The Trial of the Evaluation of Sexual Self-Consciousness in Older People
Published Date: August 16, 2018
The Trial of the Evaluation of Sexual Self-Consciousness in Older People
Andrzej Brodziak1,2*, Alicja Rozyk–Myrta2, and Estera Kolat2
1Institute of Occupational Medicine and Environmental Health, Sosnowiec, Poland
2Institute of Nursing, University of Applied Sciences, Nysa, Poland
*Corresponding author: Andrzej Brodziak, street Koscielna 1, 41-200 Sosnowiec, Poland, Tel: 48-322-660-885; Fax: 48-322-661-124; E-mail: email@example.com
Citation: Brodziak A, Rozyk–Myrta A, Kolat E (2018) The Trial of the Evaluation of Sexual Self-Consciousness in Older People. J Ger Ag Res 1(1):106.
Objectives: We tried to verify, how elderly people with cognitive impairment as opposed to persons characterized by normal mental performance answer to the questions of our own, short scale related to the sexual self-consciousness (awareness). In this way, we would like to determine whether there is a relationship, described in the literature on sexual arousal and cognitive functioning.
Methods: We gathered data from 56 persons, participants of so called University of Third Age, aged between 52 -81 years. We performed also some objective measurements, using the Montreal Cognitive Assessment (MOCA), the test of working memory system and the measurements of the parameters of “visuomotor” coordination.
Results: We didn’t found any correlation between the result of our, proposed scale for the “sexual consciousness” and the result of MOCA test and other measurements.
Conclusions: Probably the relationship, emphasized in the scientific reports, between the sexual arousal, sexual activity, and cognitive functioning doesn’t exist. However, the further exploration is needed in order to establish effective measurements of the sexual self-consciousness of older people and its relation to their cognitive functioning.
Keywords: Elderly; Cognitive performance; Sexual self- consciousness
Researchers interested in the causes of mild cognitive impairment and dementia emphasizes the importance of risk factors predisposing to these clinical conditions. Some of these researchers attach greater importance to the somatic risk factors. Other researchers attribute a greater role to lifestyle, stressful events and acquired competencies counteracting negative influences. Deckers et al.  on the basis of their study include to the most important risk factors for dementia: depression, hypertension, diabetes, obesity, hyperlipidemia, physical inactivity, and smoking. Kremen WS, et al.  are convinced that the early emergence of cognitive impairments results rather from the quality of mother-infant interactions, adverse events in childhood, long cumulative exposure to stress, ineffective coping strategies, long negative emotions, worry, rumination, and many social factors (e.g.: social ties, network size, integration, support, and conflicts). According to Kremen WS, et al. neuroticism, negative affectivity, depression or emotional instability are in old age a good indicator of the cumulative level of psychological stress experienced during the lifespan. So, according to them - the stress-related variables are important predictors of cognitive aging.
Some authors emphasized the relationship between sexual arousal, sexual activity, and cognitive performance. Hartmans C, et al.  investigated whether cognitive functioning is associated with the perception of one’s sexuality in old age. They found that: lower fluid intelligence and lower general cognitive functioning were associated with perceiving sexuality as unimportant, and lower immediate memory recall was associated with evaluating sexual life as unpleasant. Lover cognitive parameters were related also with disagreeing with a remaining need for intimacy when getting older. Thompson WK, et al.  performed cross-sectional study and found that: “Self-rated successful aging, quality of life, and sexual satisfaction appear to be stable in the face of declines in physical health, some cognitive abilities, and sexual activity and function and positively associated with each other from age 60 to 89”. Wright H, et al. take advantage of data collected in the course of "Wave 6" of The English Longitudinal Study of Ageing (ELSA)” . The questionnaire for the cohort "Wave 6 of ELSA" includes first time the questions pertaining to sexual relationships, and therefore enable the investigation of associations between sexual activity and cognitive function of older people.
Wright H, et al. elected from many questions of the used Sexual Relationships and Activities Questionnaire (SRA-Q), only a simple specific criterion enabling to distinguish older adults who were sexually active from those who were not. They assumed that sexual activity could include: intercourse, masturbation, petting or fondling. The dependent variables in this study were scores from cognitive tests of recall and a number sequencing. These authors found that “there were significant associations between sexual activity and number sequencing and recall in men. They argue that “sexual activity is associated with higher scores on tests of memory and executive function, in adults aged 50–89”. Data obtained during the "Wave 6" of the ELSA study, were also utilized by Lee DM, et al. . They estimated the overall sexual activity, problems with sexual functioning, and concerns about sexual health among all 7079 persons, who completed the SRA-Q. They found that however, the level of sexual activity declines with increasing age, although a sizable minority of men and women remain sexually active until the eighth and ninth decades of life.
The question arises however, what makes these women and men that they remain sexually active in their 70s and 80s. Of course, there are the impacts of state of health, the circumstance of having a partner, and other existential prerequisites. It seems to us; however, that important is the level of sensuality, which is formed from the earliest life years. In the terminology of psychology, this factor was recognized as the concept of so called "libido". This conviction results also from the mentioned research data of Hartmans C, et al.  and Thomsonet WK, et al. . On the other hand, other investigators consider opposite relationships. Mild cognitive impairment decreases the sexual activity . Depression, which coexists frequently with mild cognitive impairment, decreases also the interest in sex . It is therefore, an open question whether the reduced interest in sexual activity is caused just by the cognitive impairment. Thus, we have developed a extensive structured medical interview and corresponding extensive questionnaire . This interview comprises not only the questions about real, actual sexual activity, it includes also a short questionnaire, which should make possible the evaluation of so called sexual consciousness (awareness).
