A nationally representative study of more than 3000 older adults in the United States who reported having a partner showed that 59% of the men and 51% of the women with dementia said they were sexually active.
Overall, whether they had a partner or not, 46% of the men and 18% of the women with dementia were sexually active.
Clinicians should inquire or initiate conversations about sexual activity in this population and address any related problems cited by patients, such as problems with sexual interest or function or the possibility of abuse, the researchers note. More than 1 in 10 respondents, for example, reported that they felt frightened or threatened by their partner.
"The results of our study can help neurologists treating patients for early dementia," principal investigator Stacy Tessler Lindau, MD, Section of Geriatrics and Palliative Medicine, Department of Obstetrics and Gynecology and Medicine, University of Chicago, Illinois, told Medscape Medical News."Many have sexual function problems that are going unrecognized by a physician, but that is treatable."
They examined responses from 1514 men and 1682 women participating in the National Social Life, Health, and Aging Project (NSHAP). The investigators classified participants by sex, age group, and cognitive status — normal, mild cognitive impairment (MCI), or dementia — by modified Montreal Cognitive Assessment scores.
The study population included 1752 people with normal cognition, 865 with MCI, and 579 with dementia. The researchers note that because they excluded individuals who could not provide informed consent or complete an interview, most of the patients in the group with dementia likely had early-stage dementia,
Sexually active study participants reported having had sex with at least one partner in the prior 12 months. NSHAP also asks about sexual problems present for "several months or more" over the same period.
As reported in a new report released last week, the US Centers for Disease Control and Prevention predicts that the prevalence of Alzheimer's disease (AD) or related dementia in Americans older than 64 years will increase 178% between 2014 and 2060. Also, past research has predicted that the number of home-dwelling Americans with AD will grow to more than 8 million by 2050.
"Yet very little is known about the sexuality of home-dwelling people with dementia," Lindau said. Problems such as psychosocial decline, loss of recognition of their partner or the most recent sexual event, difficulty with the sequencing of behaviors, or diminished sexual interest may interfere with sexual function, the researchers note.
Later-Life sexual activity has been shown to be associated with better physical and mental health, higher quality of life, lower rates of loneliness, and, in some studies, better cognitive function, they write.