Sexual well-being and aging patternsfindings of a cluster analysis among older adults in Portugal and Spain

  1. Sofia von Humboldt
  2. Emilia Cabras 1
  3. Gail Low 2
  4. Isabel Leal
  1. 1 Universidad Alfonso X EI Sabio
  2. 2 University of Alberta
    info

    University of Alberta

    Edmonton, Canadá

    ROR https://ror.org/0160cpw27

Journal:
EJIHPE: European Journal of Investigation in Health, Psychology and Education

ISSN: 2174-8144,  2254-9625

Year of publication: 2024

Volume: 14

Issue: 7

Pages: 2013-2028

Type: Article

DOI: 10.3390/EJIHPE14070134 DIALNET GOOGLE SCHOLAR lock_openDialnet editor

More publications in: EJIHPE: European Journal of Investigation in Health, Psychology and Education

Institutional repository: lock_openOpen access Editor

Abstract

Objectives: From a cross-cultural perspective, aging well may encompass pertinent challenges in terms of adjustment, sexual well-being, and satisfaction with life in the late years. Considering the paucity of empirical data concerning cultural diversity of experiencing aging, this study aims to help fill this gap by assessing the specific patterns of sexual satisfaction, adjustment to aging (AtA), and life satisfaction with life (SwL) of older adults in Portugal and Spain. Methods: This cross-national study included 326 older adults, age 65 and older, from Portugal and Spain. Five instruments were applied: (a) Adjustment to Aging Scale (ATAS); (b) Satisfaction with Life Scale (SwLS); (c) New Sexual Satisfaction Scale-Short (NSSS-S); (d) Mini-Mental State Exam; and (e) Sociodemographic, Health and Lifestyle questionnaire. K-means cluster analysis was employed to identify and characterize the clusters considering adjustments to aging, sexual satisfaction, and life satisfaction. One-way ANOVAs were conducted to analyze differences in sexual well-being among clusters. Results: Findings indicated three clusters, which explained 77.7% (R-sq = 0.777) of the total variance: Cluster 1: “Most skilled” (n = 26, 8.0%), Cluster 2: “Least adjusted” (n = 115, 35.3%), and Cluster 3: “Aging strivers” (n = 185, 56.7%). Participants in Cluster 1 were mostly Portuguese, with high levels of AtA, sexual satisfaction, and SWL. Conversely, Cluster 2 included mostly Portuguese participants with moderate sexual satisfaction and lower levels of AtA and SwL. Participants from Cluster 3 were mostly Spanish, with moderate levels of AtA and reduced sexual satisfaction and SwL. Conclusions: This study innovates by exploring the elaborate interplay among sexual satisfaction, AtA, and SwL in a cross-cultural perspective, with implications for tailoring interventions, service planning, development, and evaluation of culturally diverse older populations.

€ View funding

Funding information

Funders

  • Fundação para a Ciência e Tecnologia
    • SFRH/BPD/116114/2016
    • UID/04810/2020

