critical interpretive synthesis; Older adults; sexual behavior; sexuality; Gender Studies; Social Psychology; Reproductive Medicine; Dermatology; Public Health, Environmental and Occupational Health
Abstract :
[en] Objectives: This study aimed to explore past studies that have focused exclusively on the sexuality of adults older than 65 from a positive public health approach. Methods: We performed a critical interpretive synthesis, starting with the literature review on sexual behaviors in later life, adding policy documents on aging sexuality, and bringing new perspectives. Results: Older adults continue to be sexually active. Healthcare professionals lack knowledge and communication skills surrounding aging sexuality and no policies before 2013 mention aging sexuality. Conclusions: We posit that society’s view of later life sexuality reflects on practice, policies, and research on this topic, which influence back society’s view.
Disciplines :
Social & behavioral sciences, psychology: Multidisciplinary, general & others
Author, co-author :
Cismaru Inescu, Adina ; Université de Liège - ULiège > Adaptation, Résilience et CHangement (ARCH)
Adam, Stéphane ; Université de Liège - ULiège > Adaptation, Résilience et CHangement (ARCH)
Nobels, Anne ; International Centre for Reproductive Health, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
Kempeneers, Philippe ; Université de Liège - ULiège > Département de Psychologie > Psychologie clinique cognitive et comportementale
Beaulieu, Marie; School of Social Work and Research Centre on Aging, University of Sherbrooke, Sherbrooke, Canada
Vandeviver, Christophe ; Department of Criminology, Criminal Law and Social Law, Ghent University, Ghent, Belgium ; Research Foundation—Flanders (FWO), Belgium
Keygnaert, Ines ; International Centre for Reproductive Health, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
Nisen, Laurent ; Université de Liège - ULiège > > Emancipation sociale, Santé des Populations, Réduction des Inégalités sociales dans des sociétés en transition
Language :
English
Title :
The Elephant in the Room–A Critical Interpretive Synthesis of Older Adults’ Sexuality
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. This research was subsidized by the Belgian Federal Science Policy via contract BR/175/A5/UN-MENAMAIS. 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.This research was subsidized by the Belgian Federal Science Policy via contract BR/175/A5/UN-MENAMAIS. 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.
Anderson, R. M. (2013). Positive sexuality and its impact on overall well-being. Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz, 56 (2), 208–214. https://doi.org/10.1007/s00103-012-1607-z
Beaulieu, M., Leboeuf, R., Pelletier, C., … Cadieux Genesse, J. (2018). Mistreatment in Older Adults. In Laforest, J., Maurice, P. and Bouchard, L M. (Eds.), Québec Report on Violence and Health. Montréal: Institut national de santé publique du Québec.
Belgian Federal Government. (2020). Retrieved from https://statbel.fgov.be/fr/themes/population/structure-de-la-population#panel-14
Berdychevsky, L., & Nimrod, G. (2017). Sex as Leisure in later life: A netnographic approach. Leisure Sciences, 39 (3), 224–243. https://doi.org/10.1080/01490400.2016.1189368
Choi, K. B., Jang, S. H., Lee, M. Y., & Kim, K. H. (2011). Sexual life and self-esteem in married elderly. Archives of Gerontology and Geriatrics, 53 (1), e17–e20. https://doi.org/10.1016/j.archger.2010.08.011
Debrot, A., Meuwly, N., Muise, A., Impett, E. A., & Schoebi, D. (2017). More than just sex: Affection mediates the association between sexual activity and well-being. Personality and Social Psychology Bulletin, 43 (3), 287–299. https://doi.org/10.1177/0146167216684124
DeLamater, J. (2012). Sexual expression in later life: A review and synthesis. Journal of Sex Research, 49 (2–3), 125–141. https://doi.org/10.1080/00224499.2011.603168
DeLamater, J. D., & Sill, M. (2005). Sexual desire in later life. Journal of Sex Research, 42 (2), 138–149. https://doi.org/10.1080/00224490509552267
Depraetere, J., Vandeviver, C., Keygnaert, I., & Vander Beken, T. (2020). The critical interpretive synthesis: An assessment of reporting practices. International Journal of Social Research Methodology, 2020, 1–21. https://doi.org/10.1080/13645579.2020.1799637
Dixon-Woods, M., Bonas, S., Booth, A., Jones, D. R., Miller, T., Sutton, A. J., Shaw, R. L., Smith, J. A., & Young, B. (2006). How can systematic reviews incorporate qualitative research? A critical perspective. Qualitative Research, 6 (1), 27–44. https://doi.org/10.1177/1468794106058867
