; male partner's emotional intimacy was related to his female partner's reported frequency of sex and sexual well-being but not the other way around. Apart from being one of the few cross-cultural assessments of successful sexual aging, this study's findings support the use of a new sexual well-being measure in research on older adults' sexuality.

Prevalence of Sexual Problems and Associated Distress in Aging Men Across 4 European Countries

BACKGROUND

Among older men, comparable cross-cultural investigations of sexual problems and associated distress that also include a multitude of relevant explanatory variables of these sexual problem and related distress are rare in the research literature.

AIMS

To investigate prevalence rates of sexual problems and associated distress among older men across 4 European countries (Norway, Denmark, Belgium, and Portugal) and assess for associated mental and physical health-related factors.

METHODS

Multinational cross-sectional questionnaire study using self-report measures.

OUTCOMES

Prevalence rates of sexual problems and associated distress levels.

RESULTS

We found a high prevalence of sexual problems persisting for months or longer across countries, but noted that many affected men experienced minimal or no distress related to these problems. We also found marked cross-cultural differences in reported distress about sexual problems, with southern European men (ie Portugal) reporting significantly more distress related to the majority of sexual problems investigated compared with northern European men (ie Denmark and Norway). Finally, we identified several relational, physical, and mental health problems associated with the reported number of sexual problems and the distress related to these problems.

CLINICAL IMPLICATIONS

We suggest that healthcare professionals also target distress when considering sexual problems among older men and contextualize these considerations within a multifactorial approach to general health in which (other) mental and physical health factors relevant to these patients' sexual health and function are also jointly considered.

STRENGTHS & LIMITATIONS

Strengths of this study include the large sample size, inclusion of participants from 4 European countries, assessment of distress associated with sexual problems, and similar research design and method of data collection across the 4 included countries. Limitations of the study include the cross-sectional design, which precludes causal conclusions; the low response rate in the Portuguese sample; the lack of homosexual participants; and the lack of comprehensive assessments of dyadic factors that may be of relevance to sexual problems and associated distress.

CONCLUSION

This study identified a high prevalence of sexual problems persisting for 3 months or longer among older men across 4 European countries, but also found that many of the men with sexual problems experienced minimal or no distress related to these problems. G.M. Hald, C. Graham, A. Štulhofer, et al. Prevalence of Sexual Problems and Associated Distress in Aging Men Across 4 European Countries. J Sex Med 2019;16:1212-1225.

Emotional intimacy and sexual well-being in aging European couples: a cross-cultural mediation analysis

Sexual health research tends to focus on problematic aspects of sexuality. This also applies to research on sexuality in older men and women, where attention has been primarily on the negative impact of aging. To contribute to the emerging interest in positive (successful) sexual aging, we aimed to: (1) further validate a recently developed 5-dimensional measure of sexual well-being (Štulhofer et al. in J Happiness Stud, 2018. 10.1007/s10902-018-0049-1) and (2) explore the structure of associations among emotional intimacy, frequency of sexual intercourse, and sexual well-being in older European couples. Using data from a 2016 community-based survey of 218 Norwegian, 207 Danish, 135 Belgian, and 117 Portuguese couples aged 60-75 years, we applied actor-partner interdependence structural modeling approach to confirm the validity of the sexual well-being measure in couples and explore a path analytic model in which the frequency of sexual intercourse was hypothesized to mediate the association between emotional intimacy and sexual well-being. Although we observed consistent and significant actor effects, with emotional intimacy and frequency of sexual intercourse predicting both male and female partners' sexual well-being across countries, the proposed mediation was observed only in Norwegian and Portuguese men and Norwegian and Belgian women. Partner effects were gender-specific; male partner's emotional intimacy was related to his female partner's reported frequency of sex and sexual well-being but not the other way around. Apart from being one of the few cross-cultural assessments of successful sexual aging, this study's findings support the use of a new sexual well-being measure in research on older adults' sexuality.

Kissing, Cuddling, and Massage at Most Recent Sexual Event: Findings From a U.S. Nationally Representative Probability Sample

Using data from the 2014 National Survey of Sexual Health and Behavior, a probability survey of Americans aged 14+, we assessed the prevalence and correlates of kissing, cuddling, and massage during 1,493 individuals' most recent sexual event from the past year. Most respondents reported kissing (87%) and cuddling (70%); fewer (23%) reported massage. Each was significantly associated with age, education, and relationship structure. Respondents younger than 30 were significantly more likely to indicate they did not kiss because kissing would have been too intimate with their partner. Only cuddling was significantly associated with event-level emotional intimacy and sexual pleasure.

Cognitive Impairment, Sexual Activity and Physical Tenderness in Community-Dwelling Older Adults: A Cross-Sectional Exploration

BACKGROUND

The ability to engage in sexual activity and better cognitive functioning are both associated with better health. However, the association between cognitive functioning and sexual activity is understudied.