Bibliographic References

  • Ageing and Health. Available online: https://www.who.int/news-room/fact-sheets/detail/ageing-and-health (accessed on 14 January 2024).
  • Aging Europe: Looking at the Lives of Older People in the EU. Available online: https://ec.europa.eu/eurostat/documents/32 17494/11478057/KS-02-20-655-EN-N.pdf (accessed on 15 January 2024).
  • Population Structure and Ageing. Available online: https://ec.europa.eu/eurostat/statistics-explained/index.php?title= Population_structure_and_ageing#The_share_of_elderly_people_continues_to_increase (accessed on 15 January 2024).
  • Marzo, R.R.; Khanal, P.; Shrestha, S.; Mohan, D.; Myint, P.K.; Su, T.T. Determinants of active aging and quality of life among older adults: Systematic review. Front. Public Health 2023, 11, 1193789.
  • Asejeje, F.O.; Ogunro, O.B. Deciphering the mechanisms, biochemistry, physiology, and social habits in the process of aging. Arch. Gerontol. Geriatr. Plus 2024, 1, 100003.
  • Von Humboldt, S.; Leal, I. The Orientation to Life Questionnaire: Validation of a Measure to Assess Older Adults’ Sense of Coherence. Educ. Gerontol. 2015, 41, 451–465.
  • Von Humboldt, S.; Leal, I. Correlates of adjustment to aging among the young-old and the oldest-old: A comparative analysis. Educ. Gerontol. 2017, 43, 175–185.
  • Schaller, S.L.; Kvalem, I.L.; Træen, B. Constructions of Sexual Identities in the Ageing Body: A Qualitative Exploration of Older Norwegian Adults’ Negotiation of Body Image and Sexual Satisfaction. Sex. Cult. 2023, 27, 1369–1402.
  • Flynn, T.J.; Gow, A.J. Examining associations between sexual behaviours and quality of life in older adults. Age Ageing 2015, 44, 823–828.
  • Štulhofer, A.; Jurin, T.; Graham, C.; Janssen, E.; Træen, B. Correction to: Emotional intimacy and sexual well-being in aging European couples: A cross-cultural mediation analysis. Eur. J. Ageing 2020, 17, 139–150.
  • Ménard, A.D.; Kleinplatz, P.J.; Rosen, L.; Lawless, S.; Paradis, N.; Campbell, M.; Huber, J.D. Individual and relational contributors to optimal sexual experiences in older men and women. Sex. Relatsh. Ther. 2015, 30, 78–93.
  • DeLamater, J. Sexual Expression in Later Life: A Review and Synthesis. J. Sex Res. 2012, 49, 125–141.
  • Træen, B.; Carvalheira, A.; Kvalem, I.L.; Štulhofer, A.; Janssen, E.; Graham, C.A.; Hald, G.M.; Enzlin, P. Sexuality in Older Adults (65+)—An Overview of The Recent Literature, Part 2: Body Image and Sexual Satisfaction. Int. J. Sex. Health 2017, 29, 11–21.
  • Orr, J.; Layte, R.; O’Leary, N. Sexual activity and relationship quality in middle and older age: Findings from the Irish Longitudinal Study on Ageing (TILDA). J. Gerontol. B Psychol. Sci. Soc. Sci. 2019, 74, 287–297.
  • Gillespie, B.J. Correlates of sex frequency and sexual satisfaction among partnered older adults. J. Sex Marital Ther. 2017, 43, 403–423.
  • Soysal, P.; Smith, L. Sexual activity and successful aging. Eur. Geriatr. Med. 2022, 13, 1235–1238.
  • Carrasco, M.H.; de la Fuente Ballesteros, S.L.; Granja, N.G.; Benito, A.H.; Álvarez, I.G.; Pazos, M.C. Characteristics of the sexual sphere in elderly patients. Semergen 2019, 45, 37–43.
  • Monteiro, A.; von Humboldt, S.; Leal, I. How do formal caregivers experience the sexuality of older adults? Beliefs and attitudes towards older adults’ sexuality. Psychol. Community Health 2017, 6, 77–92.
  • Palacios-Ceña, D.; Carrasco-Garrido, P.; Hernández-Barrera, V.; Alonso-Blanco, C.; Jiménez-García, R.; Fernández-de-las-Peñas, C. Sexual behaviors among older adults in Spain: Results from a population-based national sexual health survey. J. Sex. Med. 2012, 9, 121–129.
  • Von Humboldt, S.; Leal, I.; Pimenta, F.; Maroco, J. Assessing Adjustment to Aging: A Validation Study for the Adjustment to Aging Scale (AtAS). Soc. Indic. Res. 2014, 119, 455–472.
  • Sánchez-Fuentes, M.M.; Sierra, J.C. Sexual satisfaction in a heterosexual and homosexual Spanish sample: The role of sociodemographic characteristics, health indicators, and relational factors. Sex. Relat. Ther. 2015, 30, 226–242.
