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Learn More. The sample included 1, married and cohabiting respondents aged 57 to 85 at the baseline survey. We examined four factors related to partnered sex: being sexually active, sexual frequency, feeling okay with sexual frequency, and sexual quality. Mental health was measured by self-rated poor mental health, unhappiness, and psychological distress. The relationship quality measures 6 2 Rapid City guy in sexless relationship both relationship support and relationship strain. from mixed-effects models suggest that being sexually active, having sex more frequently, feeling okay with sexual frequency, and reporting better sexual quality were all related to better mental health outcomes.
Relationship quality partially explained the effects of sex on mental health. This study highlights the importance of sex for mental health and relationship quality among older adults. The findings have implications for health policy and programs that seek to promote healthy aging. Yet, partnered sex i. According to a nationally representative survey about sexual attitudes and practices to adults ages 45 and older, a large proportion of older Americans believe that sex is critical to a good relationship and agree that sex is important to their overall quality of life AARP, Guided by a life course perspective, we examined the association between partnered sex and mental health among older adults.
We analyzed three waves of longitudinal data from the National Social Life, Health, and Aging Project NSHAP to address five specific research questions: a Is being sexually active with a partner related to better mental health in late life?
This study is particularly important given the continuous increase in life expectancy, which has likely expanded the of years in which older adults can potentially engage in sexual activities DeLamater, The importance of this study is further highlighted by growing scholarly and public recognition of the importance of sexual well-being for older adults Laumann et al.
The findings also have ificant implications for health policy and programs that seek to promote healthy aging. Although the empirical knowledge about the risk factors for poor mental health is sound and growing, there has been little systematic investigation of how sex lives shape mental health among the aging population.
The limited empirical evidence suggests that the incidence and frequency of sexual activity are related to certain dimensions of mental health. For example, using the first wave — of NSHAP, Ganong and Larson found that having sex in the past year was associated with lower levels of depression among older adults ages 57— Further, a recent study of older adults in England ages 57—75 examined inflammatory biomarkers and found that more frequent sex was related to a lower level of stress-related inflammation and thus better quality of life Allen, A growing body of research, primarily clinical-based studies, has examined the link between sexual activity and physical health, among midlife and older adults.
These studies suggest that frequent sexual intercourse and orgasm are correlated with 6 2 Rapid City guy in sexless relationship lower risk of heart disease, breast cancer, and prostate cancer Ebrahim et al. Prior studies on the link between sex and health have focused more on the quantitative aspects of sexual activity e. Using data from the Global Study of Sexual Attitudes and Behaviors a survey of 27, men and women age 40—80 living in 29 countriesLaumann et al. Another study of women age 40—65 found that greater enjoyment of partnered sexual activity was associated with more social support, better emotional well-being, and a greater sense of purpose in life Prairie et al.
Nevertheless, sexual quality of older adults has received minimal research attention, especially the specific pathways through which it links to elderly well-being. The scientific understanding of partnered sex in later life is limited. Two common conceptions are that older adults do not have sex as often as their younger counterparts and that sexual quality tends to decline at older ages DeLamater, ; Lindau et al. While the prevalence of sexual activity does decline with age, a substantial proportion of men and women continue to engage in sexual activity in their 60s, 70s, and beyond, mostly within partnered relationships DeLamater, Based on data from a nationally representative sample, more than half of men and 6 2 Rapid City guy in sexless relationship between the ages of 57 and 74 in the United States continued to be sexually active Laumann et al.
Moreover, a sizable proportion of older people reported that sex is a key part of their relationship and well-being DeLamater, ; Lindau et al. Therefore, we expect relationship quality to be a potential pathway linking partnered sex and mental health. Hypothesis 3: Feeling okay with sexual frequency is related to better mental health.
Hypothesis 4: The association between sex and mental health is, at least partially, explained by relationship quality. To take advantage of the longitudinal data, we restricted the focal sample to the 3, respondents who were first interviewed at Wave 1. The newly added sample in Waves 2 and 3 was not included due to shorter duration of follow-up or no follow-up.
Additional analysis shown in Supplementary Table S7 suggested that including the newly added respondents in Waves 2 and 3 showed similar findings as reported in the paper. The final analytic sample included 1, respondents who contributed to 4, person-period observations across three waves. We used the multiple imputation method to impute the missing data in Stata StataCorp, from additional analyses not shown but available upon request suggested that using other methods to deal with the missing values such as listwise deletion or Heckman-type correction for sample selection bias Heckman, revealed similar findings as we reported in the article.
In this study, we examined the following sex factors all time-varying, measured across all waves that are available in the data and also often considered as key aspects of sex lives e.
Respondents who answered yes were defined as sexually active. Respondents were asked how often they had sex with their current partner or a recent partner during the last 12 months. Response included none referenceonce a month, two to three times a month, and once a week or more. Sexuality scholars distinguish two dimensions of sexual quality: physical pleasure and emotional satisfaction Laumann et al. Respondents were asked how physically pleasurable they found their sexual relationship and how emotionally satisfied they found their sexual relationship.
