Factors Associated with Sexuality in Older Adults: A Scoping Review

Background and Purpose: The increasing life expectancy and aging global population highlight the importance of understanding the multifaceted aspects of life in older age, including sexuality. Sexuality remains a vital component of emotional and physical well-being throughout an individual's life, yet it is often overlooked or misunderstood in the context of aging. This study aims to explore factors associated with sexuality among older adults, focusing particularly on sexual satisfaction and attitudes towards sexuality, recognizing these elements as central to the overall quality of life and well-being of older individuals.

Methods: We conducted a scoping review based on the framework developed by Arksey and O’Malley using the Embase electronic database. A total of 31 relevant studies were identified and later screened for eligibility. To be included in the review, studies must: (1) examine sexuality among older adults, (2) include a sample of older adults (65 years or older), (3) be published in English, (4) be peer-reviewed journal articles, and (5) be published between 2018 and 2024. Literature review studies were excluded from this review. An iterative approach was adopted for screening and data analysis.

Results: A total of nine eligible studies were included in this review. Findings revealed that older adults maintain a significant interest in sex and intimacy, challenging the stereotype that sexual desire inevitably wanes with age. Despite an increase in sexual inactivity due to age-related health issues such as erectile dysfunction, the desire for intimacy remains robust. Noticeable gender differences were highlighted in the reviewed studies, with men demonstrating a greater tendency towards maintaining sexual activity. These studies also identified several barriers to sexual activity among older adults, including physical health conditions, the availability of a partner, and restrictive social and cultural norms, particularly in settings such as assisted living facilities where privacy is often limited. Additionally, there is a gap in sexual health information and a general reluctance to discuss sexual issues, indicating a need for more open dialogues and resources.

Conclusions and Implications: This review underscores that older adults maintain an interest in sexuality, with sexual satisfaction significantly influencing overall life satisfaction. Key factors affecting sexual activity include health status, partner availability, and societal norms. The findings challenge stereotypes of sexual decline solely due to aging and highlight the importance of addressing physical and social barriers. Findings imply that understanding and support for sexuality in older age can improve quality of life. Healthcare providers should incorporate discussions and interventions around sexuality into routine care for older adults. Additionally, policies should promote privacy and social support in living arrangements for the elderly.