Study first to report sexual behavior norms for US adults with dementia living at home

September 12, 2018, University of Chicago Medical Center

The majority of partnered, home-dwelling people in the U.S. with dementia are sexually active, according to a University of Chicago Medicine study out this week in the Journal of the American Geriatrics Society. In addition, people with cognitive impairment and dementia often have bothersome sexual function problems they don't discuss with a doctor.

"Until now, most of what we knew on this topic came from studies or legal cases involving people with advanced living in nursing homes," said lead study author Stacy Tessler-Lindau, MD, MAPP, and UChicago Medicine professor of obstetrics/gynecology and geriatrics.

"In the next 30 years, more than 80 million people in the U.S. will be 65 or older. A growing number of people with dementia live at home, cared for by a spouse who, like doctors and society more generally, don't have the knowledge they need to manage the sexual aspects of life with a person with dementia," she said.

This study is the first to look at a nationally-representative sample of this population.

The number of home-dwelling people with Alzheimer's Disease (the most common type of dementia) is expected to grow to more than eight million by 2050.

Researchers found that of partnered people with dementia in their study, 59 percent of men and 51 percent of were sexually active. More than 40 percent of partnered men and women ages 80 to 91 also reported being sexually active. But the likelihood of partnered sexual activity declined with lower cognitive scores for both women and men in the study.

"The lack of basic information about sexual behavior, function and desires in this growing population is a problem," said Lindau, "because these aspects of life with dementia raise ethical, legal, clinical and even moral questions that we as a society are largely unprepared for."

For example, posited Lindau, can a person with dementia consent to sex or be deprived of sex because we're not sure she can consent? Should a doctor treat a person with dementia for sexual dysfunction? Does a person with have an obligation to fulfill "marital duty?"

The study's authors looked at data from more than three thousand home-dwelling people in the United States between the ages of 62 and 91. In a previous study, Lindau and co-authors found later-life sexual activity to be positively associated with physical and mental health and was regarded by most men and women as an important part of life.

The majority of people, across all cognition groups in the current study, reported positive attitudes about sex and that they were having sex less often that they would like. More than one in 10 partnered men and women reported feeling threatened or frightened by their partner; this rate was not higher among people with dementia.

"Physicians may be asked to determine whether a patient with dementia has the capacity to consent to sex and have to balance the obligation to protect the patient from harm with the obligation to protect the person's autonomy," Lindau said. "We now have normative evidence that should help counter negative bias and inform important decisions about sex for people with dementia."

More than one-third of men and one in 10 women in the study's dementia group reported bothersome sexual problems, but only 17 percent of men and one percent of women with dementia talked to a physician about sex life changes that result from a medical condition like dementia.

According to Lindau, there are a growing number of FDA-approved treatments for sexual dysfunction, and many of these are targeted to older adults.

"Sometimes the person complaining about the patient's sexual function problems is the partner, not the patient with dementia. Doctors need to be prepared for how to handle that," she said.

The study is titled "Sexuality and Cognitive Status: A U.S. Nationally Representative Study of Home-Dwelling Older Adults."

Explore further: Dementia increases the risk of 30-day readmission to the hospital after discharge

More information: Stacy Tessler Lindau et al, Sexuality and Cognitive Status: A U.S. Nationally Representative Study of Home-Dwelling Older Adults, Journal of the American Geriatrics Society (2018). DOI: 10.1111/jgs.15511

Related Stories

Dementia increases the risk of 30-day readmission to the hospital after discharge

February 23, 2018
About 25 percent of older adults admitted to hospitals have dementia and are at increased risk for serious problems like in-hospital falls and delirium (the medical term for an abrupt, rapid change in mental function). As ...

Helping prevent falls in older adults with dementia

March 23, 2018
Annually, about one-third of all American adults aged 65 or older experience a fall. Falls are a major cause of medical problems, especially among those who have dementia. In fact, twice the number of older adults with dementia ...

Diabetes, heart disease, smoking increase risk of death for older adults with dementia

January 27, 2016
Dementia (a decline in memory and other mental abilities) is a serious condition, and its prognosis (the likely course of the disease) is marked by progressive loss of cognitive function and complications such as infections ...

Nursing home use up with cognitive impairment category

October 1, 2017
(HealthDay)—Nursing home (NH) use increases with increasing cognitive impairment category, according to a study published online Sept. 11 in the Journal of the American Geriatrics Society.

Study examines unsafe behaviors in older adults who likely have dementia

June 7, 2016
Dementia currently affects some 5 million people in the U.S., and that number is expected to triple by 2050. Having dementia affects the way you think, act, and make decisions.

Older adults who have slower walking speeds may have increased risk for dementia

March 23, 2018
As of 2015, nearly 47 million people around the world had dementia, a memory problem significant enough to affect your ability to carry out your usual tasks. The most common cause of dementia is Alzheimer's disease, but other ...

Recommended for you

Meditation and music may alter blood markers of cellular aging and Alzheimer's disease

November 13, 2018
A research team led by Dr. Kim Innes, a professor in the West Virginia University School of Public Health, has found that a simple meditation or music listening program may alter certain biomarkers of cellular aging and Alzheimer's ...

Alzheimer's and cardiovascular disease share common genetics in some patients

November 9, 2018
Genetics may predispose some people to both Alzheimer's disease and high levels of blood lipids such as cholesterol, a common feature of cardiovascular disease, according to a new study by an international team of researchers ...

Artificial intelligence predicts Alzheimer's years before diagnosis

November 6, 2018
Artificial intelligence (AI) technology improves the ability of brain imaging to predict Alzheimer's disease, according to a study published in the journal Radiology.

Diabetes medications may reduce Alzheimer's disease severity

November 1, 2018
People with Alzheimer's disease who were treated with diabetes drugs showed considerably fewer markers of the disease—including abnormal microvasculature and disregulated gene expressions—in their brains compared to Alzheimer's ...

Massive study confirms that loneliness increases risk of dementia

October 29, 2018
A new Florida State University College of Medicine study involving data from 12,000 participants collected over 10 years confirms the heavy toll that loneliness can take on your health: It increases your risk of dementia ...

Bioactive compound from the Rhodiola plant improves memory

October 25, 2018
In an ageing society, more people are suffering from memory disorders. The progressive loss of memory severely impairs the quality of life of those affected. So far, no drugs are known to prevent age-related cognitive decline.


Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.