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Sexual Satisfaction and Risk of Disability in Older Women

J Clin Psychiatry 2003;64:1177-1182

Background: Most studies evaluating sexuality in older adults have focused on men, and relatively little research has evaluated the relationship between sexual satisfaction and health outcomes in older women. The aims of this study were to describe correlates of sexual satisfaction in community-dwelling older women with moderate to severe levels of disability and to examine the association of sexual satisfaction with progression of disability in this population.

Method: A total of 980 moderately to severely disabled women aged 65 years or older who had participated in The Women's Health and Aging Study entered this study. Baseline evaluations took place from 1992 through 1995. Participants rated their satisfaction with their level of sexual activity on a 0-to-10 scale. Women scoring >= 8 were considered sexually satisfied. The onset of new severe disability was determined by semiannual assessments, over 3 years, of disability in performing activities of daily living (ADLs) and walking across a room.

Results: Of 203 (49.8%) women living with a spouse, 101 were satisfied with their level of sexual activity. In this group, older age, white race, and higher level of physical function were independent predictors of sexual satisfaction. In addition, among women living with a spouse, higher sexual satisfaction was associated with a significantly decreased risk for incident disability in performing ADLs (hazard ratio [HR] = 0.58, 95% confidence interval [CI] = 0.36 to 0.94) and walking across a small room (HR = 0.38, 95% CI = 0.18 to 0.79). Among women not living with a spouse, the response on the sexual satisfaction question showed different determinants and was not associated with disability risk.

Conclusion: Sexual satisfaction in community-dwelling, older, disabled women living with their spouse is associated with reduced risk for subsequent new severe disabilities.