Alzheimer's and Changes in Sexual Behavior

Senior couple kissing and laughing
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Alzheimer's Disease is a type of dementia that causes problems with memory, thinking, and behavior. While it's impossible to say how the disease will unfold for any given individual, it does have the potential to cause unwelcome sexual behaviors.

For spouses and loved ones, such changes underscore the impact of the disease on even the most intimate of relationships. It is vital, though, to remember that this behavior is a result of the disease, or possibly of other health issues or medications.

Diminished Inhibitions and Disconcerting Behavior

Individuals with Alzheimer's may experience reduced sexual interest or, less often, sharply increased sexual interest, known as hypersexuality. Problem behaviors can include jealous accusations that a spouse is having an affair, sexual overtures to a non-spouse, or public masturbation.

Other inappropriate behaviors, such as the use of vulgar or obscene language, exposing oneself, or undressing in public (collectively termed "disinhibition") may not be sexual at all, but can be construed as such by others.

How to Manage Inappropriate Behaviors Without Drugs

The Alzheimer's Association provides a number of recommendations to friends and family members. For one, you should try to avoid becoming angry at, arguing with, or embarrassing your loved one. Instead, try to be gentle and patient, focusing on seeking out a reason for the behavior. For example, someone who disrobes in public may simply be hot or may find their clothing uncomfortable. You can also:

  • Gently but firmly remind the individual that the behavior is inappropriate.
  • Try distracting or redirecting the person's attention, or taking him someplace private.
  • Try increasing the level of appropriate physical attention, such as hugs and hair stroking. Sexual advances may reflect a need for reassuring contact.
  • Consider practical solutions: for inappropriate disrobing, try putting trousers or dresses on backward or carrying extra (more comfortable) clothing with you during outings.
  • Consult a specialist in Alzheimer's or dementia or a geriatric psychologist.

Urgent intervention is needed if the person becomes physically aggressive or violent. Have a plan of action in place, whether it be calling on family members, friends, or the police for help. It may also become necessary to move the individual to a care facility better equipped to handle such behavior.


If these strategies do not resolve matters, there are medically-based interventions that can be used to treat various underlying or accompanying issues. Ask your loved one's doctor about the medications available to treat:

  • Aggression, agitation, and delusions
  • Depression, irritability, and apathy. 
  • Fearfulness, anxiety, and sleep disturbances.

Balancing the Sexual Rights of People With Alzheimer's and Their Partners

Sexuality is a fundamental part of human existence, and sex is an important way of sharing closeness and expressing love. Many people, however, have difficulty accepting that older adult or those who have serious illnesses still have sexual needs and the right to express them.

In long-term care facilities, sexual needs can endure even after people no longer recognize their spouses or remember that they are married. Occasionally, this results in extramarital nursing home relationships, which can lead to awkwardness. Most long-term care facilities have established policies regarding relationships and sexual behavior.

Major concerns are the avoidance of sexual exploitation, abuse, or assault, and determining an individual's ability to give meaningful consent. The impact of Alzheimer's on awareness and rational thinking ultimately destroys the ability to consent. A partner seeking sexual intimacy with someone at this stage of dementia can face difficult ethical questions and may decide to forgo sex altogether—or seek it outside the relationship.

On the other hand, caregivers may experience a loss of desire. It is hard to feel attractive or aroused when providing day-in, day-out care for someone with dementia. Guilt about placing one's spouse in a nursing home can also dampen sexual desire.

Therapists, particularly geriatric psychologists, can help make sense of these issues and how to resolve them. Religious or spiritual advisers may be another source of counsel. An Alzheimer's discussion forum can be a solid source of support and suggestions in these situations. In addition, the Family Caregiver Alliance offers valuable resources, and the Alzheimer's Association has local chapters and more than 1,500 support groups nationwide.

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Article Sources

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