Introduction
Despite the popularity and analytical relevance of the concept of successful aging, little efforts have been made to address its relationship to sexuality in older individuals.

Aim
To explore the relationship between successful aging and the (retrospectively assessed) change in sexual interest and enjoyment in the past 10 years, using a new multidimensional model of successful aging.

Methods
The data for this study was collected in 2016 using national probability-based surveys in four European countries (Norway, Denmark, Belgium and Portugal). In total, information from 2,461 sexually active and inactive participants aged 60–75 years was used for analyses. Multigroup structural equation analysis was employed to address the associations between key constructs.

Main Outcome Measure
The dependent variable was a composite (two-item) indicator of change in sexual interest and enjoyment in the past 10 years; a multifaceted model of successful aging predicted the change by country and gender.

Results
Tested cross-culturally, the proposed model of successful aging demonstrated a good fit to the data. Furthermore, its metric characteristics enabled direct comparisons across gender and national cultures. Controlling for sociodemographic characteristics, higher successful aging scores were consistently related to lower reduction in sexual interest/enjoyment among men and women across the 4 countries.

Clinical Implications
Given an increased life-expectancy and focus on healthy aging in many countries, the findings about the associations between sexual expression, quality of life and aging well are valuable to professionals working in the area of healthy sexual aging.

Strength & Limitations
This is the first study to systematically address the relationship between successful aging and sexuality. Furthermore, it provides a multidimensional measure of successful aging for a wide range of sexologic studies. Among limitations, possible self-selection bias (toward more sexually permissive and sexually active participants) and the fact that the findings are restricted to older heterosexual individuals, should be considered.

Conclusion
Without stigmatizing the absence of sexual expression in aging individuals, the findings from this cross-cultural study point out that sustained sexual interest and sexual enjoyment are linked to successful aging in both genders.