OBJECTIVE

To examine the association between cognitive functioning with sexual activity and physical tenderness among community-dwelling older adults.

METHODS

From the Rotterdam Study, cognitive impairment and sexual activity were assessed in 4,201 community-dwelling, 60+ year olds between 2008 and 2014 in the Netherlands. Mild cognitive impairment (MCI) was based upon subjective complaints related to age and education-adjusted test scores. Mini-Mental State Examination (MMSE) impairment was defined by a score of < 26. Sexual activity and physical tenderness (e.g., fondling or kissing) in the last 6 months were assessed at an interview. Analyses were stratified by gender and partner status, with prevalence rates for the "no impairment" categories weighted based on age from the cognitive impairment categories. Inter-rater reliability was examined utilising 74 cohabiting couples of opposite gender.

RESULTS

It was found that 14% were categorised as having cognitive impairment, and < 1% as dementia (excluded from subsequent analyses). There was strong evidence that the odds of engaging in physical tenderness (observed through MMSE < 26, OR 2.14, 95% CI 1.32-3.48, p = 0.002) and sexual activity (MCI, OR 2.36, 95% CI 1.35-4.12, p = 0.003) among partnered females with no impairment was twice that observed among cognitively impaired partnered females. There was weak evidence that the odds of engaging in physical tenderness (MMSE < 26, OR 1.59, 95% CI 1.04-2.42, p = 0.03) and sexual activity (MMSE < 26, OR 1.51, 95% CI 1.02-2.24, p = 0.04) among partnered males with no impairment was 50% greater than observed among cognitively impaired partnered males. The associations between cognitive functioning and physical tenderness continued to remain after adjustment for physical function, diabetes, cardiovascular disease and cancer. There was no clear evidence of a difference between amnestic and non-amnestic MCI for sexual behaviour. There was moderate to substantial agreement among the coupled adults who had 1 partner categorised with MCI.

CONCLUSION

Having no cognitive impairment was associated with more engagement in sexual activity and physical tenderness among community-dwelling older adults. Sexuality is an important aspect of active aging and our findings illustrate a potential barrier to maintaining or instigating intimate relationships as we age. Longitudinal analyses are required to explore the direction of effect.

Women's spousal choices and a man's handshake: Evidence from a Norwegian study of cohort differences

Both high grip strength and being married independently relate to better functional capacity and health at older ages, but the combined effect of marital status and strength have not been investigated. Especially at older ages, declining strength can have adverse health and social consequences, where having a spouse could potentially help with everyday support and alleviate some of the negative effects of sarcopenia. We investigate how grip strength relates to being married among two cohorts of 59–71 year olds (born 1923-35 and 1936-48) in the Norwegian city of Tromsø, controlling for a broad set of health variables and sociodemographic characteristics. The baseline included N = 5009 participants of whom 649 died during follow-up. We find that for men, particularly among younger cohorts, the physically stronger are more likely to be married, but no relation is found for women. This is consistent with a hypothesis that women increasingly have selected male marital partners based on preferred individual traits, whereas men do not emphasize strength when selecting women. We find that both marital status and grip strength independently affect mortality, but there is no significant joint effect. However, the distribution of strength and marital status implies that more men than women and increasing shares of later born cohorts have a “double-burden” of low strength and a lack of support from a spouse.

Sexual well-being of older men and women

Most older adults experience sexual desire and engage in sexual activity, however, our knowledge about the sexual well-being (SWB) of older adults is still scarce. The present study aimed to examine the SWB of older adults as well as differences in their SWB based on gender and relationship status. The final sample consisted of 297 adults (149 men and 148 women) who ranged in age from 65 to 75 years; 63% (n=188) were currently in a romantic relationship. Participants were recruited using the crowdsourcing platform Amazon's M-Turk. Participants completed a background questionnaire, as well as measures of sexual behaviours (frequency of genital and non-genital activity and masturbation alone), sexual affect and cognitions (sexual esteem, attitudes, and satisfaction), sexual motivation (sexual interest), and sexual functioning. Our participants reported overall positive SWB; specifically, positive sexual self-esteem and attitudes toward sex as well as high sexual satisfaction and interest. Furthermore, participants who were in a relationship engaged in frequent genital and non-genital sexual activity. About two-thirds of the participants in a current relationship had experienced at least one sexual difficulty in the last three months, but only one-quarter were distressed about it. Although some gender and relationship status differences emerged, in general both the men and women and participants who were and were not in a relationship reported positive SWB. These results are discussed in terms of the ways in which they extend our knowledge on the SWB of older adults and challenge popular myths about sexuality in later life.