Affiliations: [a] Open University of the Netherlands, Heerlen, The Netherlands | [b] Zuyd University of Applied Sciences, Heerlen, The Netherlands
Correspondence:
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Correspondence to: Dr. Susan van Hooren, Zuyd University of Applied Sciences, KenVak, 6400 AN Heerlen, The Netherlands. Tel.: +314554006483; Fax: +3145 4006069; E-mail: susan.vanhooren@zuyd.nl.
Abstract: In nursing homes, extreme sexual behavior is one of the most challenging behaviors in dementia. Despite this, however, there is no conformity in the literature regarding how to label and define this type of behavior. Examples of labels used include inappropriate sexual behavior, improper sexual behavior, sexually disinhibited behavior, or hyper sexuality. According to recent theoretical perspectives, extreme sexual behavior may be regarded as a part of disinhibited behavior or could be considered as an independent neuropsychiatric symptom. In this multicenter study, it was investigated whether there is a relationship between extreme sexual behavior and the typical neuropsychiatric symptoms seen in dementia. In 179 residents diagnosed with dementia, extreme sexual behavior was measured using an observation scale. Twelve neuropsychiatric symptoms were measured by the Neuropsychiatric Inventory. Multivariate analysis of covariance with gender showed that residents with observed extreme sexual behavior (n = 43) only showed a higher score on neuropsychiatric symptom ‘disinhibition’, as compared to residents with non-observed sexual behavior (n = 136). In addition, the effect size was large. These findings indicate that among residents with dementia, extreme sexual behaviors should not be considered as an independent neuropsychiatric symptom. Instead, disinhibition may be an important underlying mechanism for extreme sexual behavior and thus validates the label ‘sexually disinhibited behavior’.
Keywords: Dementia, disinhibition, elderly, sexual behavior