Dixon-Woods, M., Cavers, D., Agarwal, S., Annandale, E., Arthur, A., Harvey, J., Hsu, R., Katbamna, S., Olsen, R., Smith, L., Riley, R., & Sutton, A. J. (2006). Conducting a critical interpretive synthesis of the literature on access to healthcare by vulnerable groups. BMC Medical Research Methodology, 6, 35. https://doi.org/10.1186/1471-2288-6-35
Doll, G. (2017). Bedroom scenes: Filmic portrayals of intimacy and sexuality in long-lived relationships. The Gerontologist, 57 (1), 145–146. https://doi.org/10.1093/ger ont/gnw183
Eurostat. (2017). A look at the lives of the elderly in the EU today. https://ec.europa.eu/eurostat/cache/infographs/elderly/index.html
Eurostat. (2019). Mortality and life expectancy statistics. https://ec.europa.eu/eurostat/statistics-explained/index.php/Mortality_and_life_expectancy_statistics
Even-Zohar, A., & Werner, S. (2019). Older adults and sexuality in Israel: Knowledge, attitudes, sexual activity and quality of life. Journal of Aging Science Open Access, 7, 209. https://doi.org/10.35248/2329-8847.19.7.209
Farrell, J., & Belza, B. (2012). Are older patients comfortable discussing sexual health with nurses? Nursing Research, 61 (1), 51–57. https://doi.org/10.1097/NNR.0b013e31823a8600
Fileborn, B., Thorpe, R., Hawkes, G., Minichiello, V., Pitts, M., & Dune, T. (2015). Sex, desire and pleasure: Considering the experiences of older Australian women. Sexual and Relationship Therapy, 30 (1), 117–130. https://doi.org/10.1080/14681994.2014.936722
Flynn, T. J., & Gow, A. J. (2015). Examining associations between sexual behaviours and quality of life in older adults. Age and Ageing, 44 (5), 823–828. https://doi.org/10.1093/ageing/afv083
Freak-Poli, R., Kirkman, M., De Castro Lima, G., Direk, N., Franco, O. H., & Tiemeier, H. (2017). Sexual activity and physical tenderness in older adults: Cross-sectional prevalence and associated characteristics. The Journal of Sexual Medicine, 14 (7), 918–927. https://doi.org/10.1016/j.jsxm.2017.05.010
Ganong, K., & Larson, E. (2011). Intimacy and belonging: The association between sexual activity and depression among older adults. Society and Mental Health, 1 (3), 153–172. https://doi.org/10.1177/2156869311431612
Gewirtz-Meydan, A., & Ayalon, L. (2017). Physicians’ response to sexual dysfunction presented by a younger vs. An older adult. International Journal of Geriatric Psychiatry, 32 (12), 1476–1483. https://doi.org/10.1002/gps.4638
Gewirtz-Meydan, A., Hafford-Letchfield, T., Benyamini, Y., Phelan, A., Jackson, J., & Ayalon, L. (2018). Ageism and sexuality. In Contemporary perspectives on ageism (pp. 149–162). Springer. https://doi.org/10.1007/978-3-319-73820-8_10
Gewirtz-Meydan, A., Levkovich, I., Mock, M., Gur, U., Karkabi, K., & Ayalon, L. (2020). Sex for seniors: How physicians discuss older adult’s sexuality. Israel Journal of Health Policy Research, 9 (1), 8. https://doi.org/10.1186/s13584-020-00366-5
Gianotten, W. L. (2021). The (Mental) health benefits of sexual expression. In Psychiatry and Sexual Medicine (pp. 57–70). Springer.
Goldenberg, M. (2012). Mulheres e envelhecimento na cultura brasileira. Caderno Espaço Femini, 25 (2), 46–56.
Gouvernement du Québec. Governmental Action Plan to Counter Mistreatment of Older Adults 2017–2022. [Online]. Québec: Gouvernement du Québec, 2017. Available at: https://publications.msss.gouv.qc.ca/msss/version-accessible/plan-mfa-2017-2022/
Haesler, E., Bauer, M., & Fetherstonhaugh, D. (2016). Sexuality, sexual health and older people: A systematic review of research on the knowledge and attitudes of health professionals. Nurse Education Today, 40, 57–71. https://doi.org/10.1016/j.nedt.2016.02.012
Katz, S. (2000). Busy bodies: Activity, aging, and the management of everyday life. Journal of Aging Studies, 14 (2), 135–152. https://doi.org/10.1016/S0890-4065(00)80008-0
Kenny, R. T. (2013). A review of the literature on sexual development of older adults in relation to the asexual stereotype of older adults. Canadian Journal of Family and Youth / Le Journal Canadien de Famille et de la Jeunesse, 5 (1), 91–106. https://doi.org/10.29173/cjfy18949
Lai, Y., & Hynie, M. (2011). A tale of two standards: An examination of young adults’ endorsement of gendered and ageist sexual double standards. Sex Roles, 64 (5–6), 360–371. https://doi.org/10.1007/s11199-010-9896-x
Lee, D. M., Nazroo, J., O’Connor, D. B., Blake, M., & Pendleton, N. (2016). Sexual health and well-being among older men and women in England: Findings from the English longitudinal study of ageing. Archives of Sexual Behavior, 45 (1), 133–144. https://doi.org/10.1007/s10508-014-0465-1
Mader, A. L. (2014). Older adult experience of their sexuality–A phenomenological inquiry. Widener University.