Using the answers to these two questions, we created two measures, one for the physical dimension of sexual quality and one for the emotional dimension. We analyzed three measures of mental health all time-varying : self-rated poor mental health, unhappiness, and psychological distress.
These measures reflect the most commonly studied mental health measures available in the data.
Respondents were asked how often in the past week they experienced any of the following: a I did not feel like eating; b I felt depressed; c I felt that everything I did was an effort; d My sleep was restless; e I was happy; f I felt lonely; g People were unfriendly; h I enjoyed life; i I felt sad; j I felt that people disliked me; and k I could not get going. For each of the 11 items, response ranged from 0 rarely or none of the time to 3 most of the time.
We followed studies e. We used six items that are available across all waves to construct time-varying relationship quality scales. Respondents were also asked the extent to which they preferred to spend their free time doing things with their partner Item 2.
Responses include 1 mostly together, 2 some together and some apart, and 3 mostly apart. We reverse-coded this item so that higher values indicate better relationship quality. Finally, respondents were asked: how often they could open up to the partner if they needed to talk about their worries Item 3how often they could rely on their partner for help if they had a problem Item 4how often their partner made too many demands on them Item 5and how often their partner criticized them Item 6.
Responses to each question Items 3—6 are 1 never, hardly ever, or rarely, 2 some of the time, and 3 often. Table 1 shows the factor loadings of each item used to generate the factor scores for relationship quality without imputed data. Bold s indicate factor loadings above the 0. Factor loadings are based on non-imputed items. All covariates including gender are time-invariant except age. Moreover, sexual dysfunction is also related to sexual activity, sexual quality, and mental health. Last, we controlled a flag for missing where the variable takes on the value of 1 for missing and 6 2 Rapid City guy in sexless relationship for non-missing.
We used multilevel mixed-effects models to handle the nested distribution of the longitudinal data. A major advantage of multilevel mixed-effects models compared to traditional regression analysis is the ability to distinguish the two types of heterogeneity within- and between-individual in estimates of the effects of the sex variables on changes in mental health.
Mixed-effects models for the unobserved heterogeneity related to the nested distribution of the longitudinal data by allowing random effects to vary across individuals. The linear mixed-effects model was specified as:. X i is the vector of Wave 1 time-invariant covariates and Z ij is the vector of time-varying covariates. We used Stata 15 to estimate the models StataCorp, We estimated separate mixed-effects models for each mental health outcome.
Because the sex variables may be correlated with one another, we also estimated separate models for each sex factor. We conducted three models for each combination of mental health outcome and sex variable e.
For each combination, Model 1 analyzes the basic effects of sex on mental health controlling for all covariates. Model 2 adds an interaction term for sex and analytic time i. Model 3 adds relationship support and relationship strain to test if they can explain the relationship between sex and mental health. To better understand relationship quality as a potential pathway, we further estimated the associations between sex and relationship quality using mixed-effects models.
We have also tested an additional model by including gender interaction with sex, and the not reported but available upon request showed few ificant gender differences in the relationship between sex and mental health. Table 2 displays the descriptive statistics of all analyzed variables. In our sample, Table 3 presents the from the mixed-effects models that assess the effects of being sexually active, sexual frequency, okay with frequency, physical pleasure, and emotional satisfaction on the mental health outcomes, respectively full tables with all covariates are reported in Supplementary Tables S3—S7.
In addition, more frequent sex was also negatively related to poor mental health, unhappiness, and psychological distress Model 1 in Panel B. For example, from Model 1 in 6 2 Rapid City guy in sexless relationship B suggest that compared to those who had no sex last year, those who had sex once a week or more reported self-rated poor mental health by 0.
Further, 6 2 Rapid City guy in sexless relationship Model 1 of Panel C show that those who felt their sexual frequency was less often than they wanted reported poor mental health by 0. Finally, in Model 1 of Panel D and E indicate that those who felt very or extremely physically pleasurable and those who felt very or extremely emotionally satisfied in their sexual relationships both reported ificantly lower levels of self-rated poor mental health, unhappiness, and psychological distress than those who did not feel so in their sexual relationships.
Within-individual and between-individual variances are omitted, but they are all ificant. To understand how mental health trajectories change over time in relation to sex, we added interactions between sex variables and survey year in Model 2 of Table 3. Generally, Figure 1 shows some mixed patterns. The self-rated mental health gap between those who were sexually active and those who were sexually inactive decreased over time due to a more rapid decline in poor mental health among the sexually inactive group than the sexually active group Figure 1A.
We also see a narrowing gap in unhappiness by sexual frequency, driven by a more rapid increase in unhappiness among those who had sex two to three times a month than those who had no sex last year Figure 1C. In contrast, there were widening gaps in psychological distress between those who were sexually active and those who were sexually inactive Figure 1Bas well as across sexual frequency groups Figure 1D.
Moreover, both the self-rated mental health gap by physical pleasure Figure 1E and the unhappiness gap by emotional satisfaction slightly increased over time.6 2 Rapid City guy in sexless relationship
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