Sexual problems associated with dementia: Part 2. Aetiology, assessment and treatment

✍ Scribed by Peter M. Haddad; Susan M. Benbow

• Publisher: John Wiley and Sons
• Year: 1993
• Tongue: English
• Weight: 677 KB
• Volume: 8
• Category: Article
• ISSN: 0885-6230
• DOI: 10.1002/gps.930080803

✦ Synopsis

Physical, psychological and social factors need to be considered in the aetiology and treatment of sexual problems in people with dementing illnesses. Treatment may raise ethical dilemmas and involve value judgements. Assessment within a multidisciplinary framework is therefore recommended. KEY woms-Dementia, geriatric psychiatry, review, sex behaviour, sexual partners.

In this article we consider the aetiology, assessment and treatment of sexual problems occurring in dementia.

Physical factors

Neuronal loss is a potential cause of altered sexual behaviour. Burns et al. (1990a) found that sexual disinhibition in Alzheimer disease (AD) patients was positively associated with clinical severity of dementia, but found no association with computerized tomography scan results. In man, attempts to relate behavioural changes to focal cerebral deficits have had only limited success. Sexuality is no exception. This is not surprising; one is dealing in fairly gross terms with a complex behaviour that must be under intricate and complex cerebral control. In such situations damage to any one of the many links involved may produce a similar outcome leading to a holistic view of brain function (Luria, 1964). Despite this there is some evidence linking changes in sexual behaviour to frontal and temporal lobe pathology.

Sexual disinhibition is a recognized feature of frontal lobe lesions (Lishman, 1987a). This may Correspondence to first author.