Geriatrics; Sexuality; Aging; 70 years and Older; Sex Factors; Tenderness
Abstract :
[en] Background: Despite the World Health Organization calling for sexuality to be recognized as an aspect of wellbeing, no studies have explored sexual activity and physical tenderness in older adults aged ≥ 75 years in Belgium or those aged ≥ 85 years worldwide.
Aim: To assess the prevalence and predictors of sexual activity and physical tenderness in a sample of older adults.
Methods: Using data from a Belgian cross-sectional study on sexual violence (UN-MENAMAIS), information on sexual activity, physical tenderness, and associated characteristics was collected during structured face-to-face interviews with older adults living in the community, assisted living facilities, or nursing homes. Cluster random probability sampling with a random route-finding approach was used to select the participants.
Outcomes: Current sexual activity and physical tenderness in the previous 12 months, sociodemographic characteristics, chronological age, subjective age, number of sexual partners, sexual satisfaction, attitudes toward sexuality
in later life, quality of life, and lifetime sexual victimisation.
Results: Among the 511 participants included, 50.3% were in a relationship, mainly living with their partner; 31.3% indicated they were sexually active; and 47.3% of sexually inactive participants reported having experienced forms of physical tenderness in the previous 12 months. Sexual activity was associated with the presence of a partner, satisfaction with sexual life, permissive attitudes regarding sexuality in later life, a younger age, and a
lack of disability. Physical tenderness was associated with the presence of a partner, community residency, and permissive attitudes regarding sexuality in later life.
Clinical Implications: Raising awareness among the general population, healthcare professionals, and older adults about sexuality in later life could contribute to ending this taboo and should therefore be a priority for society.
Strengths and Limitations: Our study fills a gap in the literature regarding sexual activity and physical tenderness in older adults aged ≥ 70 years, including respondents aged up to 99 years. Additionally, we explored different forms of sexual expression beyond intercourse, and face-to-face interviews contributed to the quality of the collected data. The main limitation of this study was the sample size, although the findings were similar to recent statistical indicators in Belgium.
Conclusion: One in 3 older adults aged ≥ 70 years living in Belgium are sexually active. These findings provide an opportunity to inform the general public and older adults about later life sexuality and to educate healthcare professionals about aging sexuality to increase discussions and avoid assumptions of asexuality in later life.
Research center :
International Centre for Reproductive Health, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium School of Social Work and Research Centre on Aging, University of Sherbrooke, Sherbrooke, Canada Department of Criminology, Criminal Law and Social Law, Ghent University, Ghent, Belgium
Disciplines :
Social & behavioral sciences, psychology: Multidisciplinary, general & others
Author, co-author :
Cismaru Inescu, Adina ; Université de Liège - ULiège > Adaptation, Résilience et CHangement (ARCH) ; Université de Liège - ULiège > > Emancipation sociale, Santé des Populations, Réduction des Inégalités sociales dans des sociétés en transition
Hahaut, Bastien ; Université de Liège - ULiège > > Emancipation sociale, Santé des Populations, Réduction des Inégalités sociales dans des sociétés en transition
Adam, Stéphane ; Université de Liège - ULiège > Adaptation, Résilience et CHangement (ARCH)
Nobels, Anne; UGent - Ghent University > Department of Public Health and Primary Care > International Centre for Reproductive Health
Beaulieu, Marie; University of Sherbrooke > School of Social Work and Research Centre on Aging
Vandeviver, Christophe; UGent - Ghent University > Department of Criminology, Criminal Law and Social Law > Institute for International Research on Criminal Policy
Keygnaert, Ines; UGent - Ghent University > Department of Public Health and Primary Care > International Centre for Reproductive Health
Nisen, Laurent ; Université de Liège - ULiège > > Emancipation sociale, Santé des Populations, Réduction des Inégalités sociales dans des sociétés en transition
Language :
English
Title :
Sexual Activity and Physical Tenderness in Older Adults: Prevalence and Associated Characteristics From a Belgian Study
BELSPO - Belgian Science Policy Office [BE] FWO - Flemish Research Foundation [BE]
Funding text :
The research used for this study was subsidized by the Belgian Federal Science Policy via contract BR/175/A5/UNMENAMAIS. C.V.’s contribution to this work was supported in part by the Research Foundation—Flanders (FWO) Postdoctoral Fellowship funding scheme under Grants 12C0616N to C.V., 12C0619N to C.V.
