Aging
Gendered Pathways of Pleasure, Satisfaction, and Health: A Longitudinal Study of Older U.S. Adults from 2005 to 2023 Caitlin* Caitlin Flouton Blanco Flouton Blanco University of Maryland, College Park
Objective: This gender-stratified study aims to disentangle the independent effects of age, period, and birth cohort on sexual relationship quality among older U.S. adults, and to examine the longitudinal associations between sexual quality and self-rated physical and mental health.
Methods: We analyzed four waves (2005–2023) of data from the National Social Life, Health, and Aging Project (NSHAP), comprising 6,068 adults aged 57+. Hierarchical age-period-cohort (HAPC) models quantified temporal effects on physical pleasure and emotional satisfaction. Longitudinal mixed-effects models then assessed how these dimensions predicted health trajectories among 4,113 participants with repeated measures, testing for interactions and adjusting for key sociodemographic confounders.
Results: APC analysis revealed a U-shaped age effect for emotional satisfaction in both genders, with a nadir around age 69. A pronounced gender gap emerged in cohort effects, where men reported consistently higher propensities for “extremely” pleasurable relationships (range: 23.6–32.7%) compared to women (9.0–13.7%). Longitudinally, both physical pleasure (females: aOR=1.48, 95% CI: 1.36-1.61; males: aOR=1.55, 95% CI: 1.42-1.69) and emotional satisfaction (females: aOR=1.52, 95% CI: 1.39-1.66; males: aOR=1.68, 95% CI: 1.52-1.85) were associated with better mental health. A key finding was a significant synergistic interaction among men for both health outcomes, where the protective effect of physical pleasure increased with higher emotional satisfaction.
Discussion: Sexual relationship quality is a dynamic determinant of health in later life, shaped by gendered experiences across age, historical period, and cohort. Findings underscore the importance of integrating multidimensional, gender-sensitive approaches to sexual well-being into geriatric care and health promotion.