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This study explores the relationship between sex, health, and the number of sexually active years gained through good health in older individuals. It examines various aspects of health and their association with sexual function in older age groups.
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Sex, health, and years of sexually active life gained due to good health • Natalia S. Gavrilova • NORC at The University of Chicago • Chicago, USA
SEX HEALTH Is sex an “integral part” of health at older ages? What is health? Subjective measures Functional measures Biomeasures What aspects of health are most highly associated with sexual function at older ages?
Introduction to: NSHAP
NSHAP Design Overview • Wave 1: In 2005-06 interview 3,005 community-residing adults ages 57-85 • Population-based sample, minority over-sampling • 75.5% weighted response rate • 120-minute in-home interview • Questionnaire • Biomarker collection • Leave-behind questionnaire
Domains of Inquiry • Demographics • Basic Background Information • Marriage • Employment and Finances • Religion • Social • Networks • Social Support • Activities, Engagement • Intimate relationships, sexual partnerships • Physical Contact • Medical • Physical Health • Medications, vitamins, nutritional supplements • Mental Health • Caregiving • HIV • Women’s Health • Ob/gyn history, care • Hysterectomy, oophorectomy • Vaginitis, STDs • Incontinence
NSHAP Biomeasures “Laboratory Without Walls” Salimetrics (Saliva) Analysis) McClintock Laboratory (Cytology) Jordan Clinical Lab Magee Women’s Hospital (Bacterial, HPV Analysis) McDade Lab Northwestern (Blood Spot Analysis) UC Cytopathology (Cytology)
Salivary Biomeasures • Sex hormone assays • Estradiol • Progesterone • DHEA • Testosterone • Cotinine
National survey conducted in 1994/95 7,189 Americans aged 25-74 core national sample (N=3,485) city oversamples (N=957) Strata: age, self-reported health status Control variables: partner status, partner health, race, education
Domains of Inquiry • Social Networks • Physical Health • Sexuality • Personal beliefs • Work and Finances • Children • Marriage • Religion Childhood family background Psychological turning Community involvement Neighborhood Life overall
How to Compare Sexual Activity Across Populations? We suggest to use a new measure – Sexually Active Life Expectancy (SALE) Calculated using the Sullivan method Based on self-reported prevalence of having sex over the last 6 months (MIDUS and NSHAP studies) Life tables for the U.S. population in 1995 and 2003 (from Human Mortality Database)
Prevalence of Sexual Activity by Age and Gender (MIDUS 1)Men and women having intimate partner
Publication on sexuality Lindau, Gavrilova, British Medical Journal, 2010, 340, c810
Life expectancy and sexually active life expectancy (SALE) Based on the MIDUS study
Sexually active life expectancy and self-rated health Based on the MIDUS study
Is Sex an Important Predictor of Mortality? Wave 2 of NSHAP is able to answer this question. In 2010 and 2011, nearly 3,400 interviews were completed for Wave 2 with Wave 1 Respondents, Wave 1 Non-Interviewed Respondents, and their spouses or cohabiting romantic partners. NSHAP study collected information on the number of deaths between two waves.
Results were not changed if we used “interest in sex” variable (thinking about sex once a week or more often) instead of sexual inactivity
Biomarkers tested as mortality predictors C-reactive protein (CRP) DHEA Testosterone (T) Estradiol (E2) Glycated hemoglobin (HbA1C) Note: HbA1C turned out to be non-significant predictor of mortality
Selected biomarkers and 5-year mortalityNSHAP data. Men Controlled for age and smoking status
Selected biomarkers and 5-year mortalityNSHAP data. Women Controlled for age and smoking status
More Information on Biomarkers is Available at the CCBAR website http://biomarkers.uchicago.edu/ Acknowledgements This study was supported by NIH grants. Study on SALE has been jointly conducted with Dr. Stacy Lindau, MD, MAPP at the ObGyn Dept., University of Chicago