Biopsychosocial determinants of sexual health in older age: the role of health-related, relationship, and psychosexual factors

Background Given the unprecedented aging of the population and the increased focus on overall well-being in older age, investigating the determining factors of sexual well-being in older adults becomes essential as it offers insights into promoting healthy aging and overall quality of life. Aim By applying the biopsychosocial model of sexuality in older age, we aimed to identify the role of biomedical and psychosocial factors in predicting sexual well-being in partnered older adults (>= 55 years old). Methods A total of 111 participants (mean [SD], 63.2 [5.96]) completed a self-report questionnaire assessing biopsychosocial dimensions. Bivariate correlational analyses and hierarchical multiple regression were conducted to investigate factors associated with sexual well-being. Health-related factors were entered into the first regression model. The second model included factors pertaining to relationship dimensions. Sexual beliefs were introduced in the third regression model. Outcomes Self-rated health, psychological distress, subjective cognitive decline, sexual beliefs, duration of the relationship, relationship satisfaction, and sexual well-being were assessed. Results Findings from the hierarchical regression revealed that duration of relationship [t(104) = -3.07, P < .01], relationship satisfaction [t(104) = 8.49, P < .001], and age-related sexual beliefs [t(104) = -2.75, P < .01] were significant predictors of sexual well-being of partnered older adults [F(6, 104) = 22.77, P < .001, R-2 = .57], after controlling for health-related factors. These findings suggest that relationship factors and sexual beliefs play a significant role in predicting sexual well-being of older adults, above and beyond health-related dimensions. Clinical implications Interventional approaches aimed at promoting sexual well-being in older age might benefit from incorporating exercises that demystify age-related sexual beliefs, by normalizing changes that occur with aging and fostering positive attitudes toward sexual expression in older age; particularly for older adults in long-term relationships, relationship satisfaction must also be considered as an important intervention target. Strengths and limitations Further investigation using longitudinal designs is required to examine the causal links between these factors and sexual well-being in older age. Conclusion Findings from this study underscore the role of relationship dimensions and age-related sexual beliefs for the sexual well-being of partnered older adults.