Sex and drugs (with or without rock and roll)

Annals of Internal Medicine published an interesting article today on sexual activity in 75 to 95 year-old men. Using data from a large cohort study in Australia, the authors identified several interesting findings:

While sexual activity decreases with advancing age, it is still common: approximately 40% of men age 75-79, 30% of men age 80-84, and 20% of men age 85-90 are sexually active
Roughly half of participants reported that sex was at least somewhat important. Many stated that sex was moderately or very important
Among men who were not sexually active, only 40% stated it was because of lack of interest. Reasons commonly cited for not being sexually active included lack of a partner, physical limitations of oneself or of the partner, and lack of interest by the partner.
Several reversable risk factors were associated with lack of sexual activity, including use of beta blockers and antidepressants (thus the title of this post).

These findings should not be surprising - news flash, men like to have sex - but serve as a useful reminder to consider probing about this important quality of life issue. I recently revised my clinic note template to remind myself to intermittently ask patients for updates on key geriatric issues, for example falls, functional status, continence, etc - but to my chagrin I now realize that sexual function didn't make the list. It may be time to change that template...
by: Mike Steinman

Comments

Helen Chen said…

Thanks, Mike. This is a good reminder. And while you are asking about sexual activity, please consider asking and counseling about HIV risks. Between 10-15% of new HIV infections occur in people over the age of 50, many of whom may not view themselves as being in a risk group. Since unintended pregnancy is generally not an issue, barrier methods may be perceived as unnecessary.

December 7, 2010 at 3:25 PM

Lost in Translation: Google’s Translation of Palliative Care to ‘Do-Nothing Care’

by: Cynthia X. Pan, MD, FACP, AGSF (@Cxpan5X)

My colleagues often ask me: “Why are Chinese patients so resistant to hospice and palliative care?” “Why are they so unrealistic?” “Don’t they understand that death is part of life?” “Is it true that with Chinese patients you cannot discuss advance directives?”

As a Chinese speaking geriatrician and palliative care physician practicing in Flushing, NY, I have cared for countless Chinese patients with serious illnesses or at end of life. Invariably, when Chinese patients or families see me, they ask me if I speak Chinese. When I reply “I do” in Mandarin, the relief and instant trust I see on their faces make my day meaningful and worthwhile.

At my hospital, the patient population is about 30% Asian, with the majority of these being Chinese. Most of these patients require language interpretation. It becomes an interesting challenge and opportunity, as we often need to discuss advance directives, goals of care, and end of life care options…

Elderhood: Podcast with Louise Aronson

In this week's podcast we talk with Louise Aronson MD, MFA, Professor of Geriatrics at UCSF about her new book Elderhood, available for purchase now for delivery on the release date June 11th.

We are one of the first to interview Louise, as she has interviews scheduled with other lesser media outlets to follow (CBS This Morning and Fresh Air with Terry...somebody).

This book is tremendously rich, covering a history of aging/geriatrics, Louise's own journey as a geriatrician facing burnout, aging and death of family of Louise's members, insightful stories of patients, and more.

We focus therefore on the 3 main things we think our listeners and readers will be interested in.

First - why the word "Elder" and "Elderhood" when JAGS/AGS and others recently decided that the preferred terminology was "older adult"?

Second - Robert Butler coined the term ageism in 1969 - where do we see ageism in contemporary writing/thinking? We focus on Louise's…

Psychedelics: Podcast with Ira Byock

In this week's podcast, we talk with Dr. Ira Byock, a leading palliative care physician, author, and public advocate for improving care through the end of life.

Ira Byock wrote a provocative and compelling paper in the Journal of Pain and Symptom Management titled, "Taking Psychedelics Seriously."

In this podcast we challenge Ira Byock about the use of psychedelics for patients with serious and life-limiting illness. Guest host Josh Biddle (UCSF Palliative care fellow) asks, "Should clinicians who prescribe psychedelics try them first to understand what their patient's are going through?" The answer is "yes" -- read or listen on for more!

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Eric: Welcome to the GeriPal Podcast. This is Eric Widera.

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