  • Štulhofer, A.; Hinchliff, S.; Jurin, T.; Carvalheira, A.; Træen, B. Successful aging, change in sexual interest and sexual satisfaction in couples from four European Countries. Eur. J. Ageing 2019, 16, 155–165.
  • Træen, B.; Štulhofer, A.; Janssen, E.; Carvalheira, A.A.; Hald, G.M.; Lange, T.; Graham, C. Sexual Activity and Sexual Satisfaction Among Older Adults in Four European Countries. Arch. Sex. Behav. 2019, 48, 815–829.
  • Blanchflower, D.G. Is happiness U-shaped everywhere? Age and subjective well-being in 145 countries. J. Popul. Econ. 2021, 34, 575–624.
  • Tavares, A.I. Health and life satisfaction factors of Portuguese older adults. Arch. Gerontol. Geriatr. 2022, 99, 104600.
  • Buczak-Stec, E.; König, H.-H.; Hajek, A. The link between sexual satisfaction and subjective well-being: A longitudinal perspective based on the German Ageing Survey. Qual. Life Res. 2019, 28, 3025–3035.
  • Zhang, K.; Kan, C.; Luo, Y.; Song, H.; Tian, Z.; Ding, W.; Xu, L.; Han, F.; Hou, N. The promotion of active aging through older adult education in the context of population aging. Front. Public Health 2022, 10, 998710.
  • Von Humboldt, S.; Leal, I.; Pimenta, F. Analyzing Adjustment to Aging and Subjective Age from Angolan and Portuguese Community-dwelling Older Adults’ Perspectives. Int. J. Gerontol. 2013, 7, 209–215.
  • Von Humboldt, S.; Leal, I. Adjustment to Aging in Late Adulthood: A Systematic Review. Int. J. Gerontol. 2014, 8, 108–113.
  • Von Humboldt, S.; Monteiro, A.; Leal, I. How do older adults experience intergenerational relationships? Different cultures, ambivalent feelings. Educ. Gerontol. 2018, 44, 501–513.
  • Ornat, L.; Martínez-Dearth, R.; Muñoz, A.; Franco, P.; Alonso, B.; Tajada, M.; Pérez-López, F.R. Sexual function, satisfaction with life and menopausal symptoms in middle-aged women. Maturitas 2013, 75, 261–269.
  • Santos Pechorro, P.; Almeida, A.I.; Soares Figueiredo, C.; Monteiro Pascoal, P.; Xavier Vieira, R.; Neves Jesus, S. Validação portuguesa da Nova Escala de Satisfação Sexual. Rev. Int. Androl. 2015, 13, 47–53.
  • Strizzi, J.; Fernández-Agis, I.; Alarcón-Rodríguez, R.; Parrón-Carreño, T. Adaptation of the New Sexual Satisfaction Scale-Short Form Into Spanish. J. Sex Marital Ther. 2016, 42, 579–588.
  • Larsen, R.J.; Diener, E.; Emmons, R.A. An evaluation of subjective well-being measures. Soc. Indic. Res. 1985, 17, 1–17.
  • Pavot, W.; Diener, E. The Satisfaction With Life Scale and the emerging construct of life satisfaction. J. Posit. Psychol. 2008, 3, 137–152.
  • Vázquez, C.; Duque, A.; Hervás, G. Satisfaction with life scale in a representative sample of Spanish adults: Validation and normative data. Span. J. Psychol. 2013, 16, E82.
  • Marôco, J. Análise de Equações Estruturais: Fundamentos Teóricos, Software e Aplicações [Structural Equation Analysis: Theoretical Fundamentals, Software and Applications], 3rd ed.; Pero Pinheiro: Lisbon, Portugal, 2021.
  • Kim, E.; Delaney, S.; Tay, L.; Chen, Y.; Diener, E.; VanderWeele, T. Life Satisfaction and Subsequent Physical, Behavioral, and Psychosocial Health in Older Adults. Milbank Q. 2021, 99, 209–239.
  • Hopper, S.; Hammond, N.G.; Stinchcombe, A. Satisfaction with life in mid-age and older Canadians in the CLSA: Examining personality and minority stress. Appl. Res. Qual. Life 2022, 17, 3455–3473.
  • Erens, B.; Mitchell, K.R.; Gibson, L.; Datta, J.; Lewis, R.; Field, N.; Wellings, K. Health status, sexual activity and satisfaction among older people in Britain: A mixed methods study. PLoS ONE 2019, 14, e0213835.
  • Srinivasan, S.; Glover, J.; Tampi, R.R.; Tampi, D.J.; Sewell, D.D. Sexuality and the Older Adult. Curr. Psychiatry Rep. 2019, 21, 97.
  • Ricoy-Cano, A.J.; Obrero-Gaitán, E.; Caravaca-Sánchez, F.; De La Fuente-Robles, Y.M. Factors Conditioning Sexual Behavior in Older Adults: A Systematic Review of Qualitative Studies. J. Clin. Med. 2020, 9, 1716.