The survey was carried out among the participants of so called University of Third Age in Nysa ( South of Poland) the period from 27th March to 20th of May 2015. The study was conducted in two stages. In the first stage the participant were interviewed using a structured interview . The fragment of this interview is related to the sexual self-consciousness (Table 1). The complete form of the interview  encompassed yet the item formulated as: “My sexual activity is scarce and does not satisfy me” (see “A” in the Table 1).
In the second stage, we performed some objective measurements. We used so called Montreal Cognitive Assessment (MOCA) [10,11]. All necessary information for the application of this neuro-psychological test are available in the MoCa website . We used also the neuro-psychological test of the efficiency of working memory system accessible online. The essence of this test is equivalent to the “Walking Corsi test”. We performed also the measurements by means of some tools used in psycho-physical laboratories. We measured the reaction time and the parameters of “visuomotor” coordination. Namely, we used the tool called the “cross engine”, which oblige the examined person to touch the appropriate button according the exposed pattern of glimmers. This tool enables the estimation of the speed of psychomotor reaction, concentration, attention, perceptual accuracy, the speed of decision making, and resistance to fatigue. The first stage of the survey was accomplished by 90 people between 52 and 81 years of age. The whole study (I and II stage) was completed by 56 people (49 women, 7 men). Afterward, we tried to verify the eventual relationships between the results of various, performed measurements of cognitive performance and the measure of the “sexual consciousness”.
As a reference data, we treat the measurements performed in the group of young 20 women in the range of age < 24 – 49 > (mean age 36,35, standard deviation 7.19). We chose such a comparative group because the majority of participants attending classes at the University of the Third Age in Nysa are women. Gathering of data from the group of much younger women, who are sexually active, is justified by the reasonable assumption that probably the sexual awareness in this group is higher.
The mean number of points, gathered by the mentioned group of older people, using the proposed scale for the “sexual consciousness” was 3.018 (standard deviation 1,77). The mean value of the result of MOCA test was 24.37 (standard deviation 2,96). The proportions of the examined participants, who answered “yes” for the particular questions of the short scale for the “sexual consciousness”, are given in table 1. We didn’t find any correlation between the result of the “sexual consciousness” and the result of MOCA test (Spearman Rank Correlation Coefficient, R = -0.08261, p <= 0.5514). The correlation doesn’t exist even between the reactions to the statement “My sexual activity is scarce and does not satisfy me” and the results of above scale for the “sexual consciousness” (R = 0.224, p <= 0.1169). Also the difference in the proportion of older people, who have confirmed the statement “My sexual activity is scarce and does not satisfy me” in the group of examined persons with low and rather high (> 26 points) results of MOCA test is not statistically significant. Similarly, the difference in the proportion of older people, who characterized themselves by sentence “Erotic life, sex has always been important to me” - in the group of examined persons with low and rather high results of MOCA test is not statistically significant.
Contrary to the expectations, suggested by some authors we did not find the relationship between the applied estimates of the sexual self - consciousness, sexual activity and present cognitive capacity of elderly people, estimated by the Montreal Cognitive Assessment and some psychophysical measurements. The reasons that we didn't find a relationship between results obtained using the proposed scale of the sexual self-consciousness and effective cognitive performance can be twofold:
1. The tool of measurements, used by us - can be ineffective in the estimation of the sexual self- consciousness. 2. The relationship emphasized in the scientific reports, especially by Hartmans C, et al. , and Thompson WK, et al.  between the approval of sexual activity, sexual awareness and the effective cognitive performance, does not occur in some groups of elderly people.
The proposed set of items of the short scale of “sensuality, body awareness, libido” has however some discriminative value. We draw such a conclusion by analyzing the differences in the proportions of responses to the statements of the proposed scale, found between the group of older people and the younger women. Table 1 presents the frequency at which the participants of our survey responded positively to the particular questions of our scale. The mean number of points determined by the proposed scale for the “sexual consciousness” in the reference group of 20 young women was 5,6 (standard deviation 1.39). Among these 20 women, 14 declared, in the anonymous questionnaire, that “My sexual activity is rich and satisfies me”. All of them declared that: “I accept sensuality; I perceive sexuality in myself and other people and in heroes of novels and movies”. In this subgroup of 14 women 11 declared that “Erotic life, sex has always been important to me”, 10 women declared that “I accept fully my body”, 8 women declared that “I like to read articles about sex and watch erotic videos”. So, it can be proved that some formulation of the proposed scale discerns the sexual awareness more effectively. En example of another effort for the elaboration of the appropriate tools of evaluations can be the work of DeRogates LR, et al. .
1. The most discriminative reactions to possible statements related to self-consciousness of older people are phrases: "I accept fully my body", "As a woman - I dress to look sexy; being a man I admit that I pay attention to dress and appearance of sensuality of women", "Erotic life, sex has always been important to me”.
2. It seems to us that the further exploration is needed in order to establish a sensitive, effective measurement of the sexual self-consciousness (sexual awareness) of older people.
The realization of the work was possible due to the funds for the statutory scientific activity provided to University of Applied Sciences, Nysa by the Ministry of Science and Higher Education of Poland
Source of Support
Funds for the statutory scientific activity provided to University of Applied Sciences, Nysa by the Ministry of Science and Higher Education of Poland.
Conflicts of Interest
No Disclosures to Report.
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Copyright: © 2018 Brodziak A, et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly