Artículo de revisión
Published on 15 de abril de 2024 | http://doi.org/10.5867/medwave.2024.03.2710
Literature review on sexuality in the elderly: What is being taught and with what technologies
| Gewirtz-Meydan | Systematic review of qualitative studies. | To review and synthesize qualitative studies on the sexuality of elderly adults from the perspectives, attitudes, perceptions, and personal experiences. | Inclusion: 1) Articles written in English, German, or Hebrew 2) Qualitative designs with empirical data 3) 60 years and older 4) Based on the perspectives or attitudes towards the sexuality of elderly people. | There is no single way to get elderly people to discuss their sexuality. They find it difficult to give data and talk about it. The main themes were the social legitimacy of the sexuality of elderly people, health problems that affect sexuality, and the hegemony of penetrative sex that minimizes the meaning of sexuality for elderly people. | Lack of education on how elderly people’s health problems affect sexuality. | Not mentioned. |
| López-Ramos | Systematic review (mixed). | To identify the most frequent sexual activities and problems in this field in elderly adults. | Inclusion: adults aged 65 and over, healthy or with comorbidities that do not affect their lives or that do not affect their sexual sphere. | Sexuality is important in the quality of life of the older adult. It is affected by cancer, diabetes, depression, lack of desire, erectile dysfunction in men, and menopause in women. The most frequent sexual behaviors are kissing, genital intercourse, oral sex, and masturbation. | Emphasis on educating elderly people, family members, and healthcare personnel on sexuality. | Difficulties for physicians to address sexuality in older adults. |
| Torres et al., | Systematic review of qualitative studies. | To analyze studies that inquire into the perceptions of sexuality of institutionalized and community-dwelling elderly people. | Inclusion: 1) Qualitative studies that investigate sexuality 2) Elderly people over 60 years of age in community or long-term care institutions 3) Articles in English or Spanish. | Elderly people manifest active sexuality. There are barriers to sexual expression. Older gay men, bisexuals, and people with HIV are afraid to disclose sexual orientation or any disease. Some women end sexual activity with widowhood. Healthcare personnel are not open to preserving desires and intimacy. | Healthcare personnel should be more involved in education strategies. | More attention to elderly people expressing sexual needs. There is a need to improve sexual education strategies for these groups. |
| Ricoy-Cano et al., | Qualitative systematic review. | To present the main qualitative studies that analyze how physiological and psychosocial factors influence sexual behavior in elderly people. | Inclusion: 1) Qualitative studies in elderly people on factors affecting sexual behavior 2) Studies on the potential to have sex. | Diseases affect the sexuality of elderly people (e.g., erectile dysfunction). Also, menopause, sexual stereotypes, false beliefs (asexuality), gender roles, religion, sexual satisfaction, and autoerotic behaviors. | Elderly people receive little education on sexuality, sexual pleasure, sexual health, and safety. | It is necessary to develop educational and assistance strategies to improve the sexuality and sexual health of elderly people. |
| Bortolozzi et al., | Qualitative systematic review. | To investigate what the literature says about sexual health and aging. | Criteria are not explicitly mentioned. Articles in scielo.org on sexual health and aging, prioritizing Brazilian studies found between 2001 and 2018. | Sexual health in older adulthood is valued as a relevant topic. Intervention proposals aimed at HIV/AIDS prevention are mentioned. There was a need for more sexual health education and prevention proposals aimed at elderly people. Education on HIV infection is mentioned as a protective factor against HIV/AIDS. | There is scarce information on HIV/AIDS for elderly people, with a lack of public policies on the subject. There is also a lack of group work and problems of adherence to prevention. | Healthcare professionals should consider active sexuality in old age and vulnerability to STI infection. The diagnosis should consider sexuality and actions that have an impact on late HIV/AIDS diagnosis. |
| de Souza et al., | Estudio cuantitativo, transversal, descriptivo y analítico basado en guías de verificación STROBE. | Analizar la asociación de la sexualidad con variables biosociodemográficas y síntomas depresivos en ancianos. | Inclusion: 1) Being 60 years of age or older 2) Being married or having a permanent partner 3) Residing in the Brazilian Northeast. | Males predominated (52.1%). The prevalence of severe depressive symptoms (8.6%) was associated with worse sexual intercourse and worse affective relationships. There is better sexual experience in stable union (p = 0.023) and in couples of ≤ 5 years, compared to more than 20 years (p = 0.001). There was a negative and inversely proportional correlation between sexual intercourse and severe depressive symptoms (r = - 0.442; p = 0.027). | Sexuality education is a key strategy for elderly people, valuing beliefs and knowledge as active agents of the educational process. | In general, there is no support from healthcare professionals; the study shows that 76% of elderly people had never received sexual counseling. |
| Navarro E, | Qualitative bibliographic review. | To know the interventions aimed at improving the sexuality of elderly adults and their effectiveness. | Inclusion: 1) Original articles published between 2010 and 2021 2) Spanish and English languages. | Group educational sessions explaining sexuality and sex were well-rated. There are educational interventions on sexuality associated with cancer, epilepsy, and menopause. Interventions with general or pathology-focused sexuality education were evaluated as the most effective. | There is a high appraisal of educational interventions on sexuality in elderly people. | There is little participation of health teams. |
| de Souza et al., | Estudio transversal y analítico. | To analyze the effects of experiences in sexuality on anxiety and quality of life of elderly people. | Inclusion: 1) Elderly people over 60 years old, both sexes, married, in union, or with a stable partner 2) Have internet access and an active Facebook account. | Anxiety disorders are related to loss of quality of life and detriment of sexuality. Sexual intercourse is associated with better quality of life. Affective relationships improve the detriment of sexual intercourse. Intimacy had the highest correlation coefficient for the sexual act dimension (ρ = 0.546; p < 0.001) and affective relationships (ρ = 0.592; p < 0.001). | 76.7% of the participants never received guidance on sexuality from healthcare professionals. | Healthcare services should address sexuality care for elderly people. |
| de Souza | Cross-sectional, descriptive, and analytical study. | To analyze the association between experiences in sexuality with biosocial-demographic and mental health variables in old age. | Inclusion: 1) Age older than or equal to 60 years 2) According to Brazilian norms 3) Married or have a permanent partner 4) Both sexes (male and female) 5) Living in northeastern Brazil. | There was a statistical correlation between sexual relations and age group (p = 0.039). All dimensions of sexuality were associated with marital status (p < 0.05). There was significant correlation with all domains of mental health. | Elderly people never received sexual counseling from healthcare professionals. | Education, research, and policies on sexuality for the elderly should be improved, as they improve care and understanding of sexuality problems in old age. |
HIV, human immunodeficiency virus. STI, sexually transmitted infection. STROBE, STrengthening the Reporting of OBservational studies in Epidemiology.
Source: Prepared by the authors.