  • Sala, G.; Jopp, D.; Gobet, F.; Ogawa, M.; Ishioka, Y.; Masui, Y.; Inagaki, H.; Nakagawa, T.; Yasumoto, S.; Ishizaki, T.; et al. The impact of leisure activities on older adults’ cognitive function, physical function, and mental health. PLoS ONE 2019, 14, e0225006.
  • Vasconcelos, P.; Paúl, C.; Serruya, S.; Ponce de León, R.G.; Nobre, P. A systematic review of sexual health and subjective well-being in older age groups. Rev. Panam. Salud. Publica 2022, 46, e179.
  • Faílde Garrido, J.M.; Dapía Conde, M.D.; Vázquez Vázquez, M.Á.; Vázquez Rodríguez, L. Are Older Adults’ Leisure Patterns Consistent with the Active Ageing Model? The Influence of the Ageist Stereotypes. Soc. Policy Soc. 2022, 21, 575–596.
  • Øverup, C.S.; Hald, G.M.; Pavan, S. Sociodemographic predictors of sexual communication and sexual communication as a predictor of sexual, relationship, and life satisfaction in Denmark, Finland, France, Norway, Sweden, and the UK. Sex. Cult. 2024, 1–30.
  • Velten, J.; Margraf, J. Satisfaction guaranteed? How individual, partner, and relationship factors impact sexual satisfaction within partnerships. PLoS ONE 2017, 12, e0172855.
  • Teater, B.; Chonody, J.M. How Do Older Adults Define Successful Aging? A Scoping Review. Int. J. Aging Hum. Dev. 2020, 91, 599–625.
  • Štulhofer, A.H.; Hinchliff, S.; Jurin, T.; Hald, G.M.; Træen, B. Successful aging and changes in sexual interest and enjoyment among older European men and women. J. Sex Med. 2018, 15, 1393–1402.
  • Bauer, M.H.; Haesler, E.; Fetherstonhaugh, D. Let’s talk about sex: Older people’s views on the recognition of sexuality and sexual health in the health-care setting. Health Expect. 2016, 19, 1237–1250.
  • Fisher, L.; Anderson, G.O.; Chapagain, M.; Montenegro, X.; Smoot, J.; Takalkar, A. Sex, Romance, and Relationships: AARP Survey of Midlife and Older Adults; AARP: Washington, DC, USA, 2010.
  • Ramseyer Winter, V.; O’Neill, E.A.; Cook, M.; Rose, K.L.; Hood, A. Sexual function in hook-up culture: The role of body image. Body Image 2020, 34, 135–144.
  • Rao, T.S.S.; Tripathi, A.; Manohar, S.; Tandon, A. Promoting sexual well-being. Indian J. Psychiatry 2024, 66, S262–S271.
  • Lee, D.M.; Nazroo, J.; O’Connor, D.B.; Blake, M.; Pendleton, N. Sexual health and well-being among older men and women in England: Findings from the English Longitudinal Study of Ageing. Arch. Sex. Behav. 2016, 45, 133–144.
  • Doerwald, F.; Albrecht, B.M.; Stalling, I.; Bammann, K. Domain-specific life satisfaction among older adults with and without children: The role of intergenerational contact. PLoS ONE 2021, 16, e0257048.
  • Træen, B.; Villar, F. Sexual well-being is part of aging well. Eur. J. Ageing 2020, 17, 135–138.
  • Mallory, A.B.; Stanton, A.M.; Handy, A.B. Couples’ sexual communication and dimensions of sexual function: A meta-analysis. J. Sex Res. 2019, 56, 882.
  • DeLamater, J.; Koepsel, E. Relationships and sexual expression in later life: A biopsychosocial perspective. Sex Relat. Ther. 2015, 30, 37–59.
  • Gore-Gorszewska, G.; Ševˇcíková, A.; Gottfried, J. Predicting changes to sexual activity in later life: A longitudinal study. Sex Res. Soc. Policy 2023.
  • Syme, M.L.; Cohn, T.J.; Stoffregen, S.; Kaempfe, H.; Schippers, D. “At my age. . .”: Defining sexual wellness in mid-and later life. J. Sex Res. 2019, 56, 832–842.
  • Ji, L.J.; Imtiaz, F.; Su, Y.; Zhang, Z.; Bowie, A.C.; Chang, B. Culture, aging, self-continuity, and life satisfaction. J. Happiness Stud. 2022, 23, 3843–3864.
  • Kolodziejczak, K.; Drewelies, J.; Deeg, D.J.H.; Huisman, M.; Gerstorf, D. Perceived Importance and Enjoyment of Sexuality in Late Midlife: Cohort Differences in the Longitudinal Aging Study Amsterdam (LASA). Sex Res. Soc. Policy 2021, 18, 621–635.
  • Towler, L.B.; Graham, C.A.; Bishop, F.L.; Hinchliff, S. Sex and Relationships in Later Life: Older Adults’ Experiences and Perceptions of Sexual Changes. J. Sex Res. 2022, 60, 1318–1331.
Data source: Dialnet