Mahieu, L., & Gastmans, C. (2015). Older residents’ perspectives on aged sexuality in institutionalized elderly care: A systematic literature review. International Journal of Nursing Studies, 52 (12), 1891–1905. https://doi.org/10.1016/j.ijnurstu.2015.07.007
Meyrignac, L., Bouati, N., Sagne, A., Gavazzi, G., & Zipper, A. C. (2017). Representations of their own sexuality and aging body by old people: Phenomenological and psychodynamic approach. Geriatrie et Psychologie Neuropsychiatrie du Vieillissement, 15 (3), 319–328. https://doi.org/10.1684/pnv.2017.0688
Minichiello, V., Plummer, D., & Loxton, D. (2004). Factors predicting sexual relationships in older people: An Australian study. Australasian Journal on Ageing, 23 (3), 125–130. https://doi.org/10.1111/j.1741-6612.2004.00018.x
Mohler, D., Liberati, A., Tetzlaff, J., & Altman, D. G. (2009). The PRIMSA Group. Preferred reporting items for systematic reviews and meta‐analyses: The PRISMA statement. PLoS Medicine, 6 (7), e1000097. https://doi.org/10.1371/journal.pmed.1000097
Murthy, V. H., Krumholz, H. M., & Gross, C. P. (2004). Participation in cancer clinical trials: Race-, sex-, and age-based disparities. JAMA, 291 (22), 2720–2726. https://doi.org/10.1001/jama.291.22.2720
Nobels, A., Vandeviver, C., Beaulieu, M., Cismaru Inescu, A., Nisen, L., Van Den Noortgate, N., Vander Beken, T., Lemmens, G., & Keygnaert, I. (2020). “ Too grey to be true?” Sexual violence in older adults: A critical interpretive synthesis of evidence. International Journal of Environmental Research and Public Health, 17 (11), 4117. https://doi.org/10.3390/ijerph17114117
Papaharitou, S., Nakopoulou, E., Kirana, P., Giaglis, G., Moraitou, M., & Hatzichristou, D. (2008). Factors associated with sexuality in later life: An exploratory study in a group of Greek married older adults. Arch Gerontol Geriatr, 46(2), 191–201. https://doi.org/10.1016/j.archger.2007.03.008
Palacios-Ceña, D., Carrasco-Garrido, P., Hernández-Barrera, V., Alonso-Blanco, C., Jiménez-García, R., & Fernández-de-las-Peñas, C. (2012). Sexual behaviors among older adults in Spain: Results from a population-based national sexual health survey. The Journal of Sexual Medicine, 9 (1), 121–129. https://doi.org/10.1111/j.1743-6109.2011.02511.x
Parker, R. G. (2007). Sexuality, health, and human rights. American Journal of Public Health, 97 (6), 972–973. https://doi.org/10.2105/AJPH.2007.113365
Pinho, S., & Pereira, H. (2019). Sexuality and intimacy behaviors in the elderly with Dementia: The perspective of healthcare professionals and caregivers. Sexuality and Disability, 37 (4), 489–509. https://doi.org/10.1007/s11195-019-09589-0
Queiroz, M. A. C., Lourenço, R. M. E., Coelho, M. d M. F., Miranda, K. C. L., Barbosa, R. G. B., & Bezerra, S. T. F. (2015). Social representations of sexuality for the elderly. Revista Brasileira de Enfermagem, 68 (4), 577–577. https://doi.org/10.1590/0034-7167.2015680413i
Santos-Iglesias, P., Byers, E. S., & Moglia, R. (2016). Sexual well-being of older men and women. The Canadian Journal of Human Sexuality, 25 (2), 86–98. https://doi.org/10.3138/cjhs.252-A4
Schick-Makaroff, K., MacDonald, M., Plummer, M., Burgess, J., & Neander, W. (2016). What synthesis methodology should I use? A review and analysis of approaches to research synthesis. AIMS Public Health, 3 (1), 172–215. https://doi.org/10.3934/publichealth.2016.1.172
Sinković, M., & Towler, L. (2019). Sexual aging: A systematic review of qualitative research on the sexuality and sexual health of older adults. Qualitative Health Research, 29 (9), 1239–1254. https://doi.org/10.1177/1049732318819834
Smith, L. J., Mulhall, J. P., Deveci, S., Monaghan, N., & Reid, M. C. (2007). Sex after seventy: A pilot study of sexual function in older persons. The Journal of Sexual Medicine, 4 (5), 1247–1253. https://doi.org/10.1111/j.1743-6109.2007.00568.x
Soares, K. G., & Nazareth Meneghel, S. (2021). The silenced sexuality in dependent older adults. Ciencia & Saude Coletiva, 26 (1), 129–136. 2021, 26 (1), 129-136. https://doi.org/10.1590/1413-81232020261.30772020
Štulhofer, A., Hinchliff, S., Jurin, T., Carvalheira, A., & Træen, B. (2019). Successful aging, change in sexual interest and sexual satisfaction in couples from four European Countries. European Journal of Ageing, 16 (2), 155–165. https://doi.org/10.1007/s10433-018-0492-1
Træen, B., Carvalheira, A., Kvalem, I. L., Štulhofer, A., Janssen, E., Graham, C. A., Hald, G. M., & Enzlin, P. (2017). Sexuality in older adults (65+)–An overview of the recent literature, Part 2: Body image and sexual satisfaction. International Journal of Sexual Health, 29 (1), 11–21. https://doi.org/10.1080/19317611.2016.1227012
Træen, B., Hald, G. M., Graham, C. A., Enzlin, P., Janssen, E., Kvalem, I. L., Carvalheira, A., & Štulhofer, A. (2017). Sexuality in older adults (65+)–An overview of the literature, Part 1: Sexual function and its difficulties. International Journal of Sexual Health, 29 (1), 1–10. https://doi.org/10.1080/19317611.2016.1224286
Tricco, A. C., Soobiah, C., Antony, J., Cogo, E., MacDonald, H., Lillie, E., Tran, J., D’Souza, J., Hui, W., Perrier, L., Welch, V., Horsley, T., Straus, S. E., & Kastner, M. (2016). A scoping review identifies multiple emerging knowledge synthesis methods, but few studies operationalize the method. Journal of Clinical Epidemiology, 73, 19–28. https://doi.org/10.1016/j.jclinepi.2015.08.030
Umidi, S., Pini, M., Ferretti, M., Vergani, C., & Annoni, G. (2007). Affectivity and sexuality in the elderly: Often neglected aspects. Archives of Gerontology and Geriatrics, 44 (Suppl 1), 413–417. https://doi.org/10.1016/j.archger.2007.01.058
United Nations. (2019). World Population Ageing. Highlights, Issue. United Nations.
von Humboldt, S., Ribeiro-Gonçalves, J. A., Costa, A., Low, G., & Leal, I. (2021). Sexual expression in old age: How older adults from different cultures express sexually? Sexuality Research and Social Policy, 18 (2), 246–260. https://doi.org/10.1007/s13178-020-00453-x
Wada, M., Hurd Clarke, L., & Rozanova, J. (2015). Constructions of sexuality in later life: Analyses of Canadian magazine and newspaper portrayals of online dating. Journal of Aging Studies, 32, 40–49. https://doi.org/10.1016/j.jaging.2014.12.002
Wang, T. F., Lu, C. H., Chen, I. J., & Yu, S. (2008). Sexual knowledge, attitudes and activity of older people in Taipei, Taiwan. Journal of Clinical Nursing, 17 (4), 443–450. https://doi.org/10.1111/j.1365-2702.2007.02003.x
WAS. (2008). Sexual health for the Millennium. A declaration and technical document. WAS.
Watson, W. K., Stelle, C., & Bell, N. (2017). Older women in new romantic relationships: Understanding the meaning and importance of sex in later life. International Journal of Aging & Human Development, 85 (1), 33–43. https://doi.org/10.1177/0091415016680067
WHO (2002). World report on violence and health. WHO.
WHO. (2006). Defining sexual health. WHO.
WHO. (2010). Measuring sexual health: Conceptual and practical considerations and related indicators. WHO.
WHO. (2016). Action plan for sexual and reproductive health towards achieving the 2030 Agenda for sustainable development in Europe–Leaving no one behind. WHO.
WHO. (2017). Global strategy and action plan on ageing and health. WHO.
WHO. Entre Nous. (2013). The European Magazine for Sexual and Reproductive Health, 77. WHO. Entre Nous.