United Nations. World Population Ageing 2019: Highlights. (ST/ESA/SERA/430); 2019. Available at: https://www.un.org/en/development/desa/population/publications/pdf/ageing/WorldPopulationAgeing2019-Highlights.pdf. Accessed July 6, 2020.
Belgian Federal Government. Statbel. Statistics Belgium. 2020. Available at: https://statbel.fgov.be/fr/themes/population/structure-de-la-population#panel-14. Accessed January 5, 2021.
Eurostat. Mortality and life expectancy statistics. 2019. Available at: https://ec.europa.eu/eurostat/statisticsexplained/index.php/Mortality_and_life_expectancy_statistics. Accessed January 5, 2021.
World Health Organization. Defining sexual health: Report of a technical consultation on sexual health; 2006a. Available at: https://www.who.int/reproductivehealth/publications/sexual_health/defining_sexual_health.pdf. Accessed December 8, 2017.
World Health Organization. Entre Nous. The European Magazine for Sexual and Reproductive Health. 2013. Available at: https://www.ec-ec.org/wp-content/uploads/2013/12/Entre-Nous-79-Eng.pdf. Accessed July 6, 2020.
World Health Organization. Global strategy and action plan on ageing and health. 2017. Available at: https://www.who.int/ageing/WHO-GSAP-2017.pdf?ua=1. Accessed July 6, 2020.
Umidi, S, Pini, M, Ferretti, M, et al. Affectivity and sexuality in the elderly: Often neglected aspects. Arch Gerontol Geriatr 44:Suppl 1 (2007), 413–417.
Mahieu, L, Gastmans, C., Older residents' perspectives on aged sexuality in institutionalized elderly care: A systematic literature review. Int J Nurs Stud 52 (2015), 1891–1905.
Cismaru-Inescu, A, Adam, S, Nobels, A, et al. The elephant in the room - A critical interpretive synthesis of older adults’ sexuality. Int J Sex Health, 2021, 10.1080/19317611.2021.1958040.
Haesler, E, Bauer, M., Fetherstonhaugh, D., Sexuality, sexual health and older people: A systematic review of research on the knowledge and attitudes of health professionals. Nurse Educ Today 40 (2016), 57–71.
Gewirtz-Meydan, A, Levkovich, I, Mock, M, et al. Sex for seniors: How physicians discuss older adult's sexuality. Isr J Health Policy Res, 9, 2020.
DeLamater, J, Friedrich, WN., Human sexual development. J Sex Res 39 (2002), 10–14.
Lindau, ST, Gavrilova, N., Sex, health, and years of sexually active life gained due to good health: Evidence from two US population based cross sectional surveys of ageing. BMJ, 340, 2010, c810.
Choi, KB, Jang, SH, Lee, MY, et al. Sexual life and self-esteem in married elderly. Arch Gerontol Geriatr 53 (2011), e17–e20.
Even-Zohar, A, Werner, S., Older adults and sexuality in Israel: Knowledge, attitudes, sexual activity and quality of life. J Aging Sci, 7, 2019, 209.
Flynn, TJ, Gow, AJ., Examining associations between sexual behaviours and quality of life in older adults. Age Ageing 44 (2015), 823–828.
Freak-Poli, R, Kirkman, M, De Castro Lima, G, et al. Sexual activity and physical tenderness in older adults: Cross-sectional prevalence and associated characteristics. J Sex Med 14 (2017), 918–927.
Minichiello, V, Plummer, D, Loxton, D., Factors predicting sexual relationships in older people: An Australian study. Australasian Journal on Ageing 23 (2004), 125–130.
Palacios-Ceña, D, Carrasco-Garrido, P, Hernández-Barrera, V, et al. Sexual behaviors among older adults in Spain: Results from a population-based national sexual health survey. J Sex Med 9 (2012), 121–129.
Wang, TF, Lu, CH, Chen, IJ, et al. Sexual knowledge, attitudes and activity of older people in Taipei, Taiwan. J Clin Nurs 17 (2008), 443–450.
Villar, F, Celdrán, M, Fabà, J, et al. Barriers to sexual expression in residential aged care facilities (RACFs): Comparison of staff and residents’ views. J Adv Nurs 7 (2014), 2518–2527.
Frankowski, AC, Clark, LJ., Sexuality and Intimacy in assisted living: Residents’ perspectives and experiences. Sex Res Soc Policy J NSRC 6 (2009), 25–37.
Traeen, B, Stulhofer, A, Janssen, E, et al. Sexual activity and sexual satisfaction among older adults in four European countries. Arch Sex Behav 48 (2019), 815–829.
Stulhofer, A, Hinchliff, S, Jurin, T, et al. Successful aging, change in sexual interest and sexual satisfaction in couples from four European Countries. Eur J Ageing 16 (2019), 155–165.
World Health Organization. Constitution of the World Health Organization. 1948. Available at: https://www.who.int/about/governance/constitution. Accessed March 20, 2021.
Lee, DM, Vanhoutte, B, Nazroo, J, et al. Sexual health and positive subjective well-being in partnered older men and women. J Gerontol B Psychol Sci Soc Sci 71 (2016), 698–710.
Anderson, RM., Positive sexuality and its impact on overall well-being. Bundesgesundheitsbl 56 (2013), 208–214.
Smith, L, Yang, L, Veronese, N, et al. Sexual activity is associated with greater enjoyment of life in older adults. Sex Med 7 (2019), 11–18.
Ganong, K, Larson, E., Intimacy and belonging. Society and Mental Health 1 (2012), 153–172.
Lindau, ST, Schumm, LP, Laumann, EO, et al. A study of sexuality and health among older adults in the United States. N Engl J Med 357 (2007), 762–774.
FRA. Violence against women: an EU-wide survey main results violence against women: An EU-wide survey. European Agency for Fundamental Rights;, 2014.
Krahé, B BA, Vanwesenbeeck, I, Bianchi, G, et al. Prevalence and correlates of young people's sexual aggression perpetration and victimisation in 10 European countries: A multi-level analysis. Culture, Health & Sexuality, 2015.
Nobels, A, Cismaru-Inescu, A, Nisen, L, et al. Challenges in conducting sexual health and violence research in older adults beyond GDPR: A Belgian case study. J Interpers Violence 1 (2021), 1–21.
Naughton, C, Drennan, J, Lyons, I, et al. Elder abuse and neglect in Ireland: Results from a national prevalence survey. Age Ageing 41 (2012), 98–103.
Boaz, M, Ben-David, GM, Hadas, E., Ageism and neuropsychological tests. L. Ayalon & C. Tesch-Römer (Eds), Contemporary Perspectives on Ageism, 2018, Springer, Cham, Switzerland, 277–298.
World Health Organization. Ethical and safety recommendations for intervention research on violence against women: Building on lessons from the WHO publication “Putting women first: Ethical and safety recommendations for research on domestic violence against women”. Geneva, Switzerland, 2016. Available at: https://www.who.int/reproductivehealth/publications/violence/intervention-research-vaw/en/. Accessed January 25, 2018.
Lewis-Beck, M., Bryman, A., Futing Liao, T., (Eds.) The SAGE encyclopedia of social science research methods. 2004, SAGE Publishing, 10.4135/9781412950589.
White, CB., A scale for the assessment of attitudes and knowledge regarding sexuality in the aged. Arch Sex Behav 11 (1982), 491–502.
Stephan, Y, Sutin, AR, Terracciano, A., Subjective age and mortality in three longitudinal samples. Psychosom Med 80 (2018), 659–664.
Schapansky, E, Depraetere, J, Keygnaert, I, et al. Prevalence and risk factors of sexual victimization: Findings from a national representative sample of Belgian adults aged 16-69. Int J Environ Res Public Health, 18, 2021, 7360.
Belgian Federal Government. Statbel. Statistics Belgium. 2021. Available at: https://bestat.statbel.fgov.be/bestat/crosstable.xhtml?datasource=65ee413b-3859-4c6f-a847-09b631766fa7. Accessed March 24, 2021.
Nobels, A., Cismaru-Inescu, A., Nisen, L., et al. Sexual violence in older adults: A Belgian prevalence study. BMC Geriatr, 21, 2021, 601, 10.1186/s12877-021-02485-3.
Matthias, RE, Lubben, JE, Atchison, KA, et al. Sexual activity and satisfaction amongcVery old adults: Results from a community-dwelling medicare population survey. Gerontologist, 1997.
Villar, F, Serrat, R, Celdrán, M, et al. Staff attitudes and reactions towards residents’ masturbation in Spanish long-term care facilities. J Clin Nurs 25 (2016), 819–828.
Waite, LJ, Laumann, EO, Das, A, et al. Sexuality: Measures of partnerships, practices, attitudes, and problems in the National Social Life, Health, and Aging Study. J Gerontol B Psychol Sci Soc Sci 64:Suppl 1 (2009), i56–i66.
Watson, WK, Stelle, C, Bell, N., Older women in new romantic relationships: Understanding the meaning and importance of sex in later life. Int J Aging Hum Dev 85 (2017), 33–43.
von Humboldt, S, Ribeiro-Gonçalves, JA, Costa, A, et al. Sexual expression in old age: How older adults from different cultures express sexually?. Sex Res Soc Policy 18 (2021), 246–260.
Lai, Y, Hynie, M., A tale of two standards: An examination of young adults’ endorsement of gendered and ageist sexual double standards. Sex Roles 64 (2011), 360–371.
Berdychevsky, L, Nimrod, G., Sex as leisure in later life: A netnographic approach. Leisure Sciences 39 (2016), 224–243.
Gewirtz-Meydan, A, Hafford-Letchfield, T, Benyamini, Y, et al. Ageism and sexuality. Contemp Perspect Ageism, 2018, 149–162.
Gagnon, JH, Simon, W., Sexual conduct: The social sources of human sexuality. 1973, Routledge Chicago: Aldine.
Wiederman, MW., The gendered nature of sexual scripts. The Family J: Counseling and Therapy for Couples and Families 13 (2005), 496–502.
Goldenberg, M., Mulheres e envelhecimento na cultura brasileira. Caderno Espaço Feminino. 25 (2012), 46–56.
Beckman, N, Waern, M, Gustafson, D, et al. Secular trends in self reported sexual activity and satisfaction in Swedish 70 year olds: Cross sectional survey of four populations, 1971-2001. BMJ, 2008, 337.
Papaharitou, S, Nakopoulou, E, Kirana, P, et al. Factors associated with sexuality in later life: An exploratory study in a group of Greek married older adults. Arch Gerontol Geriatr 46 (2008), 191–201.
Freak-Poli, R., It's not age that prevents sexual activity later in life. Australas J Ageing 39:Suppl 1 (2020), 22–29.
Van der Heyden J, Charafeddine R., Enquête de santé 2018: Maladies et affections chroniques Sciencesano; 2018.
DeLamater, JD, Sill, M., Sexual desire in later life. J Sex Res 42 (2005), 138–149.
Muller, B NC, Reis, O, Kropp, P, et al. Sexuality and affection among elderly German men and women in long-term relationships: Results of a prospective population-based study. PLoS One, 9, 2014, e111404.
Jakubiak, BK, Feeney, BC., Affectionate touch to promote relational, psychological, and physical well-being in adulthood: A theoretical model and review of the research. Pers Soc Psychol Rev 21 (2017), 228–252.
Lockhart, PA., The association of affectionate touch and well-being among older married adults. 2019, Iowa State University Digital Repository: Iowa State University, Iowa.
Bauer, M, McAuliffe, L, Nay, R, et al. Sexuality in older adults: Effect of an education intervention on attitudes and beliefs of residential aged care staff. Educ Gerontol 39 (2013), 82–91.
Drummond, JD, Brotman, S, Silverman, M, et al. The impact of caregiving: Older women's experiences of sexuality and intimacy. J Women Soc Work 28 (2013), 415–428.
Gewirtz-Meydan, A, Levkovich, I, Mock, M, et al. Sex for seniors: How physicians discuss older adult's sexuality. Isr J Health Policy Res, 9, 2020, 8.
Hinchliff, S, Lewis, R, Wellings, K, et al. Pathways to help-seeking for sexual difficulties in older adults: Qualitative findings from the third National Survey of Sexual Attitudes and Lifestyles (Natsal-3). Age Ageing 50 (2021), 546–553.
Ezhova, I, Savidge, L, Bonnett, C, et al. Barriers to older adults seeking sexual health advice and treatment: A scoping review. Int J Nurs Stud, 2020, 107.
World Health Organization. Sexuality education policy brief No. 1. 2016, WHO, Geneva, Switzerland Available at: https://www.euro.who.int/__data/assets/pdf_file/0008/379043/Sexuality_education_Policy_brief_No_1.pdf. (Accessed 25 January 2019)
Gouvernement-du-Québec. Governmental action plan to counter mistreatment of older adults 2017-2022. 2017, Québec: Gouvernement du Québec, Gouvernement Du Québec.
Fischer LL. Sex, romance and relationships: AARP survey of midlife and older adults. 2010.
Lavrakas, PJ., Encyclopedia of survey research methods (Vols. 1-0). 2008, Sage Publications, Inc, Thousand Oaks, CA, 10.4135/9781412963947.
DeLamater, J., Sexual expression in later life: A review and synthesis. J Sex Res 49 (2012), 125–141.
