Takes Two to Tango: Cognitive Impairment and Sexual Activity in Older Individuals and Dyads

Objectives This article examines the association between cognitive impairment, including mild cognitive impairment (MCI) and early dementia (ED), and sexual activity in a large, longitudinal sample of community-dwelling older adults. We focus here on sexual activity, which includes both sexual activity with a partner and masturbation. Methods We analyzed 3,777 older individuals and members of 955 intimate dyads using the National Social Life, Health, and Aging Project (2010 and 2015). We used ordered probit regression, cross-lagged panels models, and probit regression. Results We find that older adults with cognitive limitations, either MCI or ED, are about as likely to be sexually active with a partner as those with normal cognitive function. This is the case both in the cross-section and longitudinally. Both men and women with ED are less likely to have masturbated, however. Among married and cohabiting couples, we find no association between cognitive impairment in either the husband, the wife, or in both partners and their joint sexual activity. Women whose measured cognitive function is lower than their husbands are less likely to report any masturbation. Discussion Sex with a partner, a fundamentally social activity, seems to be conserved in the face of cognitive limitation but masturbation, a solitary activity, does not. We argue that the intimate dyad plays an important role in conserving partnered sexual activity. Results can inform strategies to maintain the sexual well-being of older adults with cognitive impairment and their partners as part of overall strategies to improve quality of life.

Automated summary

This article examines the association between cognitive impairment and sexual activity in older adults. The study finds that older adults with cognitive limitations are as likely to be sexually active with a partner as those with normal cognitive function, but are less likely to masturbate. There was no association between cognitive impairment and joint sexual activity in married and cohabiting couples. The intimate dyad plays an important role in conserving partnered sexual activity.