Sexual Knowledge, Attitudes, and Motivational Factors Associated with Sexual Activity in Older Adults: A Cross-Sectional Study

Background: Sexuality remains an important dimension of well-being in later life, yet it is often surrounded by misconceptions and ageist stereotypes. Understanding sociodemographic, cognitive, attitudinal, motivational, and behavioral aspects of sexuality among older adults may contribute to a more comprehensive view of sexual well-being in aging. Objectives: This study aimed (1) to describe older adults’ knowledge, attitudes, sexual motivation, behaviors, and satisfaction; (2) to examine differences between individuals who reported engaging in partnered eroto-genital activity during the previous six months and those who did not; and (3) to identify sociodemographic (age, gender, religiosity and health condition), cognitive, attitudinal, and motivational factors associated with engagement in partnered eroto-genital activity. Methods: A cross-sectional study was conducted with 186 adults aged 65–88 years (M = 73.29). Participants completed the Aging Sexual Knowledge and Attitudes Scale (ASKAS) and a Sexual Behavior Questionnaire assessing sexual motivation, sexual behaviors, and sexual satisfaction. Descriptive analyses, group comparisons, and hierarchical logistic regression analyses were performed. Results: Participants showed relatively adequate knowledge and generally favorable attitudes, although several misconceptions persisted. Affective behaviors were more frequent than eroto-genital practices. Individuals reporting partnered eroto-genital activity showed higher knowledge, more positive attitudes, greater perceived importance of sexuality, and higher sexual satisfaction. Regression analyses indicated that age, gender, attitudes toward sexuality, and perceived importance of sex were significant predictors of partnered eroto-genital activity, with perceived importance of sex showing the strongest association. Conclusions: Sexuality in later life reflects diverse patterns shaped by cognitive, attitudinal, and especially motivational dimensions. These findings highlight the central role of subjective importance and attitudes in sexual engagement, suggesting that interventions may benefit from moving beyond information provision to also address motivational and relational aspects of sexuality in aging populations.