Sexuality remains central to well-being in later life, yet how individual factors operate within dyadic health contexts is unclear. We examined whether age, gender, and attitudes toward sexuality (ASKAS) predict sexual behavior and sexual satisfaction and whether self-rated health (SRH) and perceived partner health (PPH) moderate these links. Cross-sectional Structural Equation Modeling (SEM) was conducted with 185 adults aged 50–90 years. Outcomes were two latent variables: Sexual Behavior (intimate activity, sexual talk, vaginal sex, or oral sex) and Sexual Satisfaction (physical and emotional pleasure). Age and gender predicted lower behavior and satisfaction; attitudes showed no direct effects. Moderation tests showed that better SRH buffered the negative associations of age and gender with sexual satisfaction and that higher PPH reduced gender differences in sexual behavior. The health of both partners shapes sexual outcomes in later life. Clinically, supporting vitality and addressing partner health may help mitigate age- and gender-linked disparities in sexual well-being.
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