Benetos 2

Sexual life and longevity

Athanase Benetos

University of Nancy

4th International Seminar in Preventive Geriatrics

Athens, April 2011

Naked-mole RatThe animal standing is a 24-year-old breeding female that is midway through gestation,

and the animal sleeping is her 28.3-year-old naked mole-rat mate.

This picture was taken a few days before he died

R. Buffenstein: J Gerontol Biol Sciences, 2005, Vol. 60A, No. 11, 1369–1377

Naked-mole Rat

- living in community

- groups of 10–290 individuals, with a unique Queen

- The Queen keeps the same partner

…but she adds 1–3 of her sons to complete her procreation activities.

. Trends in mortality in older women: findings from the Nun Study

Butler, S.M., Snowdon, D.A., J Gerontol B Psychol Sci Soc Sci, 1996, 51:S201-8.

Mortality rates at ages 50 to 84 years in a population of 2,573 Catholic sisters were compared to those in the general population during the years 1965 to 1989.

The Catholic sisters had a mortality advantage that increased dramatically over calendar time, and from early to more recent birth cohorts. This coincided with increases in smoking by U.S. women, while during the same time period the Catholic sisters had very low rates of mortality from smoking-related diseases.

The Catholic sisters had high rates of mortality from cancers of the breast and reproductive organs, suggesting an effect of nulliparity manifested in older women.

Sex and death: are they related?

G. Davey Smith, S. Frankel, J. Yarnell, Sex and death: are they related? The Caerphilly cohort study BMJ 1997;315:1641-1644

Sex and death: are they related?

Sex and death: are they related? The Caerphilly cohort study

G. Davey Smith, S. Frankel, J. Yarnell, BMJ 1997;315:1641-1644

3 groups of sexual activity (number of orgasms):

Low: >1 /month

1 /month < Intermediate <2 /week

High > 2 /week

A Cohort composed of 918 men aged 45 to 60.

Sex and death: are they related? The Caerphilly cohort study

G. Davey Smith, S. Frankel, J. Yarnell, BMJ 1997

After 10 years of follow up, mortality was reduced by 50% in those with high sexual activity as compared to the group with the lower sexual activity.

The lower cardiovascular and total mortality was confirmed even after adjustment for the initial health status of the participants.

G. Davey Smith, S. Frankel, J. Yarnell, BMJ 1997

Sex and death: are they related? The Caerphilly cohort study

After 10 years of follow up, mortality was reduced by 50% in those with high sexual activity as compared to the group with the lower sexual activity.

The lower cardiovascular and total mortality was confirmed even after adjustment for the initial health status of the participants.

The study concluded that an increase of 100 orgasms per year is able to reduce mortality by 36%!

G. Davey Smith, S. Frankel, J. Yarnell, BMJ 1997

Sex and death: are they related? The Caerphilly cohort study

Sex and death: are they related? The Caerphilly cohort study

20-year follow-up

S Ebrahim, M May, Y Ben Shlomo, P McCarron, S Frankel, J Yarnell, G Davey SmithJ Epidemiol Community Health. 2002;56:99-102

S Ebrahim et al, Epidemiol Comm Health. 2002;56:99-102

A 20-year follow-up showed that these effects were still present but somehow less significant

Huang-Kuang Chen et al, Intern J Epidemiol, 2007

Huang-Kuang Chen et al, Intern J Epidemiol, 2007

Huang-Kuang Chen et al, Intern J Epidemiol, 2007

Sexual activity and mortality in a Chinese population (>65 ans)

Huang-Kuang Chen et al, Intern J Epidemiol, 2007

Sexual activity and mortality in a Chinese population (>65 ans)

Huang-Kuang Chen et al, Intern J Epidemiol, 2007

Sexual activity and mortality in a Chinese population (>65 ans)

Sexual activity and mortality in a Chinese population (>65 ans)

What is in the mind of younger people…

….Sexual activity in the very elderly is:

- Dangerous Dangerous - Without interestWithout interest- Not adaptedNot adapted- UglyUgly- ViciousVicious

- Nice souvenirs…Nice souvenirs…

What is in the mind of younger people…

Sexual activity in the very elderly is:

Is sexual activity risky?

Sexual activity is also a physical activity. Therefore it has to be adapted to the physical (cardio-vascular, respiratory, muscular…) condition of the elderly.

For elderly men, the risk is much lower when sex is done with the regular partner…

- Is sex without interest?Is sex without interest?

Secular trends in self reported sexual activity and satisfaction in Swedish 70 year olds: cross sectional survey of four populations 1971-2001

N. Beckman, M. Waern, I. Skoog BMJ 2008

N. Beckman,et al, BMJ, 2008

Psychological stress

Life conditions

Previous sexual life

Mental and physical status

Are the most important factors

Hartmann et al. Menopause, 2004

The hormonal deficit is not a major factor in the decrease of the libido in women >45 y.o. 

Frequent diseases that can influence sexual life

Heart failure Hypertension Diabetes Arthritis Depression Neuro-degenerative diseases Sarcopenia

2007: Dpt of Geriatrics, Nancy

Age #Med #PatholAll: 82 5.8 3.2

Men : 78 5.3 3.2Women : 84 6.0 3.2

A. Benetos : personal data

Number of drugs used in the very elderly

Medications used in the very elderly

2007: Day hospital, Geriatrics, University of Nancy

Benzodiazepines: 27% (H23%, F29%)Anti-depressors : 32% (H27%, F35%)

Diuretics : 42% (H38%, F44%)Blockers: 24% (H35%, F19%)ACEI : 22% (H19%, F23%)AT1 antag : 18% (H12%, F21%)CCB: 18% (H8%, F23%)

Statins : 12% (H15%, F10%)

Anti-aggregants : 31% (H27%, F33%) Anti-coagulants : 15% (H12%, F17%)

Pain killers : 30% (H23%, F33%)

Anti-cholinesterase: 18% (H27%, 13%)

Sexuality in the elderly Conclusions (1)

• Sexuality in the elderly is one of the « key » factors against loneliness.

• Age by itself is not a major determinant for the loss of sexual desire and sexual capacities

• Diseases and drugs greatly influence sexual life

- Sexual activity is also a physical activity with some risks

- But sexual life is much more than physical performance

Succesful aging : Adapt your sexual life to your physical capacities

Sexuality in the elderly Conclusions (2)