The sexuality of aging is best understood by considering physiological evidence, personal history and beliefs, individual circumstances, and sociocultural expectations, throughout the individual's life. Aging is viewed traditionally in the Western world as a decline and loss: decline of functional capacities and loss of close attachments, health, and social status. This pessimistic, but culturally ingrained, view is consistent with several studies which found that the most common major life events reported by the aged are medical problems and illness or death of the spouse (Ruth and Coleman, 1996). Decline models of aging have been balanced most recently by models that emphasize processes of adaptation, as reflected by the perceived quality of life of people in their older years. This adaptation, positive or negative, is shaped by personal commitments, cognitive appraisal and coping responses, in keeping with the significance of events in the context of the person's life.

We have discussed, in preceding chapters, the impact that a wide range of medical illnesses and drugs have on male sexual function. We will now elaborate on the relationship between aging and disease as well as the processes of adaptation and their relevance to individual well-being, contentment, and health-care behaviors. There is a vast amount of literature in these areas, most of it recently published. However, its relevance to human sexuality has been neglected and there is virtually no research on psychosocial geriatrics and health–behavior relationships pertinent to male sexuality. The discussion that follows is oriented by a model pictured in Figure 12.1.