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Cognitive Impairment, Sexual Activity and Physical Tenderness in Community-Dwelling Older Adults: A Cross-Sectional Exploration.
Gerontology. 2018; 64(6):589-602.G

Abstract

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.

Authors+Show Affiliations

Department of Epidemiology, Erasmus Medical Centre, Rotterdam, the Netherlands. Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.Department of Epidemiology, Erasmus Medical Centre, Rotterdam, the Netherlands.Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.Department of Epidemiology, Erasmus Medical Centre, Rotterdam, the Netherlands.Department of Epidemiology, Erasmus Medical Centre, Rotterdam, the Netherlands. Department of Child and Adolescent Psychiatry, Erasmus Medical Centre, Rotterdam, the Netherlands. Department of Psychiatry, Erasmus Medical Centre, Rotterdam, the Netherlands.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

30138922

Citation

Freak-Poli, Rosanne, et al. "Cognitive Impairment, Sexual Activity and Physical Tenderness in Community-Dwelling Older Adults: a Cross-Sectional Exploration." Gerontology, vol. 64, no. 6, 2018, pp. 589-602.
Freak-Poli R, Licher S, Ryan J, et al. Cognitive Impairment, Sexual Activity and Physical Tenderness in Community-Dwelling Older Adults: A Cross-Sectional Exploration. Gerontology. 2018;64(6):589-602.
Freak-Poli, R., Licher, S., Ryan, J., Ikram, M. A., & Tiemeier, H. (2018). Cognitive Impairment, Sexual Activity and Physical Tenderness in Community-Dwelling Older Adults: A Cross-Sectional Exploration. Gerontology, 64(6), 589-602. https://doi.org/10.1159/000490560
Freak-Poli R, et al. Cognitive Impairment, Sexual Activity and Physical Tenderness in Community-Dwelling Older Adults: a Cross-Sectional Exploration. Gerontology. 2018;64(6):589-602. PubMed PMID: 30138922.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cognitive Impairment, Sexual Activity and Physical Tenderness in Community-Dwelling Older Adults: A Cross-Sectional Exploration. AU - Freak-Poli,Rosanne, AU - Licher,Silvan, AU - Ryan,Joanne, AU - Ikram,M Arfan, AU - Tiemeier,Henning, Y1 - 2018/08/23/ PY - 2017/12/18/received PY - 2018/06/04/accepted PY - 2018/8/24/pubmed PY - 2019/1/31/medline PY - 2018/8/24/entrez KW - Aged KW - Aging KW - Geriatrics KW - Sex factors KW - Sexual behaviour KW - Sexual partners KW - Sexuality KW - Touch SP - 589 EP - 602 JF - Gerontology JO - Gerontology VL - 64 IS - 6 N2 - 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. SN - 1423-0003 UR - https://www.unboundmedicine.com/medline/citation/30138922/Cognitive_Impairment_Sexual_Activity_and_Physical_Tenderness_in_Community_Dwelling_Older_Adults:_A_Cross_Sectional_Exploration_ L2 - https://www.karger.com?DOI=10.1159/000490560 DB - PRIME DP - Unbound Medicine ER -