Sexuality and Dementia: for Better or Worse?

Sexual disinhibition is recognised as one of the behavioural and psychiatric symptoms of dementia (BPSD) and is a common reason for referral to old age psychiatric services. These referrals often come from care homes and sexual disinhibition can be a reason for seeking alternative placement for a resident. Sexual disinhibition is reported in 7% of Alzheimer’s disease sufferers (Burns et al, 1990) but may be more frequent in other types of dementia such as frontotemporal dementia. Sexual problems associated with dementia include inappropriate sexual acts in public, inappropriate sexual talk, false sexual allegations and sexual abuse (Haddad and Benbow, 1993, part 1). Increased or decreased libido can both cause problems, and the change of role and identity when one partner develops dementia can impact on established relationships. Sexual problems in dementia have a range of possible causes including neuronal loss in the frontal and temporal lobes, mood disturbance, psychosis, misidentification and misinterpretation of social cues due to cognitive impairment (Haddad and Benbow, 1993, part 2).