Eating behaviours among older adults can be affected by age-associated oral physiological changes. This may influence nutritional intake, liking and acceptance of foods, increasing malnutrition risk. To better understand age-associated changes to textural perception, a systematic review was designed to evaluate the factors that affect the perception of food texture among older adults, and the impact this has on food liking and intake. Electronic searches were conducted in three databases (Pubmed, WebofScience, Scopus), yielding 12,216 articles. The 2020 PRISMA guidelines were used to screen all articles; these were assessed in three stages, by title, abstract and full text. Subsequently, PECO (population, exposure, comparison, outcome) guidelines were applied to assess study eligibility. 13 articles were included in the final review, all of which were of sufficient quality. A wide range of methodologies and outcomes were identified, leading to the discussion of findings in three categories; (i) oral manipulation and processing of food types within the oral cavity, (ii) age-associated changes to the physical properties of this cavity, and (iii) psychological factors that influence food choice and acceptance. A combination of these factors facilitate textural manipulation and perception in older adults, which were shown to significantly drive product acceptance and intake. Whereas several perceptual and physiological changes that occur with aging are unavoidable, recognising the heterogenous nature of older adults will lead to a better understanding of the oral capabilities and sensory-specific needs of this population, and could be used to improve food acceptance, nutritional intake and reduce the risk of malnutrition.