Sexual Activity and Psychological Health As Mediators of the Relationship Between Physical Health and Marital Quality

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The pathways linking spousal health to marital quality in later life have been little examined at the population level. We develop a conceptual model that links married older adults’ physical health and that of their spouse to positive and negative dimensions of marital quality via psychological well-being of both partners and their sexual activity.


We use data from 1,464 older adults in 732 marital dyads in the 2010–2011 wave of the National Social Life Health and Aging Project.


We find that own fair or poor physical health is linked to lower positive and higher negative marital quality, spouse’s health to positive quality, and that own and spouse’s mental health and more frequent sex are associated with higher positive and lower negative marital quality. Further, we find that (a) sexual activity mediates the association between own and partner’s physical health and positive marital quality, (b) own mental health mediates the association between one’s own physical health and both positive and negative marital quality, and (c) partner’s mental health mediates the associations of spouse’s physical health with positive marital quality. These results are robust to alternative specifications of the model.


The results suggest ways to protect marital quality among older adults who are struggling with physical illness in themselves or their partners.

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