Associations of Future Cognitive Decline with Sexual Satisfaction among Married Older Adults

ABSTRACT

Objectives: This study sought to explore changes in longitudinal cognitive status in relation to baseline measures of intimacy and sexuality in cognitively intact, married older adults.

Methods: Baseline intimacy and sexuality survey data from 155, cognitively intact, married, older adults were collected using a novel survey instrument that explored the domains of: 1) romance with one’s partner, 2) sexual satisfaction, 3) beliefs about sexuality, and 4) social support and emotional intimacy. These data were analyzed in relation to change in cognitive status over a 10-year follow-up period using binary logistic regression modeling. Exploratory factor analysis was used to assess the shared variance of survey items attributable to intimacy and sexuality without specification of an a priori hypothesis regarding the association of intimacy and sexuality with future change in cognitive status.

Results: Over the 10-year study period, 33.5% (n = 52) of individuals developed cognitive impairment. Participants with greater sexual satisfaction scores at baseline were statistically less likely to convert from cognitively intact to mild cognitive impairment or dementia in the future (p = .01). The domains of romance with one’s partner, beliefs about sexuality, and social support/emotional intimacy were not predictive of future longitudinal changes in cognitive status.

Conclusions: Sexual satisfaction is associated with longitudinal cognitive outcomes in cognitively intact, married, older adults.

Clinical implications: Clinicians should routinely assess for sexual satisfaction among older adults and refer to appropriate providers, such as couples or sex therapists, when appropriate.

KEYWORDS:

• Aging
• cognition
• couples
• intimacy
• sexuality

Clinical implications

• Sexual satisfaction may represent a novel social determinant of cognitive health

• Enhanced surveillance of sexual satisfaction may help identify those at increased risk for future cognitive status changes including the development of MCI and/or dementia

• Clinicians working with older adults should have a low threshold for referral to couples or sex therapists if signs and symptoms of sexual dissatisfaction are identified or suspected.

Acknowledgments

We would like to thank all of the participants who contribute their time to make this research possible. We would also like to thank Dr. Erin Abner for consulting with us on the statistical approach.

Disclosure statement

There is no potential conflict of interest among the authors.

Additional information

Funding

This work was supported by the National Institutes of Health/National Institute on Aging under Grant number P30 AG028383; National Institute on Aging [P30 AG028383].