Health maintenance of the elderly. Sexuality

Empirical research, clinical experience, and greater sophistication about the interaction of social, psychological, and biological factors have produced marked changes in the appreciation of the importance of sexuality in older persons. An earlier view linking sex exclusively with reproductive function has given way to a holistic view of sex as vital to self-concept, the maintenance of healthy interpersonal relationships, and a sense of integrity. Older adults often have difficulty communicating sexual problems, concerns, and questions because of their conflicting attitudes and perceptions. Sexual problems often are presented covertly, expressed in vague terms, or masked by embarrassment. Physicians need to be aware of the possibility of covert sexual dysfunctions, clear about their own attitudes and expectations to avoid stereotyping the elderly, and knowledgeable about pharmacological, organic, and psychosocial bases of sexual problems in older patients.