Introduction

As people live longer, the global population of older adults is increasing rapidly. In 2019, there were 703 million individuals aged 65 and older, a number expected to double by 2050. Promoting health and well-being for this age group is a public health priority.

Sexual health is now recognized as important for overall well-being at all ages. Research shows that older adults often face sexual difficulties and engage less frequently in sexual activities, with chronic diseases like cardiovascular issues significantly affecting their sexual health. Cognitive decline and psychological factors, such as mental health, also greatly influence sexual satisfaction.

On the other hand, positive attitudes toward sex and aging can predict better sexual outcomes and satisfaction. Additionally, having a regular partner, good communication, and relationship satisfaction are crucial for maintaining sexual activity and well-being in later life. Contrary to the belief that aging reduces sexual interest, many older adults continue to enjoy and value their sexual lives. Understanding sexual health in older age requires a broad perspective that includes well-being and pleasure, not just the absence of dysfunction.

Methods

To identify factors that may predict sexual well-being in older adults, a team of researchers conducted a study that included 60 partnered men and 51 partnered women, aged 55-81 (average age 63.2 years). Most participants had at least one college degree and were in long-term relationships, with relationship durations ranging from 1 to 52 years. Most identified as heterosexual, with a small percentage indicating varying sexual orientations. They were recruited through alumni mailing lists, senior university mailing lists, and social media.

The authors of the study administered an online survey that assessed various sociodemographic variables, self-rated health, comorbidities using the Charlson Comorbidity Index, subjective cognitive decline, and psychological distress using the Brief Symptom Inventory-18. The survey also included the Sexual Dysfunctional Beliefs Questionnaire to evaluate sexual beliefs and stereotypes and a multidimensional measure of sexual well-being, covering sexual satisfaction, frequency of cuddling, sexual intimacy, perceived sexual compatibility, and distress over sexual function.

Participants completed this 30-minute questionnaire covering cognitive, psychosexual, and relational aspects. Then, the researchers analyzed the data to identify factors influencing sexual well-being, considering health, relationship factors, and sexual beliefs.

Results

The study found several factors affecting sexual well-being among older adults. Age was linked to more health issues and memory complaints. Women reported more psychological distress and memory problems than men. Higher education was associated with longer relationships, but no sociodemographic factor significantly influenced sexual well-being.

Good self-rated health correlated with fewer health problems, psychological distress, and restrictive sexual beliefs. Longer relationships were linked to lower sexual well-being, while greater relationship satisfaction led to higher sexual well-being. Harboring unconstructive age-related sexual beliefs negatively impacted sexual well-being.

A regression model showed that health factors alone explained 9% of the variance in sexual well-being. Adding relationship factors increased the explained variance to 54%, and including age-related sexual beliefs raised it to 57%. The duration of the relationship, relationship satisfaction, and age-related sexual beliefs were significant predictors of sexual well-being.

Discussion & Conclusion

This study aimed to identify factors influencing sexual well-being in older partnered adults using a biopsychosocial model. The authors found that self-reported health, psychological distress, and subjective cognitive decline were linked to sexual well-being. Surprisingly, clinical comorbidities were not significantly associated.

They also found that longer relationship duration was negatively associated with sexual well-being, while higher relationship satisfaction was positively associated.

Lastly, negative age-related sexual beliefs were linked to lower sexual well-being, suggesting that positive attitudes toward sex in older age may improve sexual well-being.

These results indicate that sexual well-being in older adults is less dependent on specific health conditions and more on overall health perception, relationship quality, and positive sexual beliefs. This underscores the importance of promoting positive attitudes towards sex in older age and maintaining fulfilling relationships for sexual well-being.

References:

• Vasconcelos, P. A., Paúl, C., & Nobre, P. J. (2024). Biopsychosocial determinants of sexual health in older age: The role of health-related, relationship, and psychosexual factors. The Journal of Sexual Medicine, 21(5), 420–429. https://doi.org/10.1093/jsxmed/qdae027