Sex doesn't stop at age 60, 70, 80 or beyond, according to a study published today that found many Americans stayed surprisingly frisky well into old age.
The study of 3,005 adults ages 57 to 85 found the majority had an active sex life. More than half of sexually active older adults had sex two to three times a month -- the same frequency reported among younger adults in a large 1992 national survey.
The report, in the New England Journal of Medicine, found passions cooled as people aged, but said the declining interest in sex couldn't be attributed to age alone.
A shortage of older men prevented many women in their 70s and 80s from hooking up, researchers said.
In addition, older adults with health problems were far less sexually active.
Participants in the study were considered sexually active if they had any sort of sexual contact with someone else in the preceding 12 months.
The nationwide study is the most comprehensive look yet at sexual activity among older Americans, an area that has received little scientific attention. Researchers said they hoped the findings would dispel commonly held notions that people lose all interest in sex as they age, and that sex is the province of the young.
"Older people are just younger people later in life," said lead author Dr. Stacy Tessler Lindau, a gynecologist at the University of Chicago Pritzker School of Medicine.
Still, Lindau cautioned the study wasn't meant to set a standard for normal sexual behavior that older people should feel compelled to achieve despite their personal preferences or circumstances.
"Certainly many people make a choice not to be sexually active," she said.
The study, funded by the National Institutes of Health, examined the nature and frequency of sexual activity among older adults, including the prevalence of such performance problems as sexual dysfunction. Subjects were interviewed about their sexual practices and researchers also collected information on participants' overall health and intimate relationships.
Subjects were divided into three age groups for the purpose of analysis.
Nearly three-quarters of adults ages 57 to 64 were sexually active compared with about one-quarter of adults ages 75 to 85, the report found. About half of adults ages 65 to 74 were sexually active.
A difference in life spans created a "lack of opportunity" for older women, Lindau said. At age 64, there were eight men for every 10 women in the U.S. By 85, there were four men for every 10 women.
American women live five to seven years longer than men.
Across all age groups, poor health substantially slowed people down. Those who rated their health as fair to poor were significantly less likely to be sexually active than those who reported their health as very good to excellent.
Diabetes was associated with reduced sexual activity, particularly in women. Sexual behavior was unaffected by arthritis and high blood pressure, two other conditions of old age assessed in the study.
Half of sexually active adults reported at least one problem that took the edge off sex. Among women, the most common problems were a lack of desire (43%) and vaginal dryness (39%). Thirty-seven percent of men reported erectile difficulties, and 14% used drugs or supplements to improve their performance.
Men and women held sharply different opinions about the importance of sex; 35% of women rated sex as "not at all important," compared with 13% of men, the report said.
Digging into subjects' sexual preferences, the study found vaginal intercourse was more common than oral sex, and men were much more likely to masturbate than women. Researchers said the information had implications for efforts to control sexually transmitted diseases.
Participants in the study were tested for the human papillomavirus, a virus best known for causing cervical cancer, researchers said, but the results were not yet available.
Dr. Wayne W. Chen, a geriatrician at USC's Keck School of Medicine, who was not involved in the study, said the findings offered a starting point for physicians to discuss sexual activity with their older patients. The study found such conversations occurred infrequently, with 38% of men and 22% of women reporting they had discussed sex with their doctors at least once since turning 50.
"Many of my colleagues don't think seniors have sexual activity and don't consider it an important clinical issue to deal with compared to stroke and arthritis and all the other things that take precedence," Chen said, adding that some patients might stop taking certain heart medications because they affect sexual performance.
Edward O. Laumann, a coauthor of the study and a sociologist at the University of Chicago, said a decline in sexual activity might be an early signal of deterioration in overall health.
Researchers said the findings should help reassure older adults that whatever their sexual preferences and problems, they were not alone -- a message infrequently heard in a culture that worships youth.
"Sexuality does not disappear when you get Social Security," said Dr. Edward Schneider, a professor of gerontology at USC's Andrus Gerontology Center who was not connected with the study.