Benetos 2

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Benetos 2

  1. 1. Sexual life and longevity <ul><li>Athanase Benetos </li></ul><ul><li>University of Nancy </li></ul><ul><li>4th International Seminar in Preventive Geriatrics </li></ul><ul><li>Athens, April 2011 </li></ul>
  2. 3. Naked-mole Rat The 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
  3. 4. Naked-mole Rat <ul><li>- living in community </li></ul><ul><li>- groups of 10–290 individuals, with a unique Queen </li></ul><ul><li>- The Queen keeps the same partner </li></ul><ul><li>… but she adds 1–3 of her sons to complete her procreation activities. </li></ul>
  4. 5. . 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. <ul><ul><ul><ul><ul><li>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. </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>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. </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>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 . </li></ul></ul></ul></ul></ul>
  5. 6. Sex and death: are they related?
  6. 7. 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?
  7. 8. Sex and death: are they related? The Caerphilly cohort study G. Davey Smith, S. Frankel, J. Yarnell, BMJ 1997;315:1641-1644 <ul><li>3 groups of sexual activity (number of orgasms): </li></ul><ul><ul><li>Low : >1 /month </li></ul></ul><ul><ul><li>1 /month < Intermediate <2 /week </li></ul></ul><ul><ul><li>High > 2 /week </li></ul></ul>A Cohort composed of 918 men aged 45 to 60.
  8. 9. Sex and death: are they related? The Caerphilly cohort study G. Davey Smith , S. Frankel , J. Yarnell , BMJ 1997
  9. 10. <ul><li>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. </li></ul><ul><li>The lower cardiovascular and total mortality was confirmed even after adjustment for the initial health status of the participants. </li></ul>G. Davey Smith , S. Frankel , J. Yarnell , BMJ 1997 Sex and death: are they related? The Caerphilly cohort study
  10. 11. <ul><li>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. </li></ul><ul><li>The lower cardiovascular and total mortality was confirmed even after adjustment for the initial health status of the participants. </li></ul><ul><li>The study concluded that an increase of 100 orgasms per year is able to reduce mortality by 36%! </li></ul>G. Davey Smith , S. Frankel , J. Yarnell , BMJ 1997 Sex and death: are they related? The Caerphilly cohort study
  11. 12. 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 Smith J Epidemiol Community Health. 2002;56:99-102
  12. 13. S Ebrahim et al, Epidemiol Comm Health . 2002;56:99-102 <ul><li>A 20-year follow-up showed that these effects were still present but somehow less significant </li></ul>
  13. 14. Huang-Kuang Chen et al, Intern J Epidemiol , 2007
  14. 15. Huang-Kuang Chen et al, Intern J Epidemiol , 2007
  15. 16. Sexual activity and mortality in a Chinese population (>65 ans) Huang-Kuang Chen et al, Intern J Epidemiol , 2007
  16. 17. Huang-Kuang Chen et al, Intern J Epidemiol , 2007 Sexual activity and mortality in a Chinese population (>65 ans)
  17. 18. Sexual activity and mortality in a Chinese population (>65 ans) Huang-Kuang Chen et al, Intern J Epidemiol , 2007
  18. 19. Sexual activity and mortality in a Chinese population (>65 ans)
  19. 20. What is in the mind of younger people… … .Sexual activity in the very elderly is:
  20. 21. <ul><li>Dangerous </li></ul><ul><li>Without interest </li></ul><ul><li>Not adapted </li></ul><ul><li>Ugly </li></ul><ul><li>Vicious </li></ul><ul><li>Nice souvenirs… </li></ul>What is in the mind of younger people… Sexual activity in the very elderly is:
  21. 22. Is sexual activity risky? <ul><li>Sexual activity is also a physical activity. Therefore it has to be adapted to the physical (cardio-vascular, respiratory, muscular…) condition of the elderly. </li></ul><ul><li>For elderly men, the risk is much lower when sex is done with the regular partner… </li></ul>
  22. 23. <ul><li>Is sex without interest? </li></ul>
  23. 24. 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
  24. 25. N. Beckman,et al, BMJ, 2008
  25. 26. <ul><li>Psychological stress </li></ul><ul><li>Life conditions </li></ul><ul><li>Previous sexual life </li></ul><ul><li>Mental and physical status </li></ul><ul><li>Are the most important factors </li></ul>The hormonal deficit is not a major factor in the decrease of the libido in women >45 y.o.  Hartmann et al. Menopause , 2004
  26. 27. Frequent diseases that can influence sexual life <ul><li>Heart failure </li></ul><ul><li>Hypertension </li></ul><ul><li>Diabetes </li></ul><ul><li>Arthritis </li></ul><ul><li>Depression </li></ul><ul><li>Neuro-degenerative diseases </li></ul><ul><li>Sarcopenia </li></ul>
  27. 28. 2007: Dpt of Geriatrics, Nancy Age #Med #Pathol All: 82 5.8 3.2 Men : 78 5.3 3.2 Women : 84 6.0 3.2 A. Benetos : personal data Number of drugs used in the very elderly
  28. 29. 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%)
  29. 30. Sexuality in the elderly Conclusions (1) <ul><li>Sexuality in the elderly is one of the « key » factors against loneliness. </li></ul><ul><li>Age by itself is not a major determinant for the loss of sexual desire and sexual capacities </li></ul><ul><li>Diseases and drugs greatly influence sexual life </li></ul>
  30. 31. <ul><li>- Sexual activity is also a physical activity with some risks </li></ul><ul><li>But sexual life is much more than physical performance </li></ul>Succesful aging : Adapt your sexual life to your physical capacities Sexuality in the elderly Conclusions